What do you give 5 year old for diarrhea?
Moms View Message Board: Parenting Discussion: What do you give 5 year old for diarrhea?
We will ask the pharmacist too, but you have any suggestions?
Well, a lot of times, they tell you to let it run its course for a little while because it is getting rid of a bug. Don't know how true that is, just what I've heard. Of course, not to the extent that they are going so much they will dehydrate.
That said, my children take Pepto Bismol. My ped told me it was safe for them. My son is only six, and he has taken it for a couple of years now when needed. I give him one/third of a chewable tablet. He loves them.
They also now have new Children's Pepto. But we'll stick with the regular stuff because I have to use it and ds loves it, so it's simpler for us to use the same thing. The chewables are also great to have on hand because you can take them anywhere so anytime a little belly ache or nausea creeps up, you have it.
Hope everyone starts feeling better!
My sister in law told me never to give Pepto Bismal to kids because it might cause reyes syndrome. Don't mean to be a know it all but I guess it is important for everyone to know...
Reye's Syndrome
by Leigh Ann Reynolds, M.S.S.W., M.P.A.
What is Reye's syndrome?
Reye's (pronounced "rye") syndrome is a disease which is believed to be caused by the ingestion of medicines (such as aspirin) that contain salicylate (pronounced "sa(LISS(a(late") that affects all organs of the body, but affects the liver and brain most lethally. It occurs when abnormal accumulations of fat develop in the liver and other organs of the body, along with a severe increase of pressure in the brain. It affects mostly children and teenagers and appears soon after flu-like infection or chicken pox. Reye's syndrome occurs most frequently during the months of January, February and March when influenza is most common, although cases have been reported throughout the year.
Reports of the syndrome appeared as early as 1929, but it wasn't until 1963 that the symptoms were first recognized as a distinct disease by R. Douglas Reye, M.D., an Australian pathologist. Dr. Reye suspected that a drug or poison (later identified as aspirin) triggered the disease's development, but there was no proof of such a substance in the homes of the children who acquired the illness, nor did autopsies reveal the presence of any such substance ingested by the child.
Can taking aspirin cause Reye's syndrome?
Although the exact cause of this rare syndrome remains unknown, research has shown that the ingestion of aspirin during and after a viral illness, such as chicken pox, flu or other respiratory tract illness, significantly increases the chance of Reye's syndrome. One study found that 90 percent of patients with Reye's syndrome had taken aspirin before or during a viral illness. Most of those affected (96 percent) took medications containing aspirin on or before the third day of illness. Another study found that children with the syndrome were 35 times more likely to have used aspirin than those who did not take any aspirin (Huritz, 1988; Huritz, et.al., 1987). Due to these findings, people (especially children) with viral illnesses are encouraged not to use aspirin or any medications containing aspirin since it could cause Reye's syndrome.
By the 1980s, reports of the danger associated with aspirin use were publicized, spurring a marked decrease in its use among children with viral illnesses. This decrease in aspirin use was accompanied by a decline in reported cases of Reye's syndrome. The decline has been most dramatic in those 5 to 10 years of age (Hurwitz, 1988). In 1988, the Food and Drug Administration (FDA) required aspirin manufacturers to add warnings to product labels about the possible association between Reye's syndrome and aspirin. The label, which is still being used today, reads: Children and teenagers should not use this medicine for chicken pox or flu symptoms before a doctor is consulted about Reye's syndrome, a rare but serious illness reported to be associated with aspirin (Zamula, 1990).
Most people are surprised to discover that giving over the counter medication during or after a time of illness can bring serious harm to children. However, aspirin contains salicylate which can accumulate within a child's body, resulting in Reye's syndrome. Many over the counter medications contain salicylates, including Pepto Bismol, Excedrin, Anacin, Bufferin, Coricidin, Triaminicin, Alka-Seltzer, Aspergum and Dristan tablets. Due to the danger associated with taking aspirin, doctors recommend that children be given medication containing acetaminophen (pronounced "a(SEE(ta(men(o(fen") which is found in non-aspirin drugs such as Tylenol and Tempra. Acetaminophen is safer because it does not accumulate in the body with repeated doses as aspirin does. Both are equally effective in reducing fever and pain (Stehlin, 1987).
What is the incidence of Reye's syndrome?
Reye's syndrome is rare, affecting approximately one per one million individuals in the population. However, the number of known cases (along with milder cases) has increased as awareness of the syndrome has grown. In 1977, there were over 500 cases found by the Centers for Disease Control (CDC), but by 1985 the number of cases decreased to 93. The National Reye's Syndrome Foundation continues to track the number of cases, documenting approximately 50 per year. Reye's syndrome has been found to affect all ages, from a four day old newborn to a 59 year old individual. However, more than 90 percent of those affected are under age 15 (Zamula, 1990).
