: Diarrhea in children usually doesn't require
specific treatment
DEAR DR.PAUL: My niece's baby, who is nine-months-old,
has had a fever and diarrhea for six days now. When is it appropriate
for the pediatrician to do stool samples and other blood tests
to determine if the cause is a bacteria? And is there any specific
treatment?
PEDIATRICIAN DR.PAUL Answers: Viruses usually cause
diarrhea in children. This is why most children with diarrhea
get better on their own, without any specific medications or
antibiotics. Typically with diarrhea, a child may have associated
vomiting, as well as a low-grade fever. In most cases the illness
lasts for three to six days. Often, there is a history of contact
with a person who has had similar symptoms. The main concern
when dealing with diarrhea is to prevent dehydration. Children,
especially younger ones, can easily become dehydrated if they
lose more fluid than they take in. So taking care of them is
like playing "catch-up"; with the goal being for them to drink
enough to make up for the fluid lost in the diarrhea. So, it
is very important to be able to recognize the signs of dehydration
which include:
Less frequent urination (less than 6 wet diapers per day,
in babies)
No tears when crying,
Dry or sticky mouth,
Weight loss
Extreme thirst
It is also important for parents to be able to know when to seek
immediate medical attention. You should take your child to a doctor
immediately if:
There are signs of dehydration, or
Your child is younger than six months, or
There is blood in the stool,or
There is frequent vomiting preventing him/her from drinking,
or
Your child complains of abdominal pain, looks or behaves
unwell and/or has high fever
Fortunately, in most cases though, the treatment is simply to
give the child adequate amounts of fluid, depending on the severity
of the symptoms. Recently, doctors have modified their approach
to mild cases of diarrhea and usually do not change the child's
diet at all. In moderate illness, specific liquids are used called
"oral rehydration solutions". Never give only water to a child
who is vomiting or has diarrhea. This can be dangerous. The body
needs a certain (right) amount of salt and sugar which are not
in adequate amounts in water nor in watered-down juice or soft
drinks. Only "oral rehydration solutions" such as Pedialyte or
Infalyte contain the right amount of sugar and salt. Generally
milk can be continued as long as it does not make the diarrhea
worse. Breastfeeding can usually continue as well. Also, if a
child is hungry, let him/her eat.
In severe cases of diarrhea and dehydration - and they are relatively
rare - the only treatment is the administration of intravenous
fluids in a hospital setting. Although each child is different,
and treated based on the individual situation, anti-diarrhea medicines
should not be used. They are not helpful and indeed may be harmful.
In most children with diarrhea, stool tests or other tests are
not necessary. However, if a physician suspects a bacteria as
the cause, then a stool culture (a test for bacteria) will be
sent. Clues to a bacterial cause include, blood in the stool,
a prolonged course of diarrhea, and contact with someone who has
had bacterial induced diarrhea.
The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
