Help! My child has diarrhea! What do I do? With the winter, we are all indoor more. This makes the spread of illness much more likely. Consider daycare and school as little petri dishes, a breeding ground for germs. We can’t completely isolate our kids from germs or getting sick. In fact, if we were to never expose them to germs, their immune systems would not evolve. This would place them at higher risk of becoming severely ill if they did get sick. So the daily germs we are exposed to are helpful. You can even think of it as small vaccinations throughout the day. But when is a little cold or stomach infection a problem?
Many patients are concerned about diarrhea and the recent Escherichia Coli (E. Coli) outbreak in lettuce. E. Coli is a germ that is found in stool. It can be in human or animal feces. Certain forms of E. Coli live naturally in our gut and do not cause problems. They help us to digest our food. However, certain strains of the bacteria can cause infection. One of the most problematic is E. Coli: H0157. This is a specifically virulent (strong) form. It can cause high fevers, bloody diarrhea and severe abdominal cramping. Occasionally, it can cause sepsis (a blood infection) or kidney failure. 32 people became ill from contaminated romaine lettuce in 2018; 13 of those people required hospitalization. Most of the contaminated romaine lettuce that caused the infections came from the central valley of California.
The number of cases has sharply decreased since June of 2018. However, the Center for Disease Control (CDC) has recommended that you do not eat any romaine lettuce at all. Companies will now label lettuce to inform the consumer where it was harvested. Therefore, if your lettuce is not from the California central valley, you can safely eat it. You should still always wash the lettuce well prior to eating it. This will not remove all the bacteria but as lettuce has many crevices where germs can hide, it will lessen the load of infection. The likelihood of getting an E. Coli infection is low. However, if your child has bloody diarrhea, fever, chills or swollen face and decreased urine output and has consumed lettuce from central California, notify your healthcare provider.
Routine gastroenteritis (or stomach flu” which is not the flu from influenza virus) is not dangerous. If the diarrhea is not bloody, does not have mucous and the child is able to tolerate fluids, you can treat at home. Give small frequent fluids like Pedialyte or flat (decarbonated) Sprite, Ginger Ale or 7-UP. This will provide some sugar and salt which is necessary to absorb water and prevent dehydration. Most diarrhea infections last 2-4 days. If it is not decreasing in volume and frequency by then, you need to be seen. Otherwise, just be patient. The body is expelling the germ in the diarrhea and will heal itself. So, when do you need to seek medical attention? If your child is vomiting and unable to keep liquids down, diarrhea is more than 6 x in a day, diarrhea is bloody, mucous in the diarrhea, urinating less than once every 12 hours, puffy face or diarrhea lasts more than 4 days, your child is lethargic, call you doctor. If there is fever > 103F, chills or your child is lethargic, go to the ER or urgent care.
Here is wishing you a healthy winter season and one with few tummy germs!