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Diarrhea in infants

Definition

Normal baby stools are soft and loose. Newborns have stools often, sometimes with every feeding. For these reasons, you may have trouble knowing when your baby has diarrhea.

Your baby may have diarrhea if you see changes in the stool, such as more stools all of a sudden; possibly more than one stool per feeding or truly watery stools.

Alternative Names

Diarrhea - babies

Information

Causes of Diarrhea

Diarrhea in babies usually does not last long. Most often, it is caused by a virus and goes away on its own. Your baby could also have diarrhea with:

• A change in your baby's diet or a change in the mother's diet if breastfeeding.
• Use of antibiotics by your baby, or use by the mother if breastfeeding.
• A bacterial infection. Your baby will need to take antibiotics to get better.
• A parasite infection. Your baby will need to take medicine to get better.
• Rare diseases such as cystic fibrosis.

Diarrhea Causes Dehydration

Infants and children under age 3 can become dehydrated quickly and get very sick. Dehydration means that your baby does not have enough water or liquids. Watch your baby closely for signs of dehydration, which include:

• Dry eyes and little to no tears when crying
• Fewer wet diapers than usual
• Less active than usual, lethargic
• Irritable
• Dry mouth
• Dry skin that does not spring back to its usual shape after being pinched
• Sunken eyes
• Sunken fontanelle (the soft spot on top of the head)

Taking Care of Your Baby

Make sure your baby gets plenty of liquids so your baby does not get dehydrated.

• Keep breastfeeding your baby if you are nursing. Breastfeeding helps prevent diarrhea, and your baby will recover quicker.
• If you are using formula, make it full strength unless your health care provider gives you different advice.

If your baby still seems thirsty after or between feedings, talk to your provider about giving your baby Pedialyte or Infalyte. Your provider may recommend these extra liquids that contain electrolytes.

• Try giving your baby 1 ounce (2 tablespoons or 30 milliliters) of Pedialyte or Infalyte, every 30 to 60 minutes. Do not water down Pedialyte or Infalyte. Do not give sports drinks to young infants.
• Try giving your baby a Pedialyte popsicle.

If your baby throws up, give them only a little bit of liquid at a time. Start with as little as 1 teaspoon (5 ml) of liquid every 10 to 15 minutes. Do not give solid foods when your baby is vomiting.

Do not give your baby ant-diarrhea medicine unless your provider says it is OK.

Feeding Your Baby

If your baby was on solid foods before the diarrhea began, start with foods that are easy on the stomach, such as:

• Bananas
• Crackers
• Toast
• Pasta