Research has found that as the incidence of Reye's syndrome decreased, patients with clinical features similar to those of Reye's syndrome were more likely to be due to inborn errors of metabolism (Rowe, Valle & Brusilow, 1988). Inborn errors of metabolism are disorders of metabolism that occur when cells are unable to produce proteins or enzymes which are needed to change certain chemicals into others. Some of the clinical and laboratory features of the syndrome can mimic those disorders found in metabolic disorders, making it difficult to establish an exact diagnosis.
What are the warning signs?
Reye's syndrome should be suspected if a pattern of certain symptoms appears either during or after a viral illness. Symptoms often occur AFTER an illness, such as the flu or chicken pox. Other viruses associated with Reye's syndrome include: Mumps, Rubella (German measles), Rubeola (measles), Polio, Epstein-Barr, Herpes Complex, Cytomegalovirus, Coxsackie A and B and Adenovirus 2 and 3 (Stehlin, 1987). Although many diseases have symptoms in common, Reye's syndrome can be identified when symptoms (which occur in two stages) are carefully noted so that an observable pattern emerges.
Reye's syndrome can occur several days (1-14 days) after a viral infection and generally progresses through two stages. The first stage includes persistent or continuous vomiting, severe tiredness, belligerence due to illness (moodiness), nausea and loss of energy. The second stage follows with personality changes, bizarre mental and physical behavior (such as confusion, restlessness and irrational behavior), and lethargy or inactivity of the senses sometimes to the point of comatose and convulsions. Vomiting is often the first sign of Reye's syndrome, except for children under two who may have diarrhea or hyperventilate. The duration varies according to the severity of the disease. Symptoms can range from mild to serious, possibly progressing to death. However, its progression can also stop at any stage allowing for full recovery in five to ten days.
Why is early diagnosis important?
Early diagnosis is vital. Unless the individual with Reye's syndrome is properly diagnosed and treated successfully, death is common and may occur in only a few days. The earlier the diagnosis and treatment, the better the chance of survival. There is a 90 percent chance of recovery for those diagnosed early and only a 10 percent chance of recovery for those diagnosed late. The fatality rate among those with Reye's syndrome is 52 percent (National Reye's Syndrome Foundation, 1996).
If the child does survive there can be lasting effects, depending on the severity of the swelling of the brain. These children often have neurological abnormalities resulting in mental retardation. While some have slight to severe brain damage, others appear to recover completely. Psychological and neuropsychological testing should be conducted to determine the extent of impairment that was sustained as a result of the syndrome.
Due to the speed at which the illness can progress, it is important to be informed of the warning signs associated with this condition in order to identify its existence as soon as possible. This can be difficult since doctors are often unfamiliar with this disorder due to its rarity. Medical staff in emergency rooms sometimes misdiagnose Reye's syndrome as encephalitis, meningitis, diabetes, poisoning, mental illness or drug abuse, since the incidence of the syndrome is low, and many people are still unaware of its existence. Writing down the child's specific symptoms (including the exact description and frequency of behaviors) and requesting the doctor's careful documentation of the symptoms within the child's medical file is crucial in obtaining a more timely and accurate diagnosis.
How is Reye's syndrome treated?
Although there is no cure for Reye's syndrome, treatment can help reduce the effects caused by the disorder. Treatment is typically provided in an intensive care unit at a hospital. Children affected by this disorder require intensive monitoring of their fluids, electrolytes, blood gas status and nutrition. The amount of pressure of the fluids within the skull, as well as blood pressure, is closely monitored. Barbiturates and other drugs may be given to reduce this pressure and cool body temperature. Insulin is often given to increase glucose metabolism, corticosteroids to reduce brain swelling and diuretics to increase fluid loss. Patients are not given any food by mouth, but are fed intravenously. A breathing machine or respirator may be needed if the child begins having greater difficulty in breathing. The outcome of each case depends, in large part, on the amount of swelling that occurred in the brain (Kids Health Organization, 1996).
Where can I get more information about Reye's syndrome?
The National Reye's Syndrome Foundation, formed in 1974 by parents of affected children, can provide educational materials, telephone counseling, information on support groups and other assistance. The foundation has 120 volunteer affiliates in 43 states. To find out if there is a local chapter near you, contact the National Reye's Syndrome Foundation (426 North Lewis Street, Bryan, OH 43506) at 1-800-233-7393.
