Diarrhea, Age 11 and Younger
Diarrhea, Age 11 and YoungerSkip to the navigationTopic OverviewDiarrhea occurs when there is an increase in the frequency of bowel movements or bowel movements are more watery and loose than normal. Diarrhea has many causes. Dietary changesA child may develop diarrhea from a change in his or her diet. A baby's or child's digestive tract may not tolerate large amounts of juice, fruit, or even milk. Diarrhea may be caused by an increase in the amount of juice or fruit a child drinks or eats. Diarrhea that is caused by a change in the child's diet is not usually serious. InfectionDiarrhea is often caused by a viral or bacterial infection, such as rotavirus, stomach flu (gastroenteritis), or food poisoning. Diarrhea is the body's way of quickly clearing any viruses, bacteria, or toxins such as botulism from the digestive tract. Most cases of diarrhea are caused by a viral infection and will usually clear up in a few days. Diarrhea may also be caused by a parasitic infection, such as Giardia lamblia. This parasite, as well as other viral and bacterial infections, may be spread by drinking untreated water, unpasteurized dairy products, or by poor hand-washing. Diarrhea can also occur from an infection passed on by animals or while traveling to a foreign country. Other causesOn rare occasions, diarrhea can be a symptom of a more serious condition, such as: Children, especially those younger than 6 months of age and those with other health risks, need special attention when they have diarrhea because they can quickly become dehydrated. Careful observation of your child's appearance and how much fluid he or she is drinking can help prevent problems. Check your child's symptoms to decide if and when your child should see a doctor. Note: Normal stool during infancy may be runny or pasty, especially if the baby is breastfed. The presence of mucus in the stool is not uncommon. Unless there is a change in your baby's normal habits, loose and frequent stools are not considered to be diarrhea. Check Your SymptomsHow old are you? Less than 3 months Less than 3 months 3 to 5 months 3 to 5 months 6 months to 3 years 6 months to 3 years 4 to 11 years 4 to 11 years 12 years or older 12 years or older Is your child having belly pain that does not go away after he or she passes stools? With diarrhea, it's normal to have cramping pain that goes away after the child passes stools. But if the pain is constant, there may be another problem. Does your baby seem sick? A sick baby probably will not be acting normally. For example, the baby may be much fussier than usual or not want to eat. How sick do you think your baby is? Extremely sick Baby is very sick (limp and not responsive) Sick Baby is sick (sleepier than usual, not eating or drinking like usual) Moderate Moderate dehydration Are the symptoms severe, moderate, or mild? Moderate Moderate dehydration Is your child having trouble drinking enough to replace the fluids he or she has lost? Little sips of fluid usually are not enough. The child needs to be able to take in and keep down plenty of fluids. Yes Unable to drink enough fluids No Able to drink enough fluids Does your child have symptoms of a serious illness? Yes Symptoms of serious illness No Symptoms of serious illness How much blood is there? More than a few drops. Blood is mixed in with the stool, not just on the surface. More than a few drops of blood on stool or diaper A few drops on the stool or diaper A few drops of blood in stool or diaper Do you think your baby has a fever? Did you take a rectal temperature? Taking a rectal temperature is the only way to be sure that a baby this age does not have a fever. If you don't know the rectal temperature, it's safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious. Yes Rectal temperature taken No Rectal temperature taken Is it 100.4°F (38°C) or higher? Yes Temperature at least 100.4°F (38°C) No Temperature at least 100.4°F (38°C) Do you think your child has a fever? Did you take your child's temperature? How high is the fever? The answer may depend on how you took the temperature. High: 104°F (40°C) or higher, oral High fever: 104°F (40°C) or higher, oral Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral Mild: 100.3°F (37.9°C) or lower, oral Mild fever: 100.3°F (37.9°C) or lower, oral How high do you think the fever is? Moderate Feels fever is moderate Mild or low Feels fever is mild How long has your child had a fever? Less than 2 days (48 hours) Fever for less than 2 days From 2 days to less than 1 week Fever for more than 2 days and less than 1 week 1 week or longer Fever for 1 week or more Does your child have a health problem or take medicine that weakens his or her immune system? Yes Disease or medicine that causes immune system problems No Disease or medicine that causes immune system problems Does your child have shaking chills or very heavy sweating? Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off the child or soaking through his or her clothes. Yes Shaking chills or heavy sweating No Shaking chills or heavy sweating Does the fever come and go? Has your child traveled to another country in the past 6 weeks? Has your baby had large stools every 1 to 2 hours for longer than 4 hours? Yes Large stools every 1 to 2 hours for more than 4 hours No Large stools every 1 to 2 hours for more than 4 hours Has your baby had large stools every 1 to 2 hours for more than 8 hours? Yes Large stools every 1 to 2 hours for more than 8 hours No Large stools every 1 to 2 hours for more than 8 hours Has your child had 6 or more large, loose stools in 12 hours? Yes 6 or more large, loose stools in 12 hours No 6 or more large, loose stools in 12 hours Does your child have diabetes? Is your child's diabetes getting out of control because your child is sick? Yes Diabetes is affected by illness No Diabetes is affected by illness Is the plan helping get your child's blood sugar under control? Yes Diabetes illness plan working No Diabetes illness plan not working How fast is it getting out of control? Quickly (over several hours) Blood sugar quickly worsening Slowly (over days) Blood sugar slowly worsening Does the diarrhea come and go? Is your child having diarrhea more often? Yes More frequent diarrhea episodes No More frequent diarrhea episodes Has your child had diarrhea off and on for more than 1 month? Yes Diarrhea off and on for more than 1 month No Diarrhea off and on for more than 1 month Do you think that a medicine could be causing the diarrhea? Think about whether the diarrhea started after your child began taking a new medicine or a higher dose of a medicine. Yes Medicine may be causing diarrhea No Medicine may be causing diarrhea Has your child been taking antibiotics in the past 2 weeks? Many antibiotics can cause diarrhea. Yes Antibiotic in the past 2 weeks No Antibiotic in the past 2 weeks Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in children are: - Diseases such as diabetes, cystic fibrosis, sickle
cell disease, and congenital heart disease.
- Steroid medicines,
which are used to treat a variety of conditions.
- Medicines taken
after organ transplant.
- Chemotherapy and radiation therapy for
cancer.
- Not having a spleen.
What you are looking for is a change in your child's usual bowel habits. - Diarrhea means that the
child is having more stools and looser ones than usual.
- Constipation means that the child is having fewer stools than
usual.
Every baby and child has different bowel habits. What is
"normal" for one child may not be normal for another. In general: - Many newborns have at least 1 or 2 bowel movements a day. By the end of their first week, they may have as many as 5 to 10 bowel movements a day. They may pass a stool after each feeding.
- By 6 weeks of age, your baby may not have a bowel movement every day. This usually isn't a problem as long as the baby seems comfortable and is growing as expected, and as long as the stools aren't hard.
- By about 4 years of age, it's normal for a child to have as many as 3 bowel movements a day or as few as 3
a week.
Anywhere in these ranges can be considered normal if the habit
is normal or usual for your child. Babies can quickly get dehydrated when they lose fluids because of problems like
vomiting or fever. Symptoms of dehydration can range from mild to
severe. For example: - The baby may be fussy or cranky (mild dehydration),
or the baby may be very sleepy and hard to wake up (severe
dehydration).
- The baby may have a little less urine than usual
(mild dehydration), or the baby may not be urinating at all (severe
dehydration).
You can get dehydrated when
you lose a lot of fluids because of problems like vomiting or fever. Symptoms of dehydration can range from mild to severe. For
example: - You may feel tired and edgy (mild dehydration), or
you may feel weak, not alert, and not able to think clearly (severe
dehydration).
- You may pass less urine than usual (mild
dehydration), or you may not be passing urine at all (severe
dehydration).
Severe dehydration means: - The baby may be very sleepy and hard to wake
up.
- The baby may have a very dry mouth and very dry eyes (no
tears).
- The baby may have no wet diapers in 12 or more hours.
Moderate dehydration means: - The baby may have no wet diapers in 6 hours.
- The
baby may have a dry mouth and dry eyes (fewer tears than usual).
Mild dehydration means: - The baby may pass a little less urine than usual.
Severe dehydration means: - The child's mouth and eyes may be extremely dry.
- The child may pass little or no urine for 12 or more
hours.
- The child may not seem alert or able to think clearly.
- The child may be too weak or dizzy to stand.
- The
child may pass out.
Moderate dehydration means: - The child may be a lot more thirsty than
usual.
- The child's mouth and eyes may be drier than
usual.
- The child may pass little or no urine for 8 or more hours.
- The child may feel dizzy when he or she stands or sits up.
Mild dehydration means: - The child may be more thirsty than
usual.
- The child may pass less urine than usual.
Symptoms of serious illness in a baby
may include the following: - The baby is limp and floppy like a rag doll.
- The baby doesn't respond at all to being held, touched, or talked
to.
