Babies and diarrhea

Definition

Alternative Names

Diarrhea and babies

Information

Normal or healthy baby stools are soft and loose. Babies have frequent stools during the first 1 - 2 months. Because of this, it may be difficult to tell when your baby has diarrhea.

Most babies have a stool pattern that is typical for them. This pattern may change slowly over time. Look for the following to help decide whether your baby has diarrhea:

• A sudden increase in how often your baby has stools
• More than one stool per feeding
• Stools that appear to be more watery

If your baby is feeding poorly, or has nasal congestion or a fever, the changes you notice are more likely to be diarrhea.

Most diarrhea in children is short-lived. It is usually caused by a virus, and goes away on its own. Other causes of diarrhea include:

• A change in the baby's diet or the breast-feeding mother's diet
• Use of antibiotics by the baby or breast-feeding mother
• Rare diseases such as cystic fibrosis

Infants and young children (under age 3) can dehydrate quickly, so they should be watched very carefully. Dehydration means that the body does not have enough water or liquids.

Signs of mild dehydration:

• Dry eyes and crying with few tears or no tears
• Fewer wet diapers than usual
• Less active than usual or irritable
• Slightly dry mouth

Signs of moderate dehydration:

• Dry skin that is not springy
• Sluggish or lethargic
• Sunken appearing eyes

Signs of severe dehydration:

• No urine output in 8 hours
• Skin that is pinched between fingers fails to spring back to its original shape
• Sunken fontanelle (the soft spot on top of the head) in infants
• Very lethargic or possibly unconscious

HOME CARE

Make sure the child gets plenty of liquids.

• If you are nursing, the doctor will probably recommend that you continue nursing. Breast-feeding helps prevent diarrhea, and it also speeds recovery.
• If your baby still seems thirsty after or between nursing or feeding sessions, you can add an oral rehydration solution, such as Pedialyte. Often, your pediatrician will recommend extra fluids that contain electrolytes. Follow the doctor's instructions. Do not use sports drinks for young infants.

Talk to your pediatrician right away if there are signs of dehydration. If the infant develops signs of moderate or severe dehydration, he or she should be seen right away.

The following can help prevent diaper rash:

• Air drying
• Frequent diaper changes
• Protective ointments and creams, such as Desitin
• Rinsing the bottom with water

Cut down on baby wipes during diarrhea.

Call your pediatritian if:

• A newborn (under 3 months old) has diarrhea
• Diarrhea contains blood, mucus, or puss
• Fever and diarrhea last for more than 3 days
• The child appears dehydrated
• The child has more than 8 stools in 8 hours
• The diarrhea does not go away in older infants or lasts in children for 2 days or longer
• Vomiting continues for more than 24 hours

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References

Canavan A, Arant BS Jr. Diagnosis and management of dehydration in children. Am Fam Physician. 2009;80:692-696.