Traveler’s Diarrhea (Child)

Home care

Follow all instructions given by your child’s health care provider.

If giving medicines to your child:

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

• If antibiotics were prescribed, make sure your child takes them every day until they are finished. Don’t stop giving them if your child feels better. Antibiotics must be taken as a full course.

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

• Sometimes your child's provider will prescribe medicine to control the vomiting. Take it only as directed by your child's provider. If your child continues to vomit despite giving this medicine, contact your child's provider.

• Don’t give aspirin to anyone under 18 years of age who has a fever. This may cause liver damage and a life-threatening condition called Reye syndrome.

To prevent the spread of illness:

• Remember that washing with soap and water 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.

• Keep your child out of day care until your child's health care provider says it's okay.

• Wash your hands before and after preparing food. Keep in mind that people with diarrhea or vomiting should not prepare food for others.

• Wash your hands 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 food

The main goal while treating vomiting or diarrhea is to prevent dehydration. This is done by giving your child 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 child is vomiting (with or without diarrhea):

• Start with oral rehydration solution at room temperature. Give 1 teaspoon (5 ml) every 5 minutes. Even if your child vomits, continue to give oral rehydration solution. Much of the liquid will be absorbed, despite the vomiting.

• Don’t give your child plain water, milk, formula, or other liquids until after the vomiting stops.

• Only give liquids at the prescribed rate. Do this even if your child is thirsty and wants to drink faster. Filling the stomach with too much liquid can cause more vomiting.

• As vomiting decreases, try giving larger amounts of oral rehydration solution. Space this out with more time in between. Continue this until your child is making urine and is no longer thirsty (has no interest in drinking).

• If frequent vomiting continues for more than 4 hours, contact your health care provider.

• After 2 hours with no vomiting, you can try small amounts of formula, milk, or other liquids. Increase the amount as your child can tolerate.

• Don't give your child sweet juices or sodas. If you have no other choice, dilute them with clean water. Don't give soda with bubbles. Let soda go flat first.

• After 4 hours with no vomiting, give your child solid foods. This can include rice cereal, other cereals, oatmeal, bread, noodles, mashed carrots, mashed bananas, mashed potatoes, rice, applesauce, dry toast, crackers, soups with rice or noodles, and cooked vegetables. Give as much liquid as your child wants.

• If your child keeps vomiting, go back to giving small amounts of clear liquids.

If your child has diarrhea only (no vomiting):

• Fluids are the most important thing. Don’t be in a rush to give food to your child.

• You can feed your child. But don't force your child to eat, especially if they are having stomach pain or cramping.

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

• If you are giving milk or formula to your child and the diarrhea is not going away, stop the milk or formula. In some cases, milk or formula can make diarrhea worse. If that happens, use oral rehydration solution instead. Don't give apple juice, soda, or other sweetened drinks. Drinks with sugar can make diarrhea worse.

• 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.

• 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 health care provider, or as advised. If a stool sample was taken or cultures were done, call the provider for the results as instructed.

Call 911

Call 911 if any of these occur:

• Trouble breathing

• Confusion

• Abnormal drowsiness or trouble walking

• Fainting or loss of consciousness

• Rapid heart rate

• Stiff neck

• Seizure

• More than just a small amount of blood in the stool

• No urine for 8 hours, no tears when crying, sunken eyes, or dry mouth

• Fussiness or crying that can't be soothed

When to get medical advice

Contact your child’s health care provider right away if any of these occur:

• Abdominal pain that gets worse

• Constant lower right abdominal pain

• Repeated vomiting after the first 2 hours on liquids

• Occasional vomiting for more than 24 hours

• Continued severe diarrhea for more than 24 hours

• Small amount of blood in stool

• Reduced oral intake

• Dark urine

• New rash

• More than 8 diarrhea stools within 8 hours

• 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 years, 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 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're 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 okay using a rectal thermometer, ask the health care provider what type to use instead. When you talk with any 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 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 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 health care provider in these cases:

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

• Fever of 100.4° F (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