The most important thing you can do for a child with diarrhea is keep them hydrated. Most cases in kids are caused by viral infections, resolve on their own within a few days, and don’t need medication. In fact, common over-the-counter anti-diarrheal drugs shouldn’t be used in young children at all. What actually helps is replacing lost fluids, getting your child back to normal food quickly, and knowing which warning signs need a doctor’s attention.
Fluids Come First
Every loose stool pulls water and electrolytes out of your child’s body. For mild cases, you can keep up by offering extra fluids throughout the day. Water is fine for older kids, but for infants and toddlers, an oral rehydration solution (like Pedialyte) is the better choice because it contains the right balance of sugar and salt to help the body absorb fluid efficiently.
If your child is showing early signs of dehydration, such as fewer wet diapers, a dry mouth, or no tears when crying, you’ll want to be more deliberate. Start with small, frequent sips: about 5 mL (one teaspoon) every five minutes, then gradually increase as your child tolerates it. A syringe works well for babies and toddlers who won’t drink from a cup. The general guideline is roughly 50 mL per kilogram of body weight over four hours for mild dehydration, and 100 mL per kilogram for moderate dehydration. For a 22-pound (10 kg) toddler, that works out to about 2 cups over four hours on the mild end.
After each watery stool, offer an additional small drink, up to about a cup for older kids. If your child is vomiting too, the slow-sip approach is especially important. Many parents assume a vomiting child can’t keep anything down, but tiny amounts given frequently often stay put.
Skip the BRAT Diet
For decades, parents were told to feed kids with diarrhea only bananas, rice, applesauce, and toast. That advice is outdated. The American Academy of Pediatrics, the CDC, and the World Health Organization all recommend getting children back to their normal, age-appropriate diet as soon as they’re rehydrated. Randomized trials have shown that resuming regular food right away actually leads to shorter illness, lower stool output, and better nutritional recovery compared to restricting what a child eats.
If your baby is breastfeeding, keep nursing. Formula-fed infants should continue on their regular, full-strength formula. Older kids can eat whatever they normally eat. There’s no need to limit them to bland food, and restricting their diet to just a few items can deprive them of the calories and nutrients they need to recover. Good options include lean meats, yogurt, fruits, vegetables, and complex carbohydrates like bread and pasta.
Foods and Drinks That Make It Worse
While regular food is encouraged, certain drinks and snacks can pull more water into the intestines and make diarrhea worse. Sugary beverages are the main culprits. Soda, undiluted apple juice, sports drinks, and gelatin desserts all contain high concentrations of simple sugars that create an osmotic effect, essentially drawing fluid into the gut rather than letting the body absorb it. Presweetened cereals can do the same thing. If your child wants juice, dilute it heavily with water or skip it until the diarrhea resolves.
Greasy, fried, or very high-fiber foods can also be harder on an irritated digestive system, though they’re less problematic than sugary liquids.
Probiotics Can Shorten the Illness
Certain probiotics have solid evidence behind them for reducing how long diarrhea lasts in children. A large meta-analysis of 84 studies covering more than 13,000 children found that the yeast-based probiotic Saccharomyces boulardii was the most effective overall, cutting diarrhea duration by about one and a quarter days compared to placebo. It also significantly reduced the chance of diarrhea lasting two days or longer.
Two bacterial strains, Lactobacillus reuteri and Bifidobacterium lactis, also shortened illness by roughly a day. Multi-strain combinations showed similar benefits. These probiotics are available in powder, capsule, or chewable forms at most pharmacies. Look for products that list specific strain names on the label. Probiotics are most helpful when started early in the illness.
Zinc for Younger Children
The World Health Organization recommends zinc supplementation alongside rehydration for children with acute diarrhea: 20 mg daily for 10 to 14 days, or 10 mg daily for infants under six months. Zinc helps restore the intestinal lining and can reduce both the severity and duration of the episode. This recommendation is especially relevant in settings where zinc deficiency is common, but it’s worth discussing with your pediatrician regardless.
Don’t Use Adult Anti-Diarrheal Medications
Over-the-counter anti-diarrheal medications like loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol) are not safe for young children. Bismuth subsalicylate should not be used in children under 12. It contains a salicylate compound related to aspirin, and children are more sensitive to its effects, particularly when they already have a fever or are dehydrated. In children recovering from the flu or chickenpox, salicylates carry a risk of Reye’s syndrome, a rare but serious condition affecting the brain and liver. These medications can also cause severe constipation in kids.
The goal with childhood diarrhea is to manage hydration and nutrition while the infection runs its course, not to stop the diarrhea itself.
Signs Your Child Needs Medical Attention
Most childhood diarrhea resolves within three to five days without any treatment beyond fluids and food. But dehydration can escalate quickly in small children, especially infants. Watch for these signs:
- Decreased urine output or significantly fewer wet diapers than usual
- Dry lips and mouth
- No tears when crying
- Unusual sleepiness or a noticeable drop in energy
- Increased irritability that seems out of proportion
Bloody diarrhea always warrants a call to your child’s doctor. The same goes for a high fever, diarrhea lasting more than a few days without improvement, or a child who can’t keep any fluids down despite the slow-sip method. Children with moderate to severe dehydration may need IV fluids in a hospital setting.
Preventing the Next Round
Most acute diarrhea in young children comes from rotavirus and other gut viruses that spread easily in daycare and school settings. The rotavirus vaccine, introduced in 2006, has dramatically reduced severe cases. CDC data show that routine vaccination prevented an estimated 280,000 clinic visits, 62,000 emergency department visits, and 45,000 hospitalizations per year among U.S. children under five in the years following its rollout. If your child hasn’t received the rotavirus vaccine series (given in infancy), talk to your pediatrician.
Handwashing is the other major preventive measure. Teach kids to wash with soap and water after using the bathroom and before eating. For daycare and school, the CDC advises keeping children home until their diarrhea has improved and they’re having no more than two extra bowel movements above their normal pattern in a 24-hour period, with no accidents.