It wasn’t so long ago that doctors would advise parents to give sick children only “BRAT diet” foods: bananas, rice, applesauce, and toast. The reasoning was that bland, low-fiber foods would be less likely to irritate an upset stomach and would produce less stool. Now the BRAT diet is no longer recommended since it lacks nutrients. Instead, the American Academy of Pediatrics (AAP) recommends that children go back to eating a regular, well-balanced diet within 24 hours of getting sick.
Don’t back off on breastfeeding
Suggestions for feeding infants with illness include the following:
- Breastfed babies should continue to breastfeed, even more than before. Breast milk is easiest on your child’s digestive system, and the immune factors your body produces in response to your child’s illness give an important boost to your child’s immune system.
- Infants on formula should continue to formula-feed unless their health care provider recommends otherwise.
- Watch for dehydration. Signs of dehydration include fewer wet diapers, lack of tears during crying, fever, dry mouth, weight loss, extreme thirst, listlessness, and sunken eyes. Sunken fontanelles (the soft spots between the bones of the skull) may also be noticeable.
- If your child is younger than 6 months of age, do not give water or any fluids other than breast milk or formula without consulting your baby’s health care provider.
Follow your child’s lead
For feeding older children, here are some guidelines:
- Don’t make your child eat if she has no appetite. There is no need to force her to eat. When possible, offer small amounts of food throughout the day instead of larger meals. As long as she’s drinking liquids and staying hydrated, solid foods aren’t necessary.
- Don’t restrict food when he feels up to eating. ( The old adage “starve a cold, feed a fever” is actually a myth.)
- Consider giving your child probiotics. They stimulate the growth of healthy bacteria in the gastrointestinal tract. Yogurt (2–6 ounces twice a day) is the easiest source of probiotics. Kefir is another popular option. Both yogurt and kefir are available in frozen forms, which may be more appealing since they are cold, dissolve slowly on the tongue, and are similar to ice cream.
- Generally, starchy foods (dried cereals, bread, crackers, noodles, mashed potatoes, and rice) should be offered in addition to the child’s regular diet, while fatty foods and sugary foods (including beverages like soda) should be avoided.
- If your child is vomiting, the AAP recommends that for the first 24 hours, you “keep your child off solid foods, and encourage her to suck or drink small amounts of electrolyte solution, clear fluids such as water, sugar water (1/2 tsp. of sugar in 4 ounces of water), popsicles, and gelatin water (1 tsp of flavored gelatin in 4 ounces of water).”
Give favorite fluids
When giving clear fluids, the type you choose may not be as important as how much your child drinks. A randomized study of 647 children ages 6 months to 60 months with mild gastroenteritis and minimal dehydration at a pediatric clinic in Toronto, Ontario, compared treatment focused on electrolyte solution with use of diluted apple juice and other preferred fluids. The research team found that fewer children who received apple juice or other preferred fluids needed follow-up care with intravenous fluids for dehydration than children in the electrolyte solution group. So give your child what he likes.
If your child is unable to keep clear liquids down—if even small sips cause vomiting—or if the symptoms worsen, contact your child’s health care provider right away.