QUICK FACTS
Condition: Reye's syndrome (pronounced rye); a disorder that affects all organs of the body, but most lethally affects the liver and brain
Link to Mental Retardation: Children who survive are often left with neurological abnormalities and mental retardation
Primarily affects: Children and teenagers
Symptoms: Stage 1: Continuous vomiting, nausea, loss of energy, signs of brain disorder, such as drowsiness, listlessness and staring
Stage 2: Irritability, aggressive behavior, delirium, disorientation, slurred speech, convulsions, may not recognize parents, possible comatose
Incidence: Approximately one per one million individuals is affected
Cause: Unknown, but strongly associated with aspirin use taken during or following viral illness, such as chicken pox and flu
Treatment: No cure; treatment requires intensive hospital care focusing on reducing swelling of the brain
Contact for more information: The National Reye's Syndrome Foundation at 1-800-233-7393 ( http://www.bright.net/~reyessyn)
References
Hurwitz, E.S. (1988). The changing epidemiology of Reye's syndrome in the United States: Further evidence for public health success. JAMA. Vol. 260, No. 21.
Hurwitz, E., Barrett, M., Bregman, D., Gunn, W., Pinsky, P., Schonberger, L., Drage, J., Kaslow, R., Brulington, B., Quinnan, G., LaMontagne, J., Rairweather, W., Dayton, D., & Dowdle, W. (1987). Public Health Service study of Reye's syndrome and medications: Report of the main study. JAMA. Vol. 257.
Kids Health Organization (1996). Childhood infections: Reye's syndrome. [On-line]. Available: http://kidshealth.org/parent/common/reye.html
National Reye's Syndrome Foundation. (1996). Because you need to know [Brochure]. Bryan, Ohio.
Rowe, P., Valle, D., & Brusilow, S. (1988) Inborn errors of metabolism in children referred with Reye's syndrome. JAMA. Vol. 260, No. 21.
Stehlin, D. (October, 1987). As use of kids' aspirin drops, so do cases of Reye syndrome. FDA Consumer, p. 20-21.
Zamula, E. (November, 1990). Reye Syndrome: The decline of a disease. FDA Consumer, p. 21-23.
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Adena is right, dehydration is the major worry. Beyond that, give him food easy to digest that will help with the diarrhea. Chicken and rice soup is good - rice is always good with diarrhea. I'd stay away from milk for a couple of days because it actually is hard to digest, but lots of water. I'd also stay away from juices as much as possible. or use juice mixes that are mostly water. Weak tea with honey is also good, and soothing to the stomach. If he'll eat it, natural yogurt or even flavored yogurt (but without fruit in it) would probably be good. Don't ask me why because I don't remember, but yogurt is easy to digest where milk is not. No other fruit, but bananas, within reason, are good and easy on the stomach.
Adena is also right, you probably want to let his system get rid of whatever it is trying to get rid of, so some strong anti-diarrhea medicine is probably not a good idea, at least not right away. The Pepto sounds like a good idea. As I remember, your son is about the same age as her son, so the 1/3 of a chewable tablet would probably be OK, or maybe 1/4, to be on the safe side. But do check the label first.
BRAT diet (Bananas, Rice, Apples/Applesauce, Toast/Crackers) as tolerated, any liquids. Flat Coke will often help an upset stomach, Gatorade and Pedialite are good too. Popsicles also. I usually don't give my kids meds for diarrhea. Just try to keep them hyrdated and let it work its course---usually no longer than 24 hours.
Hmmmm.... Thanks Fiona for the info on the Pepto. Never realized it had aspirin in it. Wonder if the reason the drs. are okay with this is because of the small amount in it? I'll have to check into this.
I wonder if they leave the aspirin totally out of the Children's Pepto that they have developed?
I do the same as Pam, the BRAT diet. I don't give any medicine for diarrhea either.
If you dig a little deeper, Pepto does NOT have aspirin in it. Some cold medicines may indeed have aspirin in it, but most have Tylenol/Motrin/Advil-type pain relievers because of the worry about Reyes' Disease.
Here is the official response from Pepto-Bismol's website:
"Can Pepto-Bismol cause Reyes syndrome?
The cause of Reye's syndrome is still not understood despite a tremendous amount of research. However, the FDA-mandated warning for aspirin- and non-aspirin-containing products states, "Children and teenagers should not use this medicine for chicken pox or flu symptoms before a doctor is consulted about Reye's syndrome, a rare but serious illness reported to be associated with aspirin." There is no aspirin in Pepto-Bismol. The active ingredient in Pepto-Bismol is bismuth subsalicylate, a non-aspirin salicylate. Salicylates are commonly used as flavoring agents in food (wintergreen). The United States Food & Drug Administration's OTC Final Anti-Diarrheal Monograph states that there is no definitive evidence that associates use of non-aspirin salicylates with an increased risk of Reye's syndrome.
P&G has voluntarily included a Reye's syndrome label warning since 1985. P&G includes this label warning to encourage consumers and parents to consult a doctor for children and teenagers who have or are recovering from the flu or chicken pox, if nausea or vomiting occurs. These symptoms can be an early sign of Reye's syndrome, a rare but serious illness. Those suffering from Reye's syndrome should contact a doctor as soon as possible."
Taken from this website.
