Diarrhea

Diarrhea

A child can have diarrhea for a variety of reasons. When is it time to see a doctor?


Symptoms

  • Bowel movements that are more frequent and more watery than usual

Consult a doctor if your child:

  • Is under 6 months old
  • Has diarrhea lasting more than 5 days

Go to the emergency room immediately if your child:

  • Has a high fever
  • Has bloody or mucousy stools
  • Has frequent bowel movements (more than 7 to 10 times a day)
  • Is urinating less often
  • Has a stomachache
  • Has signs of dehydration (dry mouth, crying without tears, sunken fontanelle in babies, very dark urine, sunken eyes)

What is diarrhea?

It isn’t caused by teething . . .
Contrary to popular belief, teething doesn’t make children sick or cause a high fever. If your child has diarrhea or a fever, watch them closely to ensure their condition doesn’t worsen.

Diarrhea is a symptom, not a disease. It is characterized by more frequent bowel movements, which may be watery. It can be caused by:

  • Viruses (e.g., rotavirus)
  • Bacteria (e.g., E. coli, Salmonella, Campylobacter, and Shigella)
  • Parasites (e.g., Giardia)
  • An imbalance of the intestinal flora, caused by taking antibiotics
  • A reaction to certain foods (e.g., gluten, lactose, artificial sweeteners)
  • Digestive system disorders, which can range from mild to severe (though this is rarer)

Possible complications of diarrhea

The main complication of diarrhea is dehydration. This can happen quickly in babies aged 0 to 12 months, especially when the diarrhea is caused by an infection (in other words, a virus or bacteria). If a child is dehydrated, they require immediate treatment.

Age: Diarrhea affects all age groups, but it is more common in children under 5.
Duration: If the diarrhea is caused by a virus, it usually lasts 3 to 5 days. However, it can take up to a week for bowel movements to return to normal. If it is caused by bacteria or parasites, it may last longer depending on how effective the treatment is.
Infectious period: No matter the cause, diarrhea is contagious as long as the child has symptoms, and sometimes longer in the case of bacterial diarrhea.
How it spreads: Viral diarrhea spreads through direct contact (vomit or feces) or indirect contact (contaminated surfaces and objects such as towels and washcloths, toilet seats, cups and utensils, toys, etc.)
Bacterial diarrhea spreads through contaminated water or food, and sometimes from person to person through the fecal–oral route.
Parasitic diarrhea (caused by the parasite Giardia, for instance) spreads from person to person through the fecal–oral route or by drinking contaminated water.
Isolation period: It’s best to keep your child at home if they’re unable to take part in daycare or school activities, if their stool leaks from their diaper, or if they can’t use the toilet for all their bowel movements.
A child can return to daycare or school even if their stools are still frequent and not fully formed. In these cases, proper handwashing is important to reduce the risk of spreading germs.
If the diarrhea is caused by bacteria or parasites, they can return to daycare or school only when stool tests come back negative.

Treatment

Viral or bacterial?
Bacterial gastroenteritis usually doesn’t start with vomiting, unlike most viral gastroenteritis infections. Fever is generally higher, and stomach pain tends to be more intense, often in the form of cramps. Stools may also be streaked with blood.

In most cases, viral diarrhea does not require antiviral treatment and clears up on its own in a few days. However, it’s important to watch for signs of dehydration.

Antibiotics may be needed in some cases of bacterial infection. If a parasite is the cause, antiparasitic treatment is required.

Do not give your child over-the-counter anti-diarrhea medication. These can make their condition worse and cause serious problems.

Can a child with diarrhea drink milk?

It’s now known that drinking milk does not make diarrhea worse. It is no longer recommended to stop giving milk unless the diarrhea is severe or lasts more than 7 days.

During the first 24 hours of diarrhea, it’s a good idea to alternate between milk and an oral rehydration solution. Babies who are breastfed should continue nursing with shorter, more frequent feedings.

What to feed your child when they have diarrhea

Your child’s diet should stay as normal as possible. A liquid diet is not needed unless they’re vomiting. It’s important to make sure they’re drinking enough fluids to prevent dehydration.

If they’re having trouble eating, offer smaller, lighter meals more often (about 5 or 6 a day). Focus on foods that are easy to digest, such as broth, toast, eggs, chicken, rice, mashed carrots, unsweetened applesauce, and bananas. Avoid foods that are very fatty, sugary, or spicy.

How to prevent dehydration

Up to 6 months of age

Oral rehydration solution helps rehydrate faster, especially if breast milk or infant formula is not well tolerated.
  • If you’re breastfeeding, offer the breast more often but for shorter periods. If your baby is too tired or nauseous to feed well at the breast, you can also give expressed breast milk with a spoon, syringe, or cup. If your baby is vomiting, try alternating breastfeeding with a bottle of oral rehydration solution.
  • If your baby is bottle-fed, continue giving their usual formula in normal amounts. If diarrhea is accompanied by vomiting, offer fluids more often but in small amounts. Alternate between their usual formula and a bottle of oral rehydration solution. Do not dilute the formula.

Over 6 months of age

  • If your child vomits a lot, you can offer an oral rehydration solution.
  • You can give breast milk, infant formula, or milk alternated with the rehydration solution during the first 24 hours of diarrhea.
  • Avoid giving your child soda or apple, pear, grape, or prune juice, as they may have a laxative effect.

