Diarrhea in Children

What are the symptoms of diarrhea?

Diarrhea is a very common problem during childhood. Usually, it is mild and brief, but sometimes it can be severe, especially in infants. Children have different patterns of bowel movements so it is sometimes difficult to tell if a child has diarrhea or just a loose bowel movement. A child has diarrhea if there are more bowel movements than usual or if stools are more unformed and watery than usual. A child with diarrhea may also have fever, loss of appetite, nausea, vomiting, stomach pains, cramps, and blood and/or mucus in the bowel.

What causes diarrhea?

Many different germs cause diarrhea. It is most commonly caused by a virus, such as Rotavirus, that cannot be treated with antibiotics. Occasionally the illness is caused by bacteria, such as Campylobacter, Salmonella and Escherichia coli (E. coli). It is very important that the child with diarrhea continues to drink enough water or other fluids to avoid dehydration.

How is it transmitted?

Diarrhea germs are easily spread from person to person, especially from child to child. They usually spread readily among children who have learned to use the toilet. The spread of the infection can be reduced if adults and children wash their hands carefully after every diaper change, after going to the toilet, and before preparing and eating food.

Can diarrhea be dangerous?

Diarrhea can be dangerous if not treated properly because it drains water and salts from the child. If these are not put back quickly, dehydration can occur and hospitalization may be necessary. It is most important that the child with diarrhea continues to drink an appropriate quantity of fluids to avoid dehydration.

When should parents call their child's doctor?

• your child has diarrhea and is less than 6 months of age
   

• your child has bloody or black stools
   

• your child is still vomiting after 4-6 hours
   

• your child has a fever greater than 38.5ºC (101.5ºF)
   

• your child has signs of dehydration:

• decreased urination (less than 4 wet diapers in 24 hours)
   

• no tears
   

• dry skin, mouth and tongue
   

• sunken eyes
   

• grayish skin
   

• sunken soft spot (fontanel) on infant's head

How do you prevent dehydration?

• Use Oral Rehydration Solutions (ORS) available at a pharmacy or grocery store. They are exact mixtures of water, salts and sugar. These solutions can be absorbed by the body even when infection is causing the child to vomit. They are available at drugstores in ready-to-serve preparations, frozen pops and powders. Some prepared ORS brands are Gastrolyte, Pedialyte or Riceolyte.
   
• If juices are given, they should be diluted with water.
   
• Plain water is not beneficial and should be avoided.
   
• Do not give sugary drinks, such as Kool-Aid®, fruit juice/drinks, pop, Jell-O®, sweetened tea, broth, or rice water as they have the wrong amounts of water, salts and sugar and can make your child's diarrhea worse.
   
• Do not give over-the-counter medications to stop diarrhea because some of these will prevent the body from getting rid of infection.

How to prevent spread?

• Ensure all members of your household, including your child, wash their hands after every diaper change, after going to the toilet and before preparing or eating food.
   

• Ensure that household members do not share toothbrushes or eating utensils.
   

• Keep your child at home until the bowel movements are normal and he or she is well enough to return to child care.

Additional information available from the Canadian Paediatric Society at   www.cps.ca.