I am especially interested in responses from primary healthcare providers
like pediatricians and nurse practitioners who routinely manage toddlers
with GI symptoms.
What would be your general recommendation for a toddler 17 mo old, bf and
complementary foods, no formula, who has had vomiting for couple days, now
resolved, and diarrhea now? Mother states the child had bowel motions at
10a, 12n, 1p when I spoke to her around 1p (so does not sound excessive
diarrhea), does pass lite urine, continues to want to bf, every 1/2 hr
during this illness. Refuses other offers of pedialyte, popsicles, jello,
etc.
Mother has been advised by ER to d/c bf, give pedialyte due to lactose
intolerance from the diarrhea. Mother instinctively feels to continue to bf
as child keeps most of it down and child strongly desires to nurse. Mother
is symptomatic as well w/ vomiting, diarrhea. No meds on either.
I have read Jack Newman, Ruth Lawrence, and WHO Jim Akre (Physiological
Basic for Feeding) and all confirm my understanding that bf should continue;
WHO further states rapid re-feeding after initial rehydration (if in fact
child is dehydrated). Child did get a short course of IV fluids in ER. Sent
home. Had fever at onset of illness, now afebrile. Mom knows s/s
dehydration. Thanks.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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