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DR. DAVID HILL: Today, we're going to talk about how to feed your infant with diarrhea. The first question is, does your baby really have diarrhea? A normal breastfed infant will often have a stool with every single feed. The stools are usually watery, yellow, greenish, brownish and seedy and all that's normal. For children who have a more established, firmer, more rare stool pattern, you have to ask yourself, "Do I care about this diarrhea?" A few episodes of loose stools are allowed before you really have to get concerned. But if they get to four or five loose stools in rapid succession, it's probably time to start doing something about it. We used to tell mothers to stop nursing or formula feeding their babies but now we recommend continuing to give formula or nurse straight through the illness even if the baby is vomiting. They still need that fluid. You might want to start supplementing as well with the balanced sodium and sugar solution like Pedialyte, Infalyte or K-Electrolyte. Give this solution in between nursing or formula feeding. The water, salt and sugar work together to bring fluid back into the baby's body. There are some fluids you don't want to give.
 Fruit juice may worsen the diarrhea because of indigestible sugars in the juice. Water does not have enough salt and can lead to salt imbalance as in baby's blood stream. Likewise, salty fluids like broth may have too much salt and cause problems in the other direction. If your baby is not vomiting, it's fine to continue feeding solids although you may want to go with more complex carbohydrates like apple sauce, bananas or rice cereal. If your baby is vomiting, don't stop giving fluids but you will want to hold off on food for a while. If your baby is having lots of diarrhea and frequent vomiting, you should probably seek care earlier rather than later. It's possible that a brief round of IV fluids can prevent a more prolonged hospitalization. To review, for babies with diarrhea, you definitely want to continue nursing or giving formula, possibly smaller quantities a little more frequently. You also may want to supplement with a balanced electrolyte solution for the baby like Infalyte, K-Electrolyte or Pedialyte.
 If they don't like that, you might make it cold or add a little bit of Kool-Aid for flavor. There are several serious signs that you want to seek care for immediately including blood in the stool or signs of dehydration. Food is okay as long as your baby is not vomiting but you might want to use more complex carbohydrates like apple sauce. And that is what to feed your baby with diarrhea.



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