Monday, August 6, 2007

What to do when your baby has diarrhea.

Just a few weeks ago my 7 month old had a bad case of diarrhea lasting about 8 days. After doing some reading on the Internet, I found this information useful:

~Doctors now advise continuing to feed solids to a baby with diarrhea who's already made the transition to finger or table food. While there's nothing wrong with feeding your child the classic BRAT diet (bananas, rice, applesauce, and dry toast), the AAP says any foods made up of complex carbohydrates, such as rice, wheat, potatoes, bread, and baby cereal, as well as lean meats, yogurt, fruits, and vegetables, are safe to eat. (If your baby temporarily refuses to eat, don't worry. As long as he stays hydrated, his appetite should return in a day or two.)

~Studies have shown that live bacterial cultures, found in yogurt, are a safe and effective way to cut down on the amount and duration of diarrhea. It's an easy way to treat the problem, especially if your baby loves the taste of yogurt. Just be sure to buy yogurt with lactobacillus, or live cultures.

~Call the doctor immediately if your baby is 3 months old or younger and he has diarrhea. If he is over 3 months, call the doctor if your baby has diarrhea and any of the following:
• vomiting
• signs of dehydration, such as dry mouth and not having had a wet diaper for six to eight hours or more
• blood in his stool or black stool
• a high fever — over 101 degrees Fahrenheit (38.3 degrees Celsius) if he is 3 to 6 months old; 103 degrees F (39.4 degrees C) if he is 6 months or older
• refuses to eat

~Other signs of illness in your baby, such as poor feeding, a newly congested nose or a new fever, make the diagnosis of diarrhea more likely.

~Diarrhea in babies can be caused by a change in diet (including, sometimes, a change in mother's diet if the baby is breast-fed), by infection, by antibiotic use, or by a number of rare diseases. Each year there are about one billion cases of diarrhea in children worldwide. In most cases (more than 990 million of them) the diarrhea will resolve by itself within a week or so.

~The central concern with diarrhea is the possibility of dehydration from loss of body fluids. Treatment is aimed at preventing dehydration, the real culprit. Most children with diarrhea can be treated safely at home.

~If your baby is breast-fed, don't stop. Breast feeding helps prevent diarrhea (making diarrhea only half as likely); it also speeds recovery (Journal of Pediatrics, May 1996). If your baby still seems thirsty after or between nursing sessions, you can supplement with an oral rehydration solution (Pedialyte is the most well known, but other brands are also effective. Children in my practice seem to prefer the taste of grape-flavored KaoLectrolyte -- chilled).

~If your baby is formula-fed, you might want to switch to a soy-based formula while the diarrhea lasts. A soy formula containing fiber (Isomil DF) can be even more effective at slowing down the stools (Clinical Pediatrics, March 1997). Do not dilute the formula. As with breast-fed babies, supplementation with an oral rehydration solution can help replenish the fluids and electrolytes that have been lost in the diarrheal stools.

~If your baby is already big enough to be taking solid foods, then carrots, rice cereal, bananas, potatoes, and applesauce can help slow down the stools. Avoid fruit juices, peas, pears, peaches, plums, prunes and apricots until the stools are back to normal, which should be within a week or so.

~If the diarrhea lasts longer than a week, or is accompanied by more than 72 hours of fever, get in touch with your pediatrician. Contact your pediatrician right away, however, if your baby won't drink or appears to be getting dehydrated (dry mouth, crying without tears, sunken soft spot, lethargic, or going 8 hours without producing urine) or if your baby is under 3 months and has diarrhea with a fever.

~Vomiting for 24 hours, 8 stools in 8 hours, or the presence of blood, mucus, or pus in the stool should also prompt a call to your pediatrician.

~Also don't forget your baby's bottom. Stool normally contains some of the enzymes that help us digest our food. When stool travels through the intestines more quickly, not only is there more poop, but the poop contains more of these enzymes, which can then start to "digest" the soft skin of your baby's bottom. Frequent diaper changes, rinsing the bottom with water, air drying, and protective ointments and creams, such as Desitin, can be a real help. Cut down on baby wipes during diarrhea.

~During diarrhea, most parents are focused on the frequent, runny poops. Most doctors are focused on the possibility of dehydration. From your baby's point of view, however, the burning irritation of the diaper rash may be the most pressing issue.

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