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An occasional loose stool is typically nothing to worry about, but suddenly having looser, more frequent bowel movements probably means diarrhea. Causes of diarrhea include infections, too much juice, improperly mixed formula, and food allergies. Talk to your child's doctor, and above all keep her hydrated.
How can I tell if my baby or young child has diarrhea?
If your child's bowel movements suddenly change – that is, he poops more than usual and passes looser, more watery stools than usual – then it's probably diarrhea. An occasional stool that's looser than normal for your baby or child, though, is generally nothing to worry about.
Most cases of diarrhea in the United States are relatively mild and don't pose a major health threat, as long as your child doesn't get dehydrated. Dehydration can be very serious, even fatal, especially for a baby, so it's crucial that you make sure your child is getting plenty of liquids.
How long diarrhea lasts and what the best treatment is depend on the cause.
What causes diarrhea in babies and young children?
Common causes of diarrhea in kids include:
- A viral or bacterial infection in the digestive tract
- An ear infection
- A parasite
- Too much juice
- Improperly mixed formula
- A food allergy or intolerance
- A poisonous substance
Let's look at each cause of diarrhea in more detail.
Viruses – such as the rotovirus, norovirus, adenovirus, calicivirus, astrovirus, and influenza – can cause diarrhea, as well as vomiting, abdominal pain, fever, chills, and achiness.
Bacterial infection or food poisoning
Bacteria – such as salmonella, shigella, staphylococcus, campylobacter, or E. coli – can be responsible for diarrhea. Some bacterial infections clear up on their own. Others – like those caused by E. coli found in foods such as undercooked meat that cause food poisoning – can be very serious.
If your child has a bacterial infection, he may have severe diarrhea accompanied by cramps, blood and mucus in his stool, and a fever. He may or may not be vomiting. If your child has these symptoms, take him to the doctor. A stool culture can help determine if your child has a bacterial infection.
Diarrhea can accompany a viral or bacterial ear infection. This is more common in children younger than 2. Your child may pull on her ears or complain of ear pain if she's old enough to talk. Other ear infection symptoms are fussiness, vomiting, a fever, and a poor appetite.
Parasites can cause watery diarrhea and greasy stools. Giardiasis, for example, is caused by a microscopic parasite that lives in the bowel. Other symptoms include gas, bloating, nausea, and cramps.
Parasitic infections are easily spread in groups of kids, for example, at daycare or preschool. Treatment requires special medicine, so your child will need to see the doctor.
Antibiotics kill off good bacteria in the intestines along with the problem-causing bacteria. If your baby or young child has diarrhea during or after a course of antibiotics, it may be related to the medicine. If this happens, talk to the doctor, but don't stop giving any prescribed medication to your child until his doctor gives you the go-ahead.
Too much juice
Too much juice can cause diarrhea. That's because many juices contain sorbitol, a nondigestible form of sugar. Excess sorbitol levels cause the body to try to dilute the sugar by pulling water from the bloodstream into the intestines, which causes loose stools. That's how prune juice, which is high in sorbitol, helps prevent constipation. Apple, pear, peach, and cherry juice are also fairly high in sorbitol. Cutting back the amount should solve the problem in a week or so.
The American Academy of Pediatrics (AAP) provides the following daily juice recommendations:
- No juice for babies before the age of 1 year
- No more than 4 ounces (1/2 cup) for ages 1 to 3
- No more than 4 to 6 ounces (1/2 cup to 3/4 cup) for ages 4 to 6
- No more than 8 ounces (1 cup) for kids 7 and older
Improperly mixed formula
Always double-check that you're adding the right amount of water when you mix your baby's formula. Using the wrong ratio of formula to water can cause diarrhea.
If your child has a food allergy, her body's immune system responds to normally harmless food proteins in a way that can cause mild or severe reactions – including diarrhea. Other symptoms of a food allergy include, gas, abdominal pain, and blood in the stool. In more severe cases, an allergy can also cause vomiting, hives, or a skin rash.
Common food allergens include cow's milk, eggs, peanuts, soy, wheat, tree nuts, fish, and shellfish. If you think your baby or young child might have a food allergy, talk with her doctor.
If your child eats a food and has trouble breathing or his face or lips swell, this is an emergency situation. Call 911 immediately.
Unlike a food allergy, a food intolerance (also called a food sensitivity) is an abnormal reaction that does not involve the immune system. For example, lactose intolerance occurs when a person doesn't produce enough of the lactase, the enzyme needed to digest lactose, the sugar in cow's milk and other dairy products. Undigested lactose stays in the intestines, causing symptoms that include diarrhea, abdominal cramping, bloating, and gas. Lactose intolerance is very unusual in babies.
Note: If your child has a severe case of diarrhea, she may temporarily have trouble producing lactase, and as a result she might have symptoms of lactose intolerance for a week or two.
If your child has diarrhea and is vomiting, and you think he may have swallowed something dangerous such as a medication, call the Poison Control Center right away (800-222-1222). Call 911 if he becomes unconscious or has trouble breathing.
