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13 month old child, vomiting, diarrhea, no appetite, loose stools. Oral hydration, electrolyte replacement. Treatment?

we are on vacation and my 13month old son started vomiting his milk (powdered milk w/ distilled bottled water), the second day he started having smelly diarrhea and no appetite . the third and fourth day, he only vomits in the morning and his stools have been just water and cottage cheese consistency, no pungent smell. we went to the ER, stool was negative for ova and parasite. we were sent home w/ oral hydration w/ electrolyte replacement. today is the 5th day and he still has no appetite. the weather here is also very hot so we just stay indoors most of the time where there is air conditioning.
Asked On : Fri, 6 Apr 2012
Answers:  1 Views:  462
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General & Family Physician 's  Response
Hello and welcome to

Baby diarrhea can be caused by a number of things, ranging from a change in diet to an intestinal infection. Any of the following can cause diarrhea in babies:
1) infection caused by a virus, bacteria, or parasite
2) food allergy or sensitivity to medicines
3) drinking too much fruit juice
4) poisoning

Babies can pick up the bacteria and viruses that cause diarrhea through contact with contaminated food or water, or by touching contaminated surfaces and then placing hands into mouths.

Frequent hand washing is important to prevent diarrhea, especially before and after eating, and after using the bathroom. Keep bathroom and kitchen surfaces clean and maintain safe food handling.

Diarrhea can affect the baby's normal balance of water and salts (electrolytes). When too much water and electrolytes are lost in diarrhea, babies can become dehydrated. Dehydration can happen very quickly in babies -- within a day or two after the diarrhea starts.

Look for these signs of dehydration in your infant:
- urinating less often than usual (fewer wet diapers)
- irritability
- signs of thirst
- dry mouth
- no tears when crying
- unusual drowsiness or lethargy
- sunken soft spots on the top of the baby's head
- skin that isn't as elastic as usual (doesn't spring back when gently pinched and released)

Call your pediatrician or go to the nearest emergency room if you see any of the signs of dehydration listed above, or if:
- Fever of 101.4 degrees F or higher
- Abdominal pain
- You notice blood or pus in the baby's stools, or the stools are black, white, or red
- Your baby is very lethargic or is vomiting

If your child is on solid foods, your doctor might recommend switching to bland, starchy foods like strained bananas, applesauce, and rice cereal until the diarrhea stops.

Diarrhea that's caused by a viral or bacterial infection is very contagious. Wash your hands with warm water and soap every time you change your baby's diaper to prevent the infection from spreading. Keep the diaper-changing area clean and disinfected.

In all liklihood, your child has picked up a virus. Unfortunately, only the passage of time will be the main predicator of when he will get better. I sympathize with you. Sick children while on vacation is not ideal for the child or the parents.

Be well,
Dr. Kimberly
Answered: Fri, 6 Apr 2012
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