Update on Diarrhea

• On the basis of recent epidemiologic evidence, norovirus has supplanted rotavirus as the most common cause of infectious diarrhea in the postvaccine era in the United States. • On the basis of some research evidence as well as consensus, infants with milk protein-induced proctocolitis ("cow milk protein intolerance") may attempt reintroduction of milk- and soy protein-containing products as early as age 6 months. • On the basis of strong evidence, using a validated tool to assess and classify the severity of dehydration in children with acute diarrheal illness is recommended to guide management decisions. • On the basis of strong evidence, rapid initiation of oral rehydration with oral rehydration solution is the preferred method for replacing fluid and electrolyte losses in the setting of acute gastroenteritis. • On the basis of strong evidence, reintroduction of regular ageappropriate feedings, including milk, after initial fluid resuscitation is the standard of care for acute diarrheal illnesses. • On the basis of some research evidence as well as consensus, ondansetron therapy in select patients with vomiting related to acute gastroenteritis may be effective, but safety in children remains to be established. Copyright © 2016 by the American Academy of Pediatrics. All rights reserved.