- The baby is hard to wake up.
Symptoms of serious illness may
include: - A severe headache.
- A stiff
neck.
- Mental changes, such as feeling confused or much less
alert.
- Extreme fatigue (to the point where it's hard for you to
function).
- Shaking chills.
If you're not sure if a child's fever is high, moderate, or
mild, think about these issues: With a high fever: - The child feels very hot.
- It is likely
one of the highest fevers the child has ever had.
With a moderate fever: - The child feels warm or hot.
- You are
sure the child has a fever.
With a mild fever: - The child may feel a little warm.
- You
think the child might have a fever, but you're not sure.
A baby that is extremely sick: - May be limp and floppy like a rag
doll.
- May not respond at all to being held, touched, or talked
to.
- May be hard to wake up.
A baby that is sick (but not extremely
sick): - May be sleepier than usual.
- May not eat
or drink as much as usual.
Temperature varies a little depending on how you measure it.
For children up to 11 years old, here are the ranges for high, moderate, and
mild according to how you took the temperature. Oral (by mouth), ear, or rectal temperature - High:
104°F (40°C) and
higher
- Moderate:
100.4°F (38°C) to
103.9°F (39.9°C)
- Mild:
100.3°F (37.9°C) and
lower
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature. Armpit (axillary) temperature - High: 103°F (39.5°C) and higher
- Moderate:
99.4°F (37.4°C) to
102.9°F (39.4°C)
- Mild: 99.3°F (37.3°C) and lower
Note: For children under 5 years old, rectal temperatures are
the most accurate. An illness plan for people with diabetes usually covers things like: - How often to test blood sugar and what the target
range is.
- Whether and how to adjust the dose and timing of insulin
or other diabetes medicines.
- What to do if you have trouble keeping
food or fluids down.
- When to call your doctor.
The plan is designed to help keep your diabetes in control even
though you are sick. When you have diabetes, even a minor illness can cause
problems. It is easy for your diabetes to become out of control when
you are sick. Because of an illness: - Your blood sugar may be too high or too
low.
- You may not be able take your diabetes medicine (if you are
vomiting or having trouble keeping food or fluids down).
- You may
not know how to adjust the timing or dose of your diabetes
medicine.
- You may not be eating enough or drinking enough
fluids.
Blood in the stool can come from
anywhere in the digestive tract, such as the stomach or intestines. Depending
on where the blood is coming from and how fast it is moving, it may be bright
red, reddish brown, or black like tar. A little bit of bright red
blood on the stool or on the toilet paper is often caused by mild irritation of
the rectum. For example, this can happen if you have to strain hard to pass a
stool or if you have a hemorrhoid. Certain medicines and foods can affect the color of stool. Diarrhea
medicines (such as Pepto-Bismol) and iron tablets can make the stool black.
Eating lots of beets may turn the stool red. Eating foods with black or dark
blue food coloring can turn the stool black. If you take aspirin or some other medicine (called a blood thinner) that prevents blood clots, it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms. Many prescription and nonprescription medicines can cause
diarrhea. A few examples are: - Antibiotics.
- Antidepressants.
- Antacids.
- Proton
pump inhibitors, such as omeprazole (Prilosec) and lansoprazole (Prevacid).
- Medicines used to treat cancer (chemotherapy).
Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Diarrhea, Age 12 and Older Abdominal Pain, Age 11 and Younger Home TreatmentIt's important to take action to prevent dehydration. Newborns and babies younger than 1 year of age Don't wait until you see signs of dehydration in your baby. These signs include your baby being thirstier than usual and having less urine than usual. - If you breastfeed your baby, nurse him or her more often. Offer each breast to your baby for 1 to 2 minutes every 10 minutes.
- If you use a bottle to feed your baby, increase the number of feedings to make up for lost fluids. The amount of extra fluid your baby needs depends on your baby's age and size. For example, a newborn may need as little as 1 fl oz (30 mL) at each extra feeding, while a 12-month-old baby may need as much as 3 fl oz (90 mL) at each extra feeding.
- Ask your doctor if you need to use an oral rehydration solution (ORS) if your baby still isn't getting enough fluids from formula or the breast. The amount of ORS your baby needs depends on your baby's age and size. You can give the ORS in a dropper, spoon, or bottle.
- If your baby has started eating cereal, you may replace lost fluids with cereal. You also may feed your baby strained bananas and mashed potatoes if your child has had these foods before.
Children ages 1 through 11- Make sure your child is drinking often. Frequent, small amounts work best.
