What to Eat for an Upset Stomach: Why Pediatricians Stopped Recommending BRAT

What does the evidence actually support

Before getting to what to eat, it's worth settling what actually works, and it isn't a food. The WHO and UNICEF have recommended a single oral rehydration salt formula for more than 25 years, regardless of cause or age, to prevent and treat dehydration from diarrhea. The formula was revised once: a lower-osmolarity version, with reduced sodium and glucose, was shown to improve outcomes in children with acute, non-cholera diarrhea. Children on the new formula needed 33 percent fewer unplanned IV drips. In a WHO-supervised trial across India, Brazil, Mexico and Peru, the group on the older, standard formula produced 39 percent more stool volume and had diarrhea that lasted 22 percent longer.

It is, at bottom, water with a precise ratio of salt and sugar. And it sits on the WHO's Essential Medicines List, treated as a drug. That's the single most solid sentence in this article.

The second thing people reach for is probiotics, and the evidence here has a more complicated shape. A 2010 Cochrane review found that probiotics shortened the average duration of diarrhea and reduced the number of children sick for more than four days. A follow-up review in 2020, re-analyzing 82 studies and 12,127 participants, landed closer to the opposite: probiotics probably make little or no difference to the number of people with diarrhea lasting more than 48 hours, and whether they shorten its duration is uncertain. That analysis leans on large, low-bias trials. The lead author said the finding was meant to discourage probiotic use in acute infectious diarrhea, for a specific reason: not to distract from something that actually matters, staying hydrated.

One number here needs to travel with every mention of this review: of the 12,127 participants, 11,526 were children and only 412 were adults. That review is not really an adult story, and it doesn't license the claim that probiotics don't work either. The review's own language is "probably makes little or no difference" and "uncertain," a decade after concluding the opposite. Both halves of that sentence have to stay together.

How do three countries handle it

Three places independently arrived at the same idea: rest the gut with something bland and starchy. Two of them are now backing away from that idea, and for the same reason.

Table: traditional advice for an upset stomach by country and its evidentiary weight. The one item with solid evidence isn't food.

United States: the acronym that got walked back

US

Americans have a name for this advice: BRAT. It travels the way most home remedies do, from a parent's mouth to a kid's memory, reinforced by how easy it is to say. And the body that effectively popularized it, the American Academy of Pediatrics, doesn't recommend it anymore.

The reason matters more than the reversal itself. It isn't that BRAT foods are hard to digest. By the account of a pediatric nutrition committee member, the problem is that they're short on fiber, fat and protein. Most children should keep eating a normal, age-appropriate diet; BRAT foods can be added in, but shouldn't replace what a child was already eating well. The shift followed evidence that most kids who stay on a normal diet recover just fine.

Clinical sources repeat one more point: staying on BRAT for more than a day can actually slow recovery. The guidance is to not withhold food from a hungry, sick kid, and not to give anti-diarrheal medication unless a doctor specifically prescribes it.

BRAT wasn't so much wrong as incomplete, and the honest version of the story is that a catchy acronym outlived the evidence behind it. Easy to remember beats accurate, and it took decades for the correction to catch up. Cold season shows the reverse outcome as well as the same one, with one national guideline putting honey first among self-care options while another government stopped reimbursing a popular remedy altogether: what six countries reach for when they catch a cold, and what survives an evidence review. The signs that turn this from an upset stomach into something requiring care, covered below, come straight from two CDC pages.

Japan: not just rice porridge and pickled plum

JP

In Japan, the advice when a stomach settles down is starchy, easy-to-digest food like okayu or udon. But a Japanese preventive-medicine association attaches a warning: if diarrhea drags on, meals tend to narrow down to just okayu with umeboshi (pickled plum), and that narrowing itself can cause a nutritional shortfall that prolongs the diarrhea. Its advice is to choose foods that digest easily but still carry enough protein and vitamins.

Neither the American pediatric society nor this Japanese group appears to have consulted the other. They landed on the same conclusion anyway: eating too plain for too long slows recovery down. That's the most interesting overlap in this whole piece.

South Korea: the porridge every household knows

KR

When an upset stomach hits in Korea, rice porridge is close to automatic. The practice of stepping up from thin rice gruel to porridge to regular rice is common enough that it barely needs explaining to anyone who grew up there. This article treats it as a cultural practice, not a proven remedy; no evidence was found either confirming or disproving it works.

