Beware of Diarrhea Dehydration in Infants, Toddlers

We all dread diarrhea. But when the patient is your infant or toddler, diarrhea can range from a minor annoyance to a medical emergency.

The stools of healthy breast- or formula-fed infants are usually the consistency of oatmeal or cream of wheat, according to the American Academy of Pediatrics (AAP). When diarrhea occurs, the stools become frequent and watery.

The cause can be viruses, bacteria, parasites or antibiotics. Chronic diarrhea with blood in the stools, listlessness and weight loss can indicate a severe illness.

Usually, diarrhea lasts several days. Its most serious side effect is dehydration, says Paul Melinkovich, M.D., professor of pediatrics and preventive medicine at the University of Colorado at Denver. Children need plenty of fluids to replace what they're losing through illness.

Know the signs

Signs of dehydration in infants and young children include a drastic decrease in wet diapers over a 24-hour period, dry mouth, lack of tears when crying and sunken eyes. Call your health care provider if your child shows any of the signs of dehydration.

To replace the body fluids that are lost with diarrhea, children should drink glucose-electrolyte solutions (for example, Pedialyte or Kaoelectrolyte), the AAP says. These fluids have the right balance of water, sugar and salts and some are available as popsicles.  Avoid fruit juices because they can make diarrhea worse because of the high sugar content.  Avoid just plain water.  If breastfeeding, continue to do so. According to the AAP, children who have diarrhea and are not dehydrated should continue to eat their regular diet. Most children can tolerate milk and other dairy products.

The U.S. Food and Drug Administration says that loperamide should NOT be used for infants younger than 24 months or without consulting your pediatrician.

You should call the doctor if blood, mucus or pus is present in stools, if your child has a fever of 100 degrees or higher for more than three days, or if repeated vomiting, or signs of dehydration develop.

Toddlers' diarrhea

Children ages 1 to 5 may experience chronic diarrhea, yet seem to be thriving. The cause is generally unknown, the AAP says. Sometimes, children are simply getting too many fluids. Although a health care provider should always evaluate chronic diarrhea, reducing fluids may control the problem.