General Recommendations Regarding Diarrhea (page 2)
What is it?
Diarrhea occurs commonly in young children. Occasionally the complications of diarrhea can be serious and life threatening. Diarrhea causes a loss of water and minerals (electrolytes, like potassium) and can cause dehydration. Children, and particularly infants can become dehydrated much more quickly than adults, so it is important that the fluid be replaced.
Diarrhea is considered the passage of bowel movements or stools that are more frequent, looser and more watery than usual. Stools may also appear a different color, such as green or yellow, have mucus, and in the case of a more severe illness have blood present. Diarrhea may be accompanied by complaints of stomachache, headache, fever or vomiting and is often referred to as gastroenteritis or “stomach flu.” It may last just a couple of days, although most episodes of non-acute diarrhea last from three to six days.
What causes diarrhea?
Diarrhea may result from a number of causes, including infection by a virus (such as enterovirus or rotavirus), bacteria (E. coli, Shigella, Salmonella, Campylobacter) or parasites (Giardia, amebas); some medications (such as antibiotics); food allergies; and food poisoning. Some children have very sensitive stomachs resulting in nervousness that can lead to diarrhea, and some foods such as cherries or grapes may lead to diarrhea in some children.
The most common cause of severe diarrhea is a result of contracting the rotavirus, an infection of the digestive tract. It affects four out of five children in the United States by age 5. The occurrence of rotavirus increases from November through April, and it is particularly common in child care settings.
How does it spread?
Infectious diarrhea spreads in several ways. It can spread from person to person when a child or adult comes into direct contact with virus or bacteria from the stool of an infected individual and then passes the virus to the mouth. This is called fecal-oral transmission. A person also can touch a surface that has been contaminated and then touch his or her mouth. In child care settings, the germs can be on a caregiver or child’s hand, toy, play surface, food and even in the water play table.
A recent study of child care centers showed that the most common form of fecal contamination was by the hands of children and staff. Children in diapers and caregivers who change their diapers have an increased risk of getting diarrhea. Remembering to clean and sanitize the changing area and following good hand washing guidelines are key to preventing the spread. Gloves do not guarantee protection.
When is it contagious?
The contagious period can vary depending upon the cause of the diarrhea. Most infectious diarrhea caused by a virus is contagious one to two days before the start of symptoms and may continue to be contagious for a few days after the diarrhea has ended. After exposure, another person may develop diarrhea from one day to weeks later, depending upon the specific infection.
How is it treated?
When a child care provider notices a child has diarrhea, the parent should be notified. If the child has other signs of illness, such as fever or vomiting, or if the diarrhea is frequent and the child is less than 2 years old, the child’s health care provider should be contacted for specific recommendations.
Because diarrhea causes frequent watery stools leading to loss of water and salts from the body, the most important treatment for a young child with diarrhea is to replace fluids. In the more common and milder form, there are no laboratory tests of the stools or antibiotics involved. If the onset is abrupt and the diarrhea is severe with evidence of blood or high fever, an immediate visit to the child’s health care provider is necessary. Children under 3 years of age with severe diarrhea are even more at risk for becoming dehydrated due to loss of fluids in proportion to their small body size. Hospitalization for oral or intravenous rehydration is the cause of 10 percent of hospitalizations of children in the United States annually.
Child care providers and parents are now being advised to rehydrate children who show early signs of diarrhea in order to avoid potentially serious complications from dehydration. With the first signs of diarrhea, the child should be encouraged to drink small amounts of clear fluids frequently. The American Academy of Pediatrics recommends that an oral electrolyte solution (OES) such as Pedialyte, Infalyte, or other generic brands be on hand for possible use in the center. If diarrhea in a child is more than mild and the child is younger than 3 years of age, the use of an OES should be considered if signs of dehydration are present and after contacting the child’s health care provider for approval.
Whenever possible, an oral electrolyte solution should be given rather than juices, sport drinks, Kool-Aid or tea, which are high in sugar and may make the diarrhea worse. Chicken broth should be avoided because of its high salt content. It is best to give small frequent amounts of the oral electrolyte solution when a child has diarrhea. Anti-diarrhea medicines should NEVER be given to children unless prescribed by a physician. If the child has an appetite it is advisable to offer a normal diet but provide extra fluids.
Reprinted with the permission of the California Childcare Health Program.
- Coats and Car Seats: A Lethal Combination?
- Kindergarten Sight Words List
- Child Development Theories
- Signs Your Child Might Have Asperger's Syndrome
- 10 Fun Activities for Children with Autism
- Why is Play Important? Social and Emotional Development, Physical Development, Creative Development
- First Grade Sight Words List
- Social Cognitive Theory
- The Homework Debate
- GED Math Practice Test 1