infectiosum • Do not give milk. • Give the child extra liquids-tea, water, flavored gelatin water, and commercial electrolyte solutions (available from your pharmacist) are best PRECAUTIONS • Do not give antidiarrheal medications to children. • Isolate infants from children who are ill with vomiting and diarrhea. If there is blood in the stools, high fever, extreme weak ness, or severe or prolonged diarrhea (lasting more than two to three days], call your doctor. Call your doctor if your child frequently has diarrhea (especially if the child is losing weight). A child with diarrhea needs extra liquids to avoid dehvdra tion (serious loss of body fluids). DIETARY TREATMENT OF DIARRHEA (IN SUGGESTED ORDER OF INTRODUCTION) Commercial electrolyte solutions (available from your pharmacist) Sweetened tea Flavored gelatin water Diluted beef bouillon Flavored gelatin Lean beef or lamb Boiled chicken Cooked rice Dry baked or boiled potato Banana Apple Toast or crackers and jelly Soft or hardboiled egg Diarrhea refers to looseness of the stools-not to the frequency of bowel movements. (Having frequent bowel movements with stools of normal consistency is not considered diarrhea.) The number of loose stools per day reflects the seriousness of the diarrhea. Diarrhea in children over the age of five years differs in several ways from diarrhea in younger children. Diarrhea is less likely to cause dehydration (a serious loss of body fluids) in older children. The older and larger the child becomes, the smaller the chances of dehydration. Serious dehydration is unlikely past six years of age-unless diarrhea is combined with vomiting, which keeps the child from drinking enough liquids. Viruses in the intestine are the most common cause of diarrhea in older children. Dysentery bacteria and parasites in the intestine are the next most common causes. Respiratory viruses and reactions to certain foods are the least likely causes of diarrhea in older children. Other diseases may cause longterm, frequent diarrhea in older children (these disorders are rare or unknown in infants). Ulcerative colitis is a condition in which ulcers appear in the colon (large intestine). Regional enteritis (Crohn's disease) is a recurring inflammation in the small intestine. Cystic fibrosis is an inherited disease that affects the lungs, pancreas, sweat glands, and sometimes the liver and other organs. It often causes frequent diarrhea with foulsmelling stools. SIGNS AND SYMPTOMS The major symptom is loose, watery stools. There may be mucus or flecks of red blood in the stools. The child may have cramps. There may also be fever, loss of appetite, vomiting, and weight loss, depending on the cause of the diarrhea. HOME CARE If the child has both diarrhea and vomiting, treat the vomiting first, by restricting the child's diet to clear liquids. When the vomiting has stopped, treat the diarrhea by limiting or not reintroducing solid foods-especially butter, fatty meats, peanut butter, wholegrain cereals, vegetables, and most fruits (apples and bananas are all right). infectiosum