How to treat diarrhea in children over 2 years of age

Symptoms of diarrhea vary depending on age and the cause. For example, your child may have soft or watery stools of different colours (green, black, yellow) which may sometimes contain blood, mucus or poorly digested food. Diarrhea is also associated with an increase in the amount of stool.

Your child may also have the following symptoms:

• Vomiting
• Fever
• Headaches and abdominal pain

Another consequence of diarrhea is dehydration. This is the most common complication of diarrhea in children. Here are the symptoms of dehydration to watch for:

• Extreme fatigue and apathy
• Dry mouth
• No urine for several hours or very dark urine
• Sunken eyes
• Crying with no tears

Most cases of diarrhea in children are caused by viruses. The rotavirus has long been the most common cause of gastroenteritis in children. Fortunately for us, rotavirus vaccinations are now included in Quebec’s immunization program. Today, the norovirus is the virus most often associated with diarrhea in children.

It’s also possible that your child contracted bacteria such as E. coli, Salmonella, Campylobacter or Shigella.

Your child’s intestinal flora may also be disturbed. This is known as microbiome imbalance and can be caused by antibiotics, allergic reactions, intolerance to certain sugars (such as lactose) or excessive consumption of sugary drinks containing fructose or sorbitol.

Read more: Understanding your Microbiome

Short-term diarrhea can also accompany other ailments in children, such as ear infections, urinary tract infections or teeth that have trouble breaking through the gums. Although rarer, chronic diarrhea can be caused by damage to the digestive tract, such as anatomical abnormalities or absorption problems (celiac disease, inflammatory bowel disease).[1]

If the diarrhea is caused by an infection (e.g., gastroenteritis), it will be contagious as long as your child has symptoms, sometimes even a little longer. When in doubt, you should take precautions to prevent your child’s diarrhea from spreading to the rest of the family.

Transmission occurs by both direct contact (stool and vomit) and indirect contact (contaminated surfaces and objects).

Here are a few tips to limit the transmission of the virus [2] in your home:

• Avoid any contact with the infected person.
• Wash your hands regularly with soap and water: After going to the bathroom, before eating and after contact with stool or vomit
• Regularly disinfect contaminated surfaces and objects, especially in the bathroom.

You shouldn’t give your child any medications for diarrhea unless they have been prescribed by a health care professional.

The priority in treating diarrhea is to prevent and correct any dehydration, which in severe cases can be life-threatening.

Unfortunately, not all fluids can rehydrate a child.

Liquids to avoid

• Water
• Soft drinks (even decarbonated drinks)
• Sweetened drinks and juices
• Tea and coffee

These liquids can interfere with your child’s hydration and sometimes even make the diarrhea worse. To promote rehydration, liquids should contain the right amount of sugar and salt.

Your best option is to use oral rehydration solutions, such as Pedialyte, Pediatric Electrolyte and Gastrolyte. You can find these solutions in various forms at your local drug store.

If you don’t have access to these solutions, you can give your child the following fluids instead, but only for the first four hours of the diarrhea:

• Sports drinks such as Gatorade
• Beef broth, chicken broth or homemade broth
• Rice water
• “Homemade” rehydration solutions (see recipe below)

These are merely stopgap solutions, since their composition isn’t ideal. Your child should only drink them for the first four hours after the onset of diarrhea, after which he should drink an oral rehydration solution.

It’s important to follow the recipe to the letter in order to create the required proportions of sugar and salt. To do so, use a measuring cup and spoon.

Here’s a recipe suggested by the CHU Sainte-Justine (French only):

• 360 mL (12 oz.) unsweetened, ready-to-drink orange juice
• 600 mL (20 oz.) cooled boiled water
• 2.5 mL (1/2 tsp.) salt (never more)

You may need to encourage your child to drink. Depending on his age, you could use a baby bottle, cup, spoon or dropper to accomplish this. You could start with 1 teaspoon (5 mL) or 1 tablespoon (15 mL) every 5 to 15 minutes. If the amount given is tolerated, you can gradually increase it to the recommended amount. For children over 2 years of age, this amount is 125 to 250 mL per hour (4 to 8 ounces).

After about four hours of well-tolerated rehydration, your child should start eating again immediately. If vomiting occurs again, wait 30 to 60 minutes then resume the rehydration process from the beginning. [3]

Your child can eat the following foods in smaller, more frequent servings:

• Cereal
• Bread
• Pasta
• Rice
• Fruit
• Vegetables
• Meat
• Dairy products

In the majority of cases, diarrhea goes away on its own and doesn’t require medical attention. However, in some situations, it’s best to see a doctor.

The CHU Sainte-Justine recommends that you consult a health care professional if you notice any of the following signs or symptoms:

• Persistent or worsening abdominal pain (e.g., the child screams and pulls his legs up against his stomach, or his abdomen is very swollen)
• Fever that persists for more than 24 to 48 hours
• Skin rash
• Blood in the vomit or stools, or black stools
• Frequent vomiting that persists for 4 to 6 hours despite the administration of small amounts of oral rehydration solution
• Child’s refusal to hydrate
• Frequent and heavy diarrhea
• Diarrhea that persists for more than 7 days
• Worrisome or changing general condition (e.g., child is very irritable)
• Diarrhea in a child under 6 months of age
• Signs of dehydration (see above)

If in doubt or if you have any questions, contact Info-Santé at 811.

Diarrhea is one of the most common childhood ailments, but with these tips, you’ll have all the tools you need to get the situation under control and prevent this rather unpleasant symptom from getting worse.

We provide services that can help your doctor diagnose disorders of the digestive system and determine the right treatment.

• Microbiological stool analysis by PCR to facilitate the diagnosis of gastrointestinal infections
• Fecal calprotectin analysis to screen for chronic inflammatory bowel diseases
• Digestive radiology to capture dynamic images of the organs of the digestive system and observe digestive function.
• Vaccination services

Do you have a medical prescription for one of these tests? Book an appointment online or contact Biron Health Group’s customer service at 1 833 590-2712.