From the Guidelines
Diarrhea in toddlers should be managed with oral rehydration as the primary treatment, using solutions like Pedialyte, Infalyte, or Ceralyte, and avoiding sugary drinks like juice, soda, or sports drinks, as recommended by the 2017 Infectious Diseases Society of America clinical practice guidelines 1.
Key Recommendations
- Give your child an oral rehydration solution in small, frequent sips to prevent dehydration.
- Continue feeding your child their regular diet, as maintaining nutrition helps the intestines recover faster.
- Avoid giving sugary drinks like juice, soda, or sports drinks as these can worsen diarrhea.
- Most cases of toddler diarrhea resolve within 5-7 days without medication.
- Watch for signs of dehydration such as decreased urination, dry mouth, no tears when crying, unusual drowsiness, or sunken eyes.
- Anti-diarrheal medications are generally not recommended for young children as they can have serious side effects.
- If your child has bloody diarrhea, severe abdominal pain, high fever (over 102°F or 39°C), signs of dehydration, or if diarrhea persists beyond 7 days, seek medical attention immediately.
Importance of Hydration
According to the World Health Organization, oral rehydration has been credited with saving millions of lives in the management of dehydration in all age groups, regardless of the cause 1.
Prevention of Diarrheal Disease
Reduction of acute infectious diarrhea can also be achieved through general measures, including use of hand hygiene, proper food preparation and storage, avoidance of high-risk foods, and avoidance of unsafe water, as highlighted in the 2017 Infectious Diseases Society of America clinical practice guidelines 1.
Disease Burden
The burden of acute gastroenteritis has been reduced since implementation of rotavirus vaccines, but the disease still poses a significant burden, with an estimated annual burden of 179 million outpatient visits, nearly 500,000 hospitalizations, and >5000 deaths in the United States 1.
From the Research
Diarrhea in Toddlers
- Diarrhea in toddlers can be managed with oral rehydration solutions (ORS) and maintenance therapy, as shown in a study published in Pediatrics in 1995 2.
- The study compared the efficacy of two commonly used ORS solutions in rehydrating infants with mild to moderate dehydration caused by acute diarrhea.
- Another study published in JPEN. Journal of parenteral and enteral nutrition in 1999 suggested that supervised ORS followed by early refeeding of their normal diet can be an effective management strategy for acute diarrhea in infants 3.
- A review published in The American journal of gastroenterology in 2009 discussed the use of ORS in non-cholera diarrhea and highlighted the importance of improved hydration status in decreasing morbidity and mortality 4.
Treatment Options
- Oral rehydration solutions contain primarily glucose or glucose polymers and sodium as well as other electrolytes, as mentioned in a study published in Therapeutische Umschau. Revue therapeutique in 1994 5.
- Loperamide is considered a potent and safe antidiarrheal drug, while antibiotics are used only in invasive diarrhea 5.
- A study published in American family physician in 1995 emphasized the importance of rapid rehydration, early refeeding, and continuation of lactose-containing foods unless clinical signs of lactose intolerance develop 6.
Management Strategies
- Optimal management of acute infectious diarrhea includes rapid rehydration, early refeeding, and a staged laboratory evaluation, as suggested by a study published in American family physician in 1995 6.
- Supervised ORS followed by early refeeding of their normal diet can be an effective management strategy for acute diarrhea in infants, as mentioned in a study published in JPEN. Journal of parenteral and enteral nutrition in 1999 3.
- The use of ORS has revolutionized the management of acute diarrhea, and various modifications to the standard ORS have been derived, including hypo-osmolar or hyperosmolar solutions and zinc supplementation, as discussed in a review published in The American journal of gastroenterology in 2009 4.