The most important thing to give a child with diarrhea is fluid, not medication. Oral rehydration solutions like Pedialyte replace both the water and the electrolytes your child is losing, and they should be your first priority. Most childhood diarrhea resolves on its own within a few days, but dehydration is the real danger, especially in younger children.
Start With Oral Rehydration
Oral rehydration solutions (ORS) are specifically formulated to match what your child’s body is losing through diarrhea. Products like Pedialyte, Enfalyte, or store-brand equivalents contain the right balance of sodium, potassium, and sugar to help your child’s gut absorb fluid efficiently. Plain water doesn’t replace lost electrolytes, and sugary drinks can actually make diarrhea worse.
Offer small, frequent sips rather than large amounts at once. If your child vomits after drinking, wait 15 to 20 minutes and try again with even smaller sips. Breastfed infants should continue nursing, as breast milk provides both hydration and nutrients. Formula-fed babies can continue their usual formula alongside ORS.
Drinks That Make Diarrhea Worse
Soft drinks, undiluted apple juice, gelatin desserts, and presweetened cereals are all high in simple sugars that pull extra water into the intestines through osmotic pressure, making diarrhea more frequent and watery. Sports drinks like Gatorade are designed for adult athletes, not sick children. They contain too much sugar and not enough sodium to properly rehydrate a child with diarrhea.
If your child refuses ORS and will only drink juice, diluting it heavily with water (at least half and half) is a reasonable compromise, but ORS remains the better choice.
What to Feed During Diarrhea
You may have heard of the BRAT diet (bananas, rice, applesauce, toast), but it’s no longer recommended as a treatment plan. The CDC notes that it’s “unnecessarily restrictive” and provides suboptimal nutrition for a child whose gut is trying to recover. While those foods are fine to include, limiting your child to only bland starches deprives them of the protein, fat, and calories they need.
The current guidance is straightforward: children who are already eating solid foods should continue their normal diet during diarrhea. There’s no benefit to “resting” the gut. Once your child is rehydrated, return them to their regular age-appropriate meals as quickly as possible. Good options include lean meats, yogurt, fruits, vegetables, and complex carbohydrates. Avoid greasy or fried foods, which can be harder to digest during illness.
Why Most Medications Aren’t Safe for Kids
The instinct to reach for an anti-diarrheal medicine is understandable, but most are not appropriate for children. Loperamide (the active ingredient in Imodium) can cause serious side effects in young children and should not be given without a doctor’s direction. Anti-diarrheal medications are generally unhelpful for infectious diarrhea, which is the most common type in kids, and can actually prolong the illness by trapping the infection inside the gut.
Bismuth subsalicylate (Pepto-Bismol, Kaopectate) contains salicylates, the same family of compounds found in aspirin. Salicylates are linked to Reye’s syndrome, a rare but serious condition affecting the brain and liver, in children with viral illnesses. Since viral infections are the leading cause of childhood diarrhea, these products should be avoided.
Probiotics Can Help in Some Cases
Probiotics, particularly the strain Lactobacillus rhamnosus GG, have the strongest evidence for preventing diarrhea caused by antibiotics. In a pooled analysis of studies involving 445 children, those given this probiotic alongside antibiotics developed diarrhea about 10% of the time, compared to 23% in children who didn’t receive it. Higher doses (10 to 20 billion colony-forming units per day) were notably more effective than lower doses.
If your child is taking antibiotics and you want to try a probiotic, look for products that list the specific strain and CFU count on the label. For diarrhea caused by a stomach bug rather than antibiotics, the evidence for probiotics is less consistent, though they’re generally safe for otherwise healthy children.
Zinc Supplementation for Young Children
The World Health Organization recommends zinc supplementation for children under five with diarrhea: 20 mg per day for 10 to 14 days, or 10 mg per day for infants under six months. Zinc helps reduce the duration and severity of diarrhea episodes. This recommendation is especially relevant in developing countries where zinc deficiency is common, but it can be discussed with your pediatrician regardless of where you live.
How to Spot Dehydration
Dehydration is the main complication to watch for, and catching it early matters. The most reliable signs are a dry mouth, crying without producing tears, and a generally ill appearance. In infants, a sunken soft spot on the top of the head is another warning sign. If your child hasn’t produced a wet diaper in several hours, or an older child hasn’t urinated, that signals significant fluid loss.
You can also check skin turgor by gently pinching the skin on the side of your child’s belly. Normally, the skin snaps back immediately. If it stays tented or returns slowly, your child is likely dehydrated and needs more aggressive rehydration, possibly with medical help.
Signs That Need Medical Attention
For babies younger than 3 months, any diarrhea accompanied by a fever warrants an immediate call to your doctor. For children older than 3 months, seek care if diarrhea lasts more than 24 to 48 hours, particularly when accompanied by:
- Fever
- Bloody or black stools
- Severe abdominal or rectal pain
- No wet diapers or urine output for several hours
- Dry mouth or tearless crying
- Unusual sleepiness or irritability
- A sunken appearance to the eyes, cheeks, or abdomen
The presence of two or more dehydration signs at once (dry mouth, no tears, slow skin recoil, ill appearance) typically indicates a fluid loss of at least 5%, which often requires medical intervention beyond what you can manage at home with oral rehydration alone.