Pediatric Nutrition: William J. Klish

My 7-month-old has had diarrhea for the last two days. What should I do to make sure he doesn't dehydrate. Is it okay to give him water? How about yogurt? I've heard it can help with stomach bugs.

By William Klish, M.D.

Diarrhea is a very common problem in infants and young children. In the United States, most cases are mild and self-limiting. However, if the diarrhea is severe, it can lead to dehydration and even death if not treated properly. The first line of treatment is to use fluids to keep your infant from dehydrating. If the diarrhea is mild and your baby only has a few (less than four) loose stools per day, any fluid, such as water or sports drinks, is sufficient to prevent dehydration. Offer these fluids at mealtimes and in-between. Fruit juices, particularly apple or pear, should be avoided since they contain sugars which are hard to digest and can add to the diarrhea. If the diarrhea is severe (more than ten loose stools a day), oral electrolyte solutions should be given. These are designed to replace both the minerals and fluids that are lost from diarrhea. A variety of brands are often available at grocery and drug stores

Feeding should continue while your baby has diarrhea, however if vomiting is also a problem, foods low in fat and simple sugars (such as bananas, rice, applesauce, and potatoes) should be offered since they tend to be tolerated better.

Right now, yogurt is not recommended as a treatment for diarrhea. It can be used as part of the normal feeding routine but should not replace fluid, which is most important. The bacteria in some yogurt is lactobacillus acidophilus, which is considered to be a "probiotic" or good bacteria. There is some data that shows that these bacteria might prevent or make diarrhea episodes milder if eaten prior to getting the disease, however there is no data at the present time that shows that probiotics cure acute diarrhea. (Many yogurts are pasteurized and therefore contain no bacteria, so be sure to check labels.)

If your child shows signs of dehydration, she should see her pediatrician right away. Symptoms of dehydration include dry mouth and tongue, lack of tears when crying, sunken fontanel (the soft spot at the center of your baby's head), abnormally dry and inelastic skin, and listlessness or irritability.

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