Diarrhea

Please Note: These guidelines are only for children who are fully vaccinated with no chronic medical illnesses.

These guidelines provide general guidance and should not be used as a substitute for the individual advice provided over the phone or at an appointment. If you have any significant or ongoing concerns, please call the office.  Please contact Hirsch Pediatrics or go to the ER if your child is under 2 months old and has a fever (rectal temperature of 100.4 Fahrenheit or 38 Celsius).

These guidelines are written for patients of Hirsch Pediatrics and may not be copied or used without the written permission of Dr. Hirsch.

Why is my child having diarrhea?

  • Most cases of diarrhea in children are due to a viral illness also known as a “stomach bug.”
  • If it is from a stomach bug you may also notice some crampy belly pain/fussiness, fever, and/or vomiting. Note: Please see Dr. Hirsch’s other handouts on vomiting and fever management for additional guidance on these topics.
  • Note that newborns after passing their initial meconium stools (dark, sticky, tarry stool) will have stools that are very watery and loose with a yellow, seedy appearance. This is normal and not considered diarrhea! Typically by age 1-2 months the stools will change again to a firmer appearance and with different colors including brown, yellow, green, or orange (which is also normal)

How long will the diarrhea last?

  • Sometimes the diarrhea from stomach bugs can linger for up to 1-2 weeks though usually it improves sooner.

How do I treat the diarrhea?

  • Until the diarrhea has resolved in addition to pushing fluids if you think your child may be getting dehydrated, you should avoid dairy products. For infants taking formula and have persistent diarrhea you can temporarily switch to a soy formula.
  • It is not necessary to change to Pedialyte or a bland diet unless you notice vomiting or the diarrhea is still getting worse after 3-5 days.
  • You can also begin a probiotic (Bio gaia or Gerber Soothe brands) if the diarrhea persists. Also some recent studies have shown that DiaResQ which is bovine colostrum (https://diaresq.com/ – available at many places) can be very effective at stopping or reducing infectious diarrhea. Note: DiaResQ is only for age one and older and contains egg/milk proteins so it should be avoided if you have these allergies.
  • For most children Dr. Hirsch does not recommend any other over-the-counter nausea, vomiting, or diarrhea medications.
  • Reminder that infants and toddlers with infectious diarrhea can be very prone to diaper rashes. To limit diaper rashes until the diarrhea has improved please use extra thick layers of zinc oxide diaper cream with every diaper change, avoid scrubbing the skin with wipes (just gentle botting is sufficient or soak their bottom in water to clean), and if possible let their skin air dry between diaper changes.

 When can my child go back to school or daycare?

  • Your child can return to school or daycare as long as all stools are fully contained in the diaper or toilet (even if your child still has looser stools); and your child has not vomited for 24 hours, does not have a fever for 24 hours, and overall looks well.

When do I need to worry or schedule an appointment?

  • Please schedule an appointment if the diarrhea is not improving after 7-10 days or is getting much worse after 7 days. In these situations sometimes we will send the stool to the lab for testing though fortunately this is rarely needed.
  • Also please schedule an appointment if you notice persistent blood or mucous in the stool or sooner if you still have any concerns.
  • Your child does need to be seen emergently after-hours if you see very bloody stools and your child has a fever or significant pain. If it is after-hours please proceed to our recommended urgent care or Emergency Room.