How can I keep my baby or young child hydrated if she has diarrhea?
Diarrhea can cause your child to become dehydrated, which can be dangerous, so your first concern should be giving her enough liquids.
- If your baby isn't vomiting, continue to give her breast milk or formula.
- If your toddler or preschooler isn't vomiting, give her extra water. (Don't give water to your baby unless your doctor directs you to.)
- If your baby or child can't keep liquids down, call her doctor. The doctor may instruct you to give your child a pediatric electrolyte solution.
Pediatric electrolyte solutions are formulated to give a child the right amounts of sugar and salt, for rehydration, if needed. They are different from sports drinks, like Gatorade, which doctors do not recommend for children with diarrhea. (See "Is it okay to give my child Gatorade if he has diarrhea and seems dehydrated?" below.)
Pediatric electrolyte solutions come in flavors that most children will drink. They tend to taste better cold, and even come in ice pops, which your child may tolerate better if she can't keep liquids down. If your baby is eating solids, you can partially melt the ice pop and try spoon-feeding the "slush" to her.
For babies: As soon as your baby can keep liquids down, continue breastfeeding or formula feeding, so she'll get the nutrition and calories she needs.
For toddlers and preschoolers: If your young child doesn't like the taste of the electrolyte solution, try adding 1/4 teaspoon of sugar-free flavored powdered drink mix to 8 ounces of an unflavored electrolyte product.
Is it okay to give my child Gatorade if he has diarrhea and seems dehydrated?
The sugar in sports drinks can make your child's diarrhea worse. Stick with a pediatric electrolyte solution if the doctor recommends something in addition to breast milk, formula, or water (see "How can I keep my baby or young child hydrated if she has diarrhea?" above).
What should my child eat if she has diarrhea?
- Offer your child a normal diet. Eating healthy foods can help shorten a bout of diarrhea by providing essential nutrients needed to fight infection. As tolerated, your child can eat staples such as complex carbohydrates (like breads, cereals, and rice), lean meats, fruits, and vegetables. Broth or soups can help with dehydration, too. If your child refuses to eat, don't worry. As long as she stays hydrated her appetite should return in a day or two. Note: Doctors no longer recommend the BRAT diet (bananas, rice, applesauce, and toast).
- Feed your child yogurt. Studies have shown that live bacterial cultures found in yogurt are a safe and effective way to cut down on the amount and duration of diarrhea. Stick with plain, unsweetened, whole-milk yogurt that contains live cultures such as lactobacillus.
- Stay away from sugar. Avoid sweetened foods and drinks such as gelatin, sodas (including ginger ale), sports drinks, and undiluted fruit juices. The sugar draws water into the intestines, which can make diarrhea worse.
What should I do if diarrhea irritates my child's skin in the diaper area?
Your child's bottom may become red and irritated from the loose stools. Clean his bottom gently and keep it as dry as possible. Use plenty of diaper cream or ointment when changing your baby or toddler to prevent diaper rash. Diaper cream or ointment can also help protect and soothe your potty-trained child's bottom.
Is it okay to give my child an adult antidiarrheal medication?
No, don't give your child any antidiarrhea medicine unless her doctor prescribes it. These medicines can be dangerous for babies and children.
When should I call the doctor about my child's diarrhea?
3 months old or younger: Call the doctor immediately if your baby has diarrhea.
Older than 3 months: Call the doctor if diarrhea doesn't improve after 24 hours.
All ages: Call the doctor if your baby or child can't keep liquids down or if the diarrhea is severe (a watery bowel movement every two hours or more often).
Multiple symptoms: Call the doctor immediately if your child has diarrhea and any of the following symptoms:
- Vomiting multiple times
- Dehydration symptoms such as dry mouth, crying without tears, a sunken fontanel (baby's soft spot), and infrequent urination (not having had a wet diaper or urinated for six hours or more)
- Blood in his stool or black stool
- A high fever: 101 degrees Fahrenheit or higher if he's 3 to 6 months old; 103 degrees F or higher if he's 6 months or older. If your baby is younger than 3 months old and his temperature is 100.4 degrees Fahrenheit or higher, call the doctor immediately.
How can I keep my child from getting diarrhea?
Frequent hand washing for everyone in the house is your best defense against infectious diarrhea, because the microorganisms that cause diarrhea are easily passed from hand to mouth. Thoroughly wash your child's hands as well as your own for at least 15 seconds with soap and warm water before eating or preparing food, and after handling soiled diapers or using the bathroom.
As your child gets older, encourage her to keep her hands away from her face, for example, by sneezing into her elbow instead of her hand.
Your child can also catch a diarrhea-causing infection by putting her fingers in her mouth after touching toys or other objects that have been contaminated with the stool of an infected child. That's one of the reasons daycares and schools have rules that require kids who have diarrhea to stay home. When you have a playdate at your house, clean shared toys and the play area afterward. (Visitors can be infected without knowing it.)
Diarrhea is often one of the reasons to keep your child home from daycare. Find out what other symptoms mean your child is too sick to go to daycare.