To prevent dehydration, offer your child very small amounts of fluids at frequent intervals. Amounts vary by age:

If your baby refuses to take the rehydration solution from a bottle, give it using a dropper, syringe, small spoon, or cup.
  • Under 6 months: 30 to 90 ml (1 to 3 oz.) per hour; about 5 ml (1 tsp) every 5 minutes. Gradually increase the amount while lengthening the intervals, depending on your baby’s tolerance.
  • 6 months to 2 years: 90 to 125 ml (3 to 4 oz.) per hour; about 10 ml (2 tsp) every 5 minutes. Gradually increase the amount while lengthening the intervals, depending on your child’s tolerance.
  • Over 2 years: 125 to 250 ml (4 to 8 oz.) per hour; about 15 ml (1 tbsp) every 5 minutes. Gradually increase the amount while lengthening the intervals, depending on your child’s tolerance.

Electrolyte solutions sold in pharmacies

Electrolyte solutions sold in pharmacies (e.g., Pedialyte®, Gastrolyte®) help avoid dehydration and prevent your child from losing essential minerals (electrolytes). Once opened, these solutions should be refrigerated and used within 48 hours. Powder sticks and frozen solutions last longer. Be sure to check the expiry dates.
If you don’t have an electrolyte solution on hand, you can make a homemade rehydration solution. Be sure to follow the exact proportions:
  • 360 ml (12 oz.) pure orange juice (no sugar added)
  • 600 ml (20 oz.) cooled boiled water
  • 2.5 ml (1/2 teaspoon) salt
Do not use these homemade solutions for more than 12 to 24 hours during diarrhea. Solid foods should be reintroduced as soon as possible.

Prevention

  • Follow the vaccination schedule to ensure your baby receives both oral doses of the rotavirus vaccine (Rotarix) at 2 and 4 months of age.
  • Make sure your child washes their hands thoroughly and often, especially after using the toilet and before eating (do it for them if they’re too young).
  • Clean toilet surfaces thoroughly to eliminate germs that can cause illness.
  • Wash fruits and vegetables under running water before preparing them.
  • Clean countertops and kitchen utensils thoroughly when they have been in contact with raw meat, poultry, or fish. Refrigerate meat as soon as possible after purchasing; cook it thoroughly and refrigerate leftovers quickly.
  • Avoid drinking water unless you’re sure it’s safe. When travelling abroad, avoid tap water, especially in developing countries. Use bottled water, even for brushing your teeth.
  • Avoid washing pet bowls or litter boxes in the kitchen sink, and keep them away from areas where you store, prepare, or eat food.

Soothing diaper rash

When your child has diarrhea, their bottom can become irritated from frequent bowel movements. To relieve the irritation, apply a zinc oxide cream (e.g., Zincofax®) or Ihle’s paste. If they feel itchy, you can use an oat-based cream like Aveeno® on the affected area.
Avoid using baby wipes, as they may further irritate your child’s skin. Instead, wash the area gently with a washcloth, water, and mild soap. Gently pat dry with a towel; don’t rub.
Naître et grandir

Scientific review: Dr. Anne-Claude Bernard-Bonnin, pediatrician
Research and copywriting:The Naître et grandir team
Updated: June 2025

Photo: GettyImages/ELENA BESSONOVA

Resources

Note: The links to other websites are not updated regularly, and some URLs may have changed since publication. If a link is no longer valid, please use search engines to find the relevant information.

  • Billeau, Audrey. La Maman infirmière à la rescousse : tous les bobos et les soins des enfants de 0 à 6 ans. Montreal, Les Éditions de l’Homme, 2025, 232 pp.
  • CHU Sainte-Justine. La gastro-entérite : information destinée aux parents. 2010. chusj.org
  • Doré, Nicole, and Danielle Le Hénaff. From Tiny Tot to Toddler: A practical guide for parents from pregnancy to age two. Institut national de santé publique du Québec. 2025. inspq.qc.ca
  • Gouvernement du Québec. “Gastroenteritis (stomach flu).” Gouvernement du Québec. 2023. quebec.ca
  • Gouvernement du Québec. “Québec Immunization Program.” Gouvernement du Québec. 2024. quebec.ca
  • Canadian Paediatric Society. “Dehydration and diarrhea in children: Prevention and treatment.” Caring for Kids. 2018. caringforkids.cps.ca
  • Canadian Paediatric Society. “Food safety at home.” Caring for Kids. 2020. caringforkids.cps.ca

References

  • Freedman, Stephen B., et al. “Multicenter trial of a combination probiotic for children with gastroenteritis.” The New England Journal of Medicine, vol. 379, no. 21, 2018, pp. 2015–2026. nejm.org
  • Guarino, Alfredo, et al. “European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014,”, Journal of Pediatric Gastroenterology and Nutrition, vol  59, no  1, 2014, pp. 132–152. pubmed.ncbi.nlm.nih.gov
  • Nemours KidsHealth. “Diarrhea.” KidsHealth. 2021. kidshealth.org
  • Mayo Clinic Staff. “Diarrhea.” Mayo Clinic. 2023. mayoclinic.org
  • Mayo Clinic Staff. “Antibiotic-associated diarrhea.” Mayo Clinic. 2021. mayoclinic.org
  • Schnadower, David, et al. “Lactobacillus rhamnosus GG versus placebo for acute gastroenteritis in children.” The New England Journal of Medicine, vol. 379, no. 21, 2018, pp. 2002–2014. nejm.org
  • Canadian Paediatric Society. “Using probiotics in paediatric populations.” Canadian Paediatric Society. 2022. cps.ca

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