Running With The Runs

Today's guest columnist is Dr. Jamie Collins, a Family Practice resident at the University Health Center here in Lafayette. It was the start of a great day for Kevin.  It was Saturday and no school and no homework.  However, Kevin's mom was on a mission to find a new couch for the living room and as a result, Kevin and his brothers were dragged from one furniture store to another.  At their last stop of the day, Kevin felt an uncomfortable stirring in his stomach, followed by watery sounds from below.  His mother told him to get off the couch he was sitting on, but too late. His pants erupted in a gurgling roar. Diarrhea is one of the most common reasons children are brought to the doctor.  Children get diarrhea more often than adults.  Diarrhea is the body's way of ridding itself of germs, and most episodes last from a few days to a week.  Diarrhea is defined as more stools than usual and more watery than usual.  The usual amount for infants is about 3 to 10 stools per day.  Breast fed infants have more and looser stool than formula-fed infants. Some infants can go 3-4 days without stooling, and that can be normal too.  Toddlers and older children usually go once or twice daily.  So if your breast-fed baby is having six watery stools per day, that's not diarrhea, that's normal! The consistency and color of a child's stool changes with age, and most color changes are normal.  Brown, yellow, green- all normal.  Diet changes can change the consistency.  Too much fruit juice makes for looser stools.  Stools that are all watery or full of mucus- that is not normal.  And white, bloody, or coal-black stools are not normal. The most common cause of diarrhea in kids is infection from a virus, like rotavirus.  Other organisms such as salmonella or giardia, can cause diarrhea too.  Most diarrhea lasts from 3 to 14 days, and often comes with vomiting, stomach ache, headache, and fever. The biggest concern about diarrhea is dehydration, which makes it important to keep your kid drinking.  For infants, keep the breast milk or formula coming.  It was once said that milk makes diarrhea worse.  However, it turns out that the sooner infants and children are on their milk and regular diet, the sooner they get better.  Today's recommendation is to "feed through" diarrhea.  If it looks like what you are putting in the top is coming out the bottom, keep it coming!  Your child will absorb enough fluids and nutrients to get by. If your baby is too ill to drink milk, then an oral hydration solution such as pedialyte or infalyte will help supply the fluids and electrolytes that are lost from diarrhea.  Older children can drink any clear liquid they like.  Popsicles are a good way to get fluids into a child who has been vomiting and needs to rehydrate slowly. Here are things that make diarrhea worse: Drinking too much sugary fruit juice.  If your child will only drink juice when they are sick, cut the juice with half and half with water.  Antibiotics can also make diarrhea worse.  If your kid is already on an antibiotic and gets diarrhea, call your doctor to discuss whether to continue the medicine or not.  A full appetite is often the last behavior to return after an illness.  Children should be allowed to take their time returning to their normal eating.  Children usually tolerate bland, starchy foods better. Dehydration is the most worrisome complication of diarrhea.  The signs of dehydration include dizziness and light-headedness, a dry sticky mouth, very little or no urine for a 12 to 24 hour period, no tears when crying.  If you think your child is dehydrated, call your doctor. Parents of kids with diarrhea should avoid spreading infection.  Care with frequent hand washing and keeping sick kids out of school or daycare until the diarrhea is controlled are ways to limit the people exposed.  Hand washing is the best way to prevent the spread of diarrhea to others, and yourself!  Hand sanitizer is the next best way for disinfecting hands when a sink is not handy, but does not guard against all types of diarrhea. I hope you've enjoyed all this poo-poo talk with your morning paper.  Now go wash those hands!