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14 month baby started having very sour smelling diarrhoea. Giving brat diet. Any suggestions?

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Pediatrician, Cardiology
Practicing since : 2006
Answered : 1791 Questions
Our 14 month old daughter started having very sour smelling diarrhoea earlier this morning. She has had about 6 BM movements today. The corresponding diaper rash is severe, but expected with the rate of the BMs. Her overall demenor is great. She is still happy and cheerful, except when she has gas or a BM, then she seems to be in pain.
I have looked into Rotavirus symptoms, and she does not have a fever or any vomiting. We have started the BRAT diet and ensuring aht she stay hiydrated. In the morning I will pick up Pedialyte to give her as well. Any other suggestions?

Update- las tnight she had 7 BM, the same as before. Her bottom is very painful for her, as her rash is so bad. We use to use Desatin, and at times a triple ointment that ws prescribed to us, but the last time we used both it made the rash worse. We are using baby bpowder and "naked baby time" to help with the rash, which is not fun with all the BMs.
Thank you in advance.
Posted Sun, 4 Nov 2012 in Digestion and Bowels
Answered by Dr. Pradeep Kumar 59 minutes later
Thanks for writing to us
You are right, as diarrhea due to Rotavirus infection is associated with fever and vomiting in most of the cases, But there is always a variation in clinical symptoms. Beside this there are so many other viruses( like adenovirus, calcivirus, enterovirus) which can also cause this. Most of the diarrhea in this age group is due to viral infection only, if not associated with blood or mucus in stool. Foul smell may be due to unabsorbed carbohydrates, which along with increased bowel movements also causes pain in abdomen.This bowel pattern can persist for 4-7 days( the time taken for intestinal epithelial cells to regenerate)
Rashes in perianal area during diarrhea is due to
1)unabsorbed carbohydrates making the stool acidic and causing denudation of the skin
2) Ammoniacal reaction of urine
3)wet skin itself makes it prone for denudation
So, I would suggest you to continue giving BRAT diet and ORS( Pedialyte) to maintain the hydration and nutrition of the baby. You can also give Zinc syrup(This will help in better epithelialisation ) and probiotics( for maintaining normal gut flora).
Watch for danger signs like decreased urine output, decreased oral intake or any blood in stool.
Change the diaper frequently and keep the area dry by gentle wiping by tissue paper( don't rub).Apply Diaper rash cream after making the area dry only.
I hope this answers your query well
I will be happy to answer any further queries
I wish him an early recovery
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