Traveler’s Diarrhea (Child)

Front view of child showing the digestive system.

Traveler’s diarrhea is an infection in the intestinal tract. It is usually caused by bacteria called E. coli. These bacteria are often found in water supplies in less developed countries. The local people of those countries are immune to E. coli and don’t get sick. Tourists who drink water or eat foods that were washed or prepared with this water may become very ill.

The illness starts 1 to 3 days after exposure. It can last up to 5 days, or sometimes longer. Symptoms include fever, vomiting, stomach cramps, and watery diarrhea. There may be blood or mucus in the stool. Mild cases will get better without treatment. Antibiotics are used for more severe cases.

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 drugstores and most grocery stores.

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 healthcare provider tells you to.

  • If antibiotics were prescribed, make sure your child takes them every day 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.

  • Sometimes your child's healthcare provider will prescribe medicine to control the vomiting. Take it only as directed by your child's healthcare provider. If your child continues to vomit despite giving this medicine, contact your child's healthcare provider.

  • 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.

To prevent the spread of illness:

  • Remember that washing with soap and water is the best way to prevent the spread of infection. Wash your hands before and after caring for your sick child.

  • Clean the toilet after each use.

  • 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. Keep in mind that people with diarrhea or vomiting should not prepare food for others.

  • 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.

Giving liquids and food

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

If your child is vomiting (with or without diarrhea):

  • Start with oral rehydration solution at room temperature. Give 1 teaspoon (5 ml) every 5 minutes. Even if your child vomits, continue to give oral rehydration solution. Much of the liquid will be absorbed, despite the vomiting.

  • Don’t give your child plain water, milk, formula, or other liquids until after the vomiting stops.

  • Only give liquids at the prescribed rate. Do this even if your child is thirsty and wants to drink faster. Filling the stomach with too much liquid can cause more vomiting.

  • 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).

  • If frequent vomiting continues for more than 4 hours, call your healthcare provider.

  • After 2 hours with no vomiting, you can try small amounts of formula, milk, or other liquids. Increase the amount as your child can tolerate.

  • Don't give your child sweet juices or sodas. If you have no other choice, dilute them with clean water. Don't give soda with bubbles. Let soda go flat first.

  • After 4 hours with no vomiting, give your child solid foods. This can include rice cereal, other cereals, oatmeal, bread, noodles, mashed carrots, mashed bananas, mashed potatoes, rice, applesauce, dry toast, crackers, soups with rice or noodles, and cooked vegetables. Give as much liquid as your child wants.

  • If your child keeps vomiting, go back to giving small amounts of clear liquids.

If your child has diarrhea only (no vomiting):

  • Fluids are the most important thing. Don’t be in a rush to give food to your child.

  • You can feed your child. But don't force your child to eat, especially if he or she is having stomach pain or cramping.

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

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

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

  • If your child is doing well after 24 hours, try giving solid foods. These can include cereal, oatmeal, bread, noodles, mashed carrots, mashed bananas, mashed potatoes, applesauce, dry toast, crackers, soups with rice noodles, and cooked vegetables.

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

  • You can resume your child's normal diet over time as he or she feels better. If the diarrhea or cramping gets worse again, 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 healthcare provider for the results as instructed.

Call 911

Call 911 if any of the following occur:

  • Trouble breathing

  • Confusion

  • Very drowsy or trouble walking

  • Fainting or loss of consciousness

  • Rapid heart rate

  • Stiff neck

  • Seizure

When to seek medical advice

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

  • Abdominal pain that gets worse

  • Constant lower right abdominal 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 stool

  • Reduced oral intake

  • Dark urine or no urine for 8 hours, no tears when crying, sunken eyes, or dry mouth

  • Fussiness or crying that cannot be soothed

  • Unusual drowsiness

  • New rash

  • More than 8 diarrhea stools within 8 hours

  • Diarrhea lasts more than 1 week on antibiotics

  • Fever (see Fever and children, below)

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
Powered by Krames Patient Education - A Product of StayWell