"Can Pepto-Bismol cause Reyes syndrome?
The cause of Reye's syndrome is still not understood despite a tremendous amount of research. However, the FDA-mandated warning for aspirin- and non-aspirin-containing products states, "Children and teenagers should not use this medicine for chicken pox or flu symptoms before a doctor is consulted about Reye's syndrome, a rare but serious illness reported to be associated with aspirin." There is no aspirin in Pepto-Bismol. The active ingredient in Pepto-Bismol is bismuth subsalicylate, a non-aspirin salicylate. Salicylates are commonly used as flavoring agents in food (wintergreen). The United States Food & Drug Administration's OTC Final Anti-Diarrheal Monograph states that there is no definitive evidence that associates use of non-aspirin salicylates with an increased risk of Reye's syndrome.
P&G has voluntarily included a Reye's syndrome label warning since 1985. P&G includes this label warning to encourage consumers and parents to consult a doctor for children and teenagers who have or are recovering from the flu or chicken pox, if nausea or vomiting occurs. These symptoms can be an early sign of Reye's syndrome, a rare but serious illness. Those suffering from Reye's syndrome should contact a doctor as soon as possible."
My brother had Reye's Syndrome when he was in high school and a good friend of mine had it when we were in jr high. It's a very scary illness. I would not be worried about Pepto Bismol causing Reye's because it does not contain asprin, but any medication should be used with caution. Having said that, I'd also go with the BRAT diet and you can always give Gatoraide. The most important thing is to keep him hydrated. One to two teaspoons of water or other clear liquid at a time until he can handle more. Good luck.
Lol, Pam. We were posting at the same time. 
We've been told time and time again to just let it run it's course. Milk makes it worse, so hold off on that. Lots of water
Well, thanks Pam and Cat for doing the research so I didn't. I had to leave to go to my parents' right after my last post, so I came home and checked, and found these. Makes me feel so much better because I have always used this for upset stomach. My kids never really have issues with diarrhea, and when they do, it's only a few times, so I let it go. But they do use it more often for nausea.
I know no one has ever heard of this but I would suggest trying Cranberry Juice. It does not make diarrhea worse like apple juice would.
I had IBS (irritable bowel syndrome) for years and my doctor recommended drinking cranberry juice. It has always worked for me.
Thanks for the advice. The pharmacist gave him imodium. We had to give him something because there was a big mess on the floor and bed .... twice. and ever single pair of underwear was being used in minutes... Poor kid... What a mess.
If pepto bismal caused a few people to get reyes syndrome then admitting they caused reyes syndrome that would cause them to liable to law suits. So they say now not to use and ask a doctor but we didn't cause reyes syndrome. Anyway it is good to know to be careful giving kids adult medicine without checking with doctor or pharmacist. I am paranoid about it now because of what my sister in law told me about aspirin. Everyone know not to give baby aspirin to kids or babies... (I think that is right.)
It looks like everyone but pepto says not to take pepto for kids and teens. So I don't know what to say about that...
http://www.nlm.nih.gov/medlineplus/ency/article/001565.htm
I have no idea if pepto is safe or not but the med line and the government web site says don't take it if you are a child or teen. And pepto says to ask a doctor before giving pepto to kids and teens so decide for yourself.
You can do you own research and ask you doctor or pharmacist if pepto is safe for kids or teens.
http://www.google.com/search?hl=en&rls=GGLC,GGLC:1969-53,GGLC:en&q=pepto+bismol+reyes+syndrome&spell=1
http://www.nlm.nih.gov/medlineplus/ency/article/001565.htm
I have no idea if pepto is safe or not but the med line and this government web site says don't take it if you are a child or teen.
Also
http://www.reyessyndrome.org/aspirin.htm
says don't take pepto. And Pepto says ask your doctor before giving to kids and teens... Reminds me of the tobacco institute... somehow...
Adult pepto contains Bismuth subsalicylate 262 mg. Salicylate has been indicated in causing Reyes Syndrome in children particularly with viral illness and fever. Looking at the children's tablets ingredients it does not have salicylate. It has Calcium carbonate 400 mg as its active ingredient, so no salicylate. The website does not say that children's pepto tablets will help diarrhea. I would still ask your doctor or pharmacist to be sure about the children's pepto. I would NOT give adult pepto to my child because of the salicylate. I just finished up my pharmacology class and we were taught that the only safe (in regard to Reyes) pain/fever reliever for kids with fever is acetaminophen (Tylenols).
My son has had it a few times and each time i give him a sort of powder diluted in water with electrolytes to prevent dehydration. It cures it almost immediatly. I tell my son to sip it slowly, and i don't usually give him any food for a couple of hours. Once the body salts are replaced the diarrhoea stops. It works wonders. I buy it at the chemist without prescription (it's a bit like gatorade) and it's called "dioralyte" in the UK.
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