Viral Diarrhea (Infant/Toddler)

Home care

Follow all instructions given by your child’s healthcare provider.

If giving medicines to your child:

• Don’t give over-the-counter diarrhea medicines unless your child’s healthcare provider tells you to.

• You can use acetaminophen or ibuprofen to control pain and fever. Or, you can use other medicine as prescribed.

• Don’t give aspirin or products that contain aspirin to anyone under 19 years of age during times of illness. This may cause liver or brain damage due to a life-threatening condition called Reye syndrome.

Your child is considered contagious for as long as they have diarrhea. To prevent the spread of illness:

• Remember that washing hands with soap and water and using alcohol-based sanitizer is the best way to prevent the spread of infection.

• Wash your hands before and after caring for your sick child.

• Clean the toilet after each use.

• Dispose of soiled diapers in a sealed container.

• Keep your child out of daycare until they are cleared by the healthcare provider.

• Wash your hands before and after preparing food.

• Wash your hands and utensils after using cutting boards, countertops, and knives that have been in contact with raw foods.

• Keep uncooked meats away from cooked and ready-to-eat foods.

Giving liquids and feeding

The main goal while treating vomiting or diarrhea is to prevent dehydration. This is done by giving small amounts of liquids often. Liquids are the most important thing. Don’t be in a rush to give food to your child.

If your baby is breastfed:

• Keep breastfeeding. Try offering shorter but more frequent feeds,

• If diarrhea is severe, give oral rehydration solution between feedings.

• As diarrhea eases, stop giving the rehydration solution and go back to your normal breastfeeding schedule.

If your baby is bottle-fed:

• Give small amounts of fluid at a time, especially if your child is vomiting. An ounce or 2 (30 to 60 mL) every 30 minutes may improve symptoms. Start with 1 teaspoon (5 mL) every 5 minutes and increase gradually as tolerated.

• Give full-strength formula or milk. If diarrhea is severe, give oral rehydration solution between feedings.

• If you are giving your child milk and the diarrhea is not getting better, stop giving milk. In some cases, milk can make diarrhea worse. Try soy or lactose-free formula.

• Don’t give apple juice, soda, or other sweetened drinks. Drinks with sugar can make diarrhea worse.

• If your child is doing well after 24 hours, resume a regular diet and feeding schedule.

• If they start doing worse with food, go back to clear liquids.

If your child is on solid food:

• Keep in mind that liquids are more important than food right now. Don’t be in a rush to give food.

• Don’t force your child to eat, especially if they are having stomach pain, cramping, vomiting, or diarrhea.

• Don’t feed your child large amounts at a time, even if your child is hungry. This can make your child feel worse. You can give your child more food over time if they can tolerate it.

• Give small amounts at a time, especially if the child is having stomach cramps or vomiting.

• If you are giving milk to your child and the diarrhea is not going away, stop the milk. In some cases, milk can make diarrhea worse. If that happens, use oral rehydration solution instead. This sensitivity to milk usually resolves as the intestine heals.

• If diarrhea is severe, give oral rehydration solution between feedings.

• If your child is doing well after 24 hours, try giving solid foods. These can include cereal, oatmeal, bread, noodles, mashed carrots, mashed bananas, mashed potatoes, applesauce, dry toast, crackers, soups with rice noodles, and cooked vegetables.

• For a baby over 4 months, as they feel better, you may give cereal, mashed potatoes, applesauce, mashed bananas, or strained carrots. A baby over 1 year may have crackers, white bread, rice, and other complex starches, lean meats, yogurt, fruits, and vegetables. Low-fat diets are easier to digest than high-fat diets.

• If your child starts doing worse with food, go back to clear liquids.

• You can resume your child's normal diet over time as they feel better. If the diarrhea or cramping gets worse again, go back to a simple diet or clear liquids.

Follow-up care

Follow up with your child’s healthcare provider as advised. If a stool sample was taken or cultures were done, call the healthcare provider for the results as instructed.

Call 911

Call 911 if your child has any of these symptoms:

• Trouble breathing

• Confusion

• Unusual or extreme drowsiness or trouble walking

• Loss of consciousness

• Rapid heart rate

• Chest pain

• Stiff neck

• Seizure

When to get medical advice

Call your child’s healthcare provider or get medical care right away if any of these occur:

• Abdominal pain that gets worse

• Constant lower right abdominal pain

• More than 8 diarrhea stools within 8 hours

• Continued severe diarrhea for more than 24 hours

• Blood in stool

• Refusal to drink or feed

• Dark urine or no urine for a toddler or dry diaper for 4 to 6 hours, no tears when crying, sunken eyes, or dry mouth

• Fussiness or crying that can’t be soothed

• New rash

• Diarrhea lasts more than 1 week on antibiotics

• Fever (see Fever and children, below)

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 months, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The healthcare provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

• Rectal, forehead, or ear: 102°F (38.9°C) or higher

• Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

• Repeated temperature of 104°F (40°C) or higher in a child of any age

• Fever of 100.4° (38°C) or higher in baby younger than 3 months

• Fever that lasts more than 24 hours in a child under age 2

• Fever that lasts for 3 days in a child age 2 or older