Bacterial Diarrhea (Child)

Your child has bacterial gastroenteritis. This is an infection in the intestinal tract caused by bacteria. This can be more serious than what is called the stomach flu, which is caused by a virus. This infection causes diarrhea. Diarrhea is the passing of loose, watery stools 3 times a day or more.

Your child may also have these symptoms:

  • Abdominal pain and cramping

  • Nausea and vomiting

  • Fever and chills

  • Bloody stools

The main danger from this illness is dehydration. This is the loss of too much water and minerals from the body. When this occurs, body fluids must be replaced. This can be done with oral rehydration solution. Oral rehydration solution is available at pharmacies and most grocery stores.

Antibiotics are sometimes used to treat this type of infection.

Home care

Follow all instructions given by your child’s healthcare provider.

If giving medicines to your child:

  • Don’t give over-the-counter diarrhea medicines unless your child’s provider tells you to.

  • If antibiotics were prescribed, make sure your child takes them as prescribed until they're finished. Don’t stop giving them if your child feels better. Antibiotics must be taken as a full course. However, don't give your child antibiotics unless they were recommended by their provider. In some cases of bacterial diarrhea, they can cause more problems.

  • You can use acetaminophen or ibuprofen to control pain and fever. Or, you can use other medicine as prescribed.

  • Don’t give aspirin to anyone younger than age 18 who has a fever. This may cause liver damage and a life-threatening condition called Reye syndrome.

To prevent the spread of illness:

  • Remember that washing hands with soap and clean, running water or using alcohol-based sanitizer is the best way to prevent the spread of infection. Wash your hands before and after caring for your sick child.

  • Use correct handwashing technique. Teach all family members to do the same. Scrub all hand surfaces, including between the fingers, for at least 20 seconds. If you need a timer, hum the Happy Birthday song two times.

  • Clean the toilet after each use.

  • Keep your child out of daycare until your child's providers says it's OK.

  • Wash your hands before and after preparing food. Keep in mind that people with diarrhea or vomiting should not prepare or serve food to others.

  • Wash your hands after using cutting boards, counter-tops, and knives that have been in contact with raw foods.

  • Wash all cooking utensils (knives, cutting boards) after they touch raw food.

  • Use a food thermometer when cooking. Cook poultry to at least 165°F (74°C). Cook ground meat (beef, veal, pork, lamb) to at least 160°F (71°C). Cook fresh beef, veal, lamb, and pork to at least 145°F (63°C).

  • Don’t serve raw or undercooked eggs (poached or sunny side up), poultry, meat, or unpasteurized milk and juices to your child.

  • Don't eat foods prepared with unpasteurized milk

  • Keep uncooked meats away from cooked and ready-to-eat foods.

Giving liquids and food

The main goal while treating vomiting or diarrhea is to prevent dehydration. This is done by giving small amounts of liquids often.

  • Keep in mind that liquids are more important than food right now. Give small amounts of liquids at a time, especially if your child is having stomach cramps or vomiting.

  • For diarrhea: If you're giving milk to your child and the diarrhea isn't going away, stop the milk. In some cases, milk can make diarrhea worse. If that happens, use oral rehydration solution instead. Don’t give apple juice, sports drinks, soda, or other sweetened drinks. Drinks with sugar can make diarrhea worse.

  • For vomiting: Begin with oral rehydration solution at room temperature. Give 1 teaspoon (5 ml) every 5 minutes. Even if your child vomits, continue to give the solution. Much of the liquid will be absorbed, despite the vomiting. After 2 hours with no vomiting, begin with small amounts of milk or formula and other fluids. Increase the amount as tolerated. Don’t give your child plain water, milk, formula, or other liquids until vomiting stops. As vomiting decreases, try giving larger amounts of oral rehydration solution. Space this out with more time in between. Continue this until your child is making urine and is no longer thirsty (has no interest in drinking). After 4 hours with no vomiting, restart solid foods. After 24 hours with no vomiting, resume a normal diet.

  • You can resume your child's normal diet over time as they feel better. Don’t force your child to eat, especially if your child is having stomach pain or cramping. Don’t feed your child large amounts at a time, even if they're hungry. This can make your child feel worse. You can give your child more food over time if they can tolerate it. Foods you can give include cereal, mashed potatoes, applesauce, mashed bananas, crackers, dry toast, rice, oatmeal, bread, noodles, pretzels, soups with rice or noodles, and cooked vegetables.

  • If the symptoms come back, go back to a simple diet or clear liquids.

Follow-up care

Follow up with your child’s healthcare provider, or as advised. If a stool sample was taken or cultures were done, call the provider for the results as instructed.

Call 911

Call 911 if your child has any of these symptoms:

  • Trouble breathing

  • Confusion

  • Extreme drowsiness or loss of consciousness

  • Extreme drowsiness or trouble walking

  • Rapid heart rate

  • Stiff neck

  • Seizure

When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

  • Belly pain that gets worse

  • Constant lower right belly pain

  • Repeated vomiting after the first 2 hours on liquids

  • Occasional vomiting for more than 24 hours

  • Continued severe diarrhea for more than 24 hours

  • Blood in vomit or stool

  • Reduced oral intake

  • Dark urine or no urine for 4 to 6 hours in a younger child, or 6 to 8 hours in an older child, no tears when crying, sunken eyes, or dry mouth

  • Fussiness or crying that can't be soothed

  • Unusual drowsiness

  • New rash

  • More than 8 diarrhea stools within 8 hours

  • Diarrhea lasts more than 10 days

  • Chest pain

Fever is an expected symptom from bacterial diarrhea and usually isn't a cause for concern. Unless advised otherwise by your child's healthcare provider, follow these general guidelines. (See Fever and children, below.)

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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