Bacterial Diarrhea (Infant/Toddler)

Outline of infant showing digestive system.

Your child has bacterial gastroenteritis. This is an infection in the intestinal tract caused by bacteria.

This infection causes diarrhea (passing of loose, watery stools). Your child may also have these symptoms:

  • Belly pain and cramping

  • Nausea and vomiting

  • Fever and chills

  • Blood or mucus in stools

The main danger from this illness is dehydration. This is the loss of too much water and minerals from the body. 

Your child's healthcare provider will diagnose bacterial gastroenteritis with a stool culture. The result may take several days. If you submit a stool sample, follow up with the healthcare provider in 2 to 4 days.

Your child's provider may use antibiotics to treat this type of infection. Your child's healthcare provider will advise when antibiotics are needed.

Home care

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

Giving medicines to your child

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

  • If approved by your child's healthcare provider, use only the over-the-counter medicines made for children. Never give adult medicines to children. If you get confused by all of the choices, ask the store pharmacist for help.

  • If your child's healthcare provider prescribed antibiotics, make sure your child takes them as prescribed until they are finished. Don't stop giving them if your child feels better. Antibiotics must be taken as a full course.

  • 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 under 18 years of age who has a fever. This may cause liver damage and a life-threatening condition called Reye syndrome.

  • Your child's healthcare provider may prescribe a medicine for vomiting if needed. 

Giving liquids and feeding

The main goal while treating vomiting or diarrhea is to prevent dehydration. This is done by giving small amounts of liquids often. Don’t be in a rush to give food to your child.

If your baby is breastfed:

  • Keep breastfeeding. Feed your child more often than usual.

  • If diarrhea is severe, give oral rehydration solution between feedings. Don't give sports drinks or sweetened drinks. Use the oral rehydration solutions recommended by your healthcare provider.

  • As diarrhea decreases, stop giving oral rehydration solution and resume your normal breastfeeding schedule.

If your baby is bottle-fed:

  • Give small amounts of fluid at a time, especially if your child is vomiting. An ounce or two every 30 minutes may improve symptoms.

  • Give full-strength formula or milk. If diarrhea is severe, give oral rehydration solution between feedings.

  • If you are giving your child milk and the diarrhea is not getting better, stop giving milk. In some cases, milk can make diarrhea worse. Try soy or rice formula.

  • Don’t give sweetened drinks such as apple juice, sports drinks, or soda. Drinks with sugar can make diarrhea worse.

  • If your child is doing well after 24 hours, resume a regular diet and feeding schedule.

  • If your child starts doing worse with food, go back to clear liquids.

If your child is on solid food:

  • Keep in mind that liquids are more important than food right now. Don’t be in a rush to give food.

  • Don’t force your child to eat, especially if they are having stomach pain, cramping, vomiting, or diarrhea.

  • Don’t feed your child large amounts at a time, even if they are hungry. This can make your child feel worse. You can give your child more food over time if they can tolerate it.

  • Give small amounts at a time, especially if the child is having stomach cramps or vomiting.

  • If you are giving milk to your child and the diarrhea is not going away, stop the milk. In some cases, milk can make diarrhea worse. If that happens, use oral rehydration solution instead.

  • If diarrhea is severe, give oral rehydration solution between feedings.

  • If your child is doing well after 24 hours, try giving solid foods. Try to return to a normal diet as soon as possible.

  • If your child starts doing worse with food, go back to clear liquids.

  • You can resume your child's normal diet over time as they feel better. If the diarrhea or cramping gets worse again, go back to a simple diet or clear liquids.

Preventing the spread of illness

  • Washing hands well with soap and water is the best way to prevent the spread of infection. If soap and water are not available, use alcohol-based hand sanitizer.

  • Teach all people in your home when and how to wash their hands Wet your hands with clean, running water and lather the backs of your hands, between your fingers, and under your nails. Scrub your hands for at least 20 seconds. If you need a timer, try humming the Happy Birthday song from beginning to end twice. Rinse your hands well and dry using a clean towel.

  • Wash your hands before and after caring for your sick child.

  • Clean the toilet after each use.

  • Dispose of soiled diapers in a sealed container.

  • Keep your child out of day care until your child's healthcare provider says it's OK.

  • Wash your hands before and after preparing food.

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

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

  • A person with diarrhea or vomiting should not prepare food for others.

Follow-up care

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

When to seek medical advice

Unless your child's healthcare provider advises otherwise, call the provider right away if any of these occur:

  • Fever (see Children and fever, below)

  • Signs of dehydration:

    • Very dark urine

    • Dry mouth

    • Increased thirst

    • One or fewer wet diaper in 6 hours

    • No tears when crying

    • Sunken eyes

  • 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

  • Refusal to drink or feed

  • Fussiness or crying that can't be soothed

  • Unusual drowsiness

  • New rash

  • More than eight diarrhea stools within 8 hours

  • Diarrhea lasts more than 1 week on antibiotics

Call 911

Call 911 if your child has any of these symptoms:

  • Trouble breathing

  • Confusion

  • Extreme drowsiness or loss of consciousness

  • Trouble walking

  • Rapid heart rate

  • Stiff neck

  • Seizure

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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