Diarrhea

What is diarrhea?

Diarrhea is the term used to describe loose, watery stools that occur when food and fluids pass too quickly or in too large an amount through the lower bowel (colon). The colon normally absorbs liquids from the foods we digest, creating semi-solid stools, but if the liquids aren’t absorbed, stools remain watery.

As children get older, it becomes easier to identify diarrhea and treat it accordingly, but when babies are involved, it can be hard to tell whether they’re having diarrhea or normal stools. This is especially true for exclusively breastfed babies. In the absence of solid foods, normal breastfed poop resembles diarrhea (watery). Also keep in mind that babies have several bowel movements a day, sometimes after every meal, so recognizing changes in your baby’s stool pattern is the key to identifying diarrhea. If the number or size of stools your baby typically has each day doubles or the consistency changes, becoming looser and more watery, your baby may have diarrhea.

What are diarrhea symptoms?

Diarrhea’s signature symptom is frequent, loose, and watery stools. Your child may also experience abdominal cramping, abdominal pain, fever, blood in the stool, and bloating.

How do children get diarrhea?

When diarrhea plagues your child, several things could be the culprit:

  • Viruses, such as the rotavirus. If your child’s diarrhea is viral, he may also vomit and have abdominal pain, fever, and chills.
  • Bacterial infections, such as E. Coli, Salmonella, or shigella. These infections may also cause cramps, fever, and blood in your child’s stool.
  • Parasites. If a parasite is the culprit, your child will likely have watery diarrhea for about two weeks. 
  • Food intolerance, sensitivity, or allergies. Symptoms related to these three issues include gas pains, cramping, and nausea. A food allergy will also likely cause other symptoms, such as a rash or respiratory issues.

How is diarrhea treated?

If your child has mild diarrhea, he can most likely continue to eat and drink normally and should be diarrhea-free within a couple of days. Breastfed babies should continue to breastfeed. But if your baby is formula-fed or has been weaned to cow’s milk and seems bloated or gassy, your pediatrician may suggest a temporary change in diet.

With more severe diarrhea, you may feed your child smaller amounts of food and offer foods that are bland and easy on the stomach. For children taking solids, most pediatricians recommend the BRAT diet (bananas, rice, applesauce, and toast) to make the stools more solid. The American Academy of Pediatrics (AAP) recommends giving your child electrolyte solutions (such as Pedialyte) to replace the water and salts that are lost during bouts of mild to moderately severe diarrhea. Though the AAP states that brand name and generic brands are equally as effective, it does warn against trying to prepare such fluids yourself. 

Diarrhea caused by parasites may need to be treated with oral medication, so you'll want to consult with your child's pediatrician. Do not give your child anti-diarrhea medicine unless your pediatrician recommends it.

How can diarrhea be prevented?

The best way to prevent diarrhea is to wash your hands and your children’s hands frequently to avoid contracting viral or bacterial infections. In the event that your child has food sensitivities or allergies, avoid serving him the offending foods, and if he’s older, make sure he’s aware of the foods that cause problems.

When should I call a doctor?

Contact your child’s physician if the diarrhea doesn’t improve after 24 hours. Additionally, parents should seek immediate medical attention if their baby shows signs of dehydration, including:

  • Dry diaper for more than three hours
  • Fever greater than 102°F
  • Bloody or black stools
  • Dry mouth or cries without tears
  • Unusually sleepy, drowsy, unresponsive, and irritable
  • Sunken appearance to the abdomen, eyes, or cheeks
  • Skin that doesn’t flatten if pinched and released

Last updated June 9, 2020

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