What's better documented is Korea's health authority guidance on the underlying illness. The Korea Disease Control and Prevention Agency describes acute bacterial gastroenteritis as typically causing diarrhea, vomiting, abdominal pain and fever, with the possibility of serious complications like bloody stool or kidney failure in some cases. It spreads through contaminated food or water, undercooked meat or seafood, or contact with an infected person's stool, and the agency names hand hygiene alongside patient isolation and contact management as part of prevention, not just individual digestion.

What you can actually do

Once the three traditions are laid out side by side, the list of things actually worth doing gets short. In order:

Water and electrolytes come before food. The sturdiest evidence in this topic isn't attached to any food. It's oral rehydration solution, which the WHO and UNICEF recommend regardless of cause or age and which sits on the WHO's Essential Medicines List. It is sold pre-made at pharmacies, and that is as far as this article goes. Home-mixing ratios are not covered here: getting them wrong carries real risk, especially with a child.

If you can eat, eat. The American Academy of Pediatrics advises that most children keep eating a normal, age-appropriate diet, that BRAT foods can be added but shouldn't replace what a child was already eating well, and that sugary drinks and soda are worth avoiding. Its guidance also says not to withhold food from a hungry, sick child. The Japanese preventive-medicine association points the same way: once diarrhea eases, starchy easy-to-digest food like okayu or udon is fine, but meals shouldn't narrow to bland alone, so choose things that digest easily while still carrying enough protein and vitamins. Two bodies with no apparent knowledge of each other reached the same conclusion, which bears repeating here.

What that Japanese association puts on its avoid list. The same source names seaweed, mushrooms, konnyaku, vegetables and fruit as things to avoid, on the grounds that they digest poorly and irritate the gut. Spices, coffee, alcohol, carbonated drinks, garlic and onion are on the same list. Seeing vegetables and fruit filed under "avoid" reads differently depending on where you grew up. It is worth noting that this is one Japanese body's guidance, not an international guideline recommendation.

Hydration before probiotics. That was the lead author's stated reason for the 2020 Cochrane finding: saving the cost, and not distracting from an intervention that matters, staying hydrated. The caveat travels along: of the 12,127 participants in that review, only 412 were adults.

Wash your hands, and isolate when it's called for. Korea's disease control agency pairs fluid and electrolyte replacement with antibiotic treatment where the specific illness calls for it, and names patient isolation and contact management as necessary to stop the spread. Hand hygiene sits in the same passage. A stomach bug isn't always a thing you have alone.

Skip anti-diarrheal medication unless a doctor prescribed it. That is how the pediatric guidance reads. Which drug, if any, is a decision for a consultation, and this article does not name drugs.

When to see a doctor

The CDC's own pages don't agree on a single cutoff, which matters more than it sounds. One food-safety page lists diarrhea lasting more than three days as a feature of severe food poisoning; a separate page on E. coli infection lists diarrhea or vomiting lasting more than two days as a reason to call a doctor. The contexts differ, which is exactly why this article recommends watching for signs rather than counting days.

Those signs: bloody diarrhea, blood in stool or urine, a fever above 102°F (about 38.9°C), frequent vomiting, and signs of dehydration such as not urinating much, a dry mouth and throat, or feeling dizzy on standing. Fever with flu-like symptoms during pregnancy belongs on the same list. Korea's disease agency separately notes that this kind of infection can progress to complications like bloody stool or kidney failure.

Between 5 and 10 percent of people diagnosed with E. coli infection go on to develop hemolytic uremic syndrome, a life-threatening complication. That's uncommon, and the percentage applies to people already diagnosed with E. coli, not to everyone with an upset stomach. This isn't meant to alarm; it's meant to mark where the line sits between making a pot of porridge and going to see someone.

Frequently asked questions

Frequently asked

Is the BRAT diet still recommended?

No, not by the American Academy of Pediatrics. It's not that BRAT foods are hard to digest; they're just low in fiber, fat and protein, which can slow recovery if that's all a child eats for more than a day. Most kids should keep eating a normal diet suited to their age.

Do probiotics work for adults?

The most recent Cochrane review found little to no difference in diarrhea duration, but 11,526 of its 12,127 participants were children. There isn't a solid adult-specific answer here, and the review's own wording is "uncertain," not "doesn't work."

When should I see a doctor?

Watch for bloody stool, a fever above 102°F (about 38.9°C), frequent vomiting, or signs of dehydration like dizziness on standing, rather than counting days. Both US and Korean health authorities point to these signs over a fixed timeline.

What is ORS and where do I get it?

Oral rehydration solution is a precise mix of salt, sugar and water that the WHO treats as an essential medicine. It's sold pre-made at pharmacies. This article doesn't cover home-mixing ratios, since getting them wrong carries real risk, especially for children.