Diarrhea
Diet for Diarrhea
We define diarrhea as loose/watery stools occurring 4 or more times per day.
The 2R approach to treatment consists of early replacement of lost fluids and minerals (rehydration) and well-timed introduction of appropriate foods (realimentation), with the goal of preventing further damage to the intestinal lining and the development of chronic diarrhea.
Rehydration – Replacing Lost Fluids:
• Complex method: Ideally, children should be given an oral rehydration solution (ORS), such as Kulíšek, Enhydrol, Fluidex (advantage: effervescent tablets), or BioGaia ProTectis Plus. ORS should be served chilled to 8°C – place the first batch in the freezer for an hour to cool it quickly; prepare the second batch at the same time and keep it in the fridge. These solutions often taste unpleasant to children, which is why serving them cold is helpful.
• Simple method: If the child refuses the ORS or if preparing it feels too complicated, you can use regular fluids – a mild black tea (steeped for 30 seconds) – black tea has astringent effects on the intestinal lining. Hibiscus tea is also worth trying. Sweeten the teas with grape sugar (glucose, e.g., Glukopur), not regular beet sugar, which worsens fermentation processes in the gut. As a third step, add a shot of Fatra or Sulinka mineral water to the tea (for minerals). Avoid concentrated fruit juices, regular juices, and fizzy drinks.
Realimentation – Reintroducing Nutrition:
• If the child is breastfed, continue breastfeeding. Between feeds, you can offer ORS or plain water.
• If the child is on formula, continue with the same formula used before the illness, but temporarily switch to a Low Lactose version (IMPORTANT!) – i.e., a formula with little or no lactose. Between milk feeds, offer ORS. It's best to prepare the milk with rice water, which you can easily make at home: Boil 1 tablespoon of rice in 1 liter of baby water for one hour. Replenish any evaporated water back to 1 liter, strain the rice, and use the resulting decoction to prepare the milk. Diluting formula, as was done in the past, is no longer recommended. Complete elimination of milk is not necessary!
• For older children, give ORS for the first 4 hours, then reintroduce food if symptoms are not worsening. Avoid foods high in fats and sugars. Offer:
• Plain crackers, ladyfingers
• Boiled salted potatoes and rice
• Later: peeled apples, pears, bananas
• Boiled chicken (without oil or butter)
• Vegetable soup (avoid chicken broth at first)
• Stale bread
Avoid dairy products, including puddings and sweet yogurts.
Gut Flora Support:
Give probiotics to help restore gut flora – ideally Enterol 2 capsules twice a day, or 2 sachets twice daily for small children – this works quickly, effectively, and is completely safe.
To firm up the stool, you can also use Smecta/Sorbeca sachets, and B vitamins if needed.
Serve both food and fluids in small, frequent amounts, which helps reduce the risk of abdominal cramping.
If diarrhea lasts longer than 3 days, if the child refuses to drink, if the abdomen is tender, or if the overall condition worsens, especially in young children, and you as parents don't have experience with this situation – do not hesitate to contact a doctor. Replacing water and minerals may need to be done differently.
Most cases of diarrhea are viral and self-limiting (they resolve on their own with symptomatic treatment). However, some bacteria can cause diarrhea with fever, chills, and blood in the stool. Antibiotics are rarely needed, but if your child shows these signs, please contact us as soon as possible.