- Allow your child to drink as much fluid as he or she wants. Encourage your child to drink extra fluids or suck on flavored ice pops, such as Popsicles. Note: Do not give your child fruit juice or soda pop. Fruit juice and soda pop contain too much sugar and not enough of the essential minerals (electrolytes) that are being lost. Diet soda pop lacks calories that your child needs.
- Cereal mixed with milk or water may also be used to replace lost fluids.
- If your child still is not getting enough fluids, you can try an oral rehydration solution (ORS).
- Give your child frequent small meals, at least 6 a day, while he or she is having diarrhea.
- The best foods for your child are easily digestible foods, such as rice cereal, pasta, breads, cooked beans, mashed potatoes, cooked carrots, applesauce, and bananas.
- Pretzels or salty crackers can help your child replace the salt lost from diarrhea.
- Foods containing large amounts of sugar or fat should be avoided.
General tips- Do not withhold food from your child. Studies have shown that children who are fed easily digestible foods have shorter episodes of diarrhea.
- If your child drinks cow's milk, he or she may continue to drink it.
- Do not give your child prescription or nonprescription medicine to stop diarrhea unless you are told to do so by your child's doctor.
- Protect the diaper area with zinc oxide or another cream. Diaper rash is common after diarrhea.
- Wash your hands and your child's hands thoroughly after each diaper change and before each feeding.
- Until your doctor has assured you that your child's diarrhea is not infectious, your child should not attend school or day care.
- Learn how to clean up diarrhea safely. Protect your hands with gloves while cleaning up. Wash your hands after you are done cleaning up.
If your child is also vomiting, learn about home treatment for vomiting. Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home treatment: - Blood in diarrhea develops.
- Signs of dehydration develop. These include your child being thirstier than usual and having less urine than usual.
- Your child has diarrhea and a fever.
- Symptoms become more severe or frequent.
PreventionDo not allow your child to drink untreated or unfiltered water from a lake or stream or unpasteurized milk. Untreated water and unpasteurized milk are sources for viral, bacterial, and parasitic infections, such as Giardia lamblia. Avoid having your child brush his or her teeth with untreated water. Even a small amount of untreated water can contain enough parasites, virus, and bacteria to cause diarrhea. Diarrhea can spread because of poor hygiene. - Practice good hand-washing.
- Be sure to wash your hands and your child's hands after each diaper change or trip to the bathroom.
- Teach your child to wash his or her hands after using the bathroom and before every meal.
- Do not place soiled diapers on surfaces that are used to prepare or serve food.
- If your child attends school or day care, keep your child at home until your doctor has determined that his or her diarrhea can't be passed to others (is not infectious).
Food poisoning is a common cause of diarrhea in children and adults. Most cases of food poisoning at home may be prevented by taking a few precautions when preparing and storing food. Perishable foods, such as eggs, meats, poultry, fish, shellfish, milk, and milk products, should be treated with extra care. Also, precautions should be taken if you are pregnant, you have an impaired immune system or a chronic illness, or you are preparing foods for other high-risk groups, such as young children or older people. The following steps are recommended to prevent food poisoning: Many counties in the United States have extension services listed in the phone book. These services can answer your questions about safe home canning and food preparation. When you travel in wilderness areas or to other countries of the world, it is common to get traveler's diarrhea from food or water because the methods of food preparation are different. Rotavirus vaccine helps protect babies and young children from getting a rotavirus infection, which can cause diarrhea and dehydration. Talk to your child's doctor about this vaccine for your child. Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your doctor diagnose and treat your child's condition by being prepared to answer the following questions: - How long has your child had diarrhea?
- How many times per day does your child have diarrhea?
- Describe your child's diarrhea:
- What color is it?
- Is it mushy or watery?
- Does it contain blood or mucus?
- Have you noticed an unusual odor?
- Does your child have other symptoms such as fever, vomiting, or abdominal pain?
- Has your child taken any new prescription or nonprescription medicines?
- Do you regularly give your child laxatives or stool softeners?
- Has your child been eating new or different foods?
- Has your child been exposed to other children or adults who have diarrhea?
- Has your child drunk untreated lake, stream or well water?
- Has your child recently visited a foreign country where clean water or proper food preparation was not available?
- Has your child been exposed to farm animals?
- Does your child have a history of chronic disease such as cystic fibrosis or celiac disease?
- Does your child have any health risks?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Kathleen Romito, MD - Family Medicine Specialist Medical ReviewerAdam Husney, MD - Family Medicine Current as of:
May 3, 2017 Last modified on: 8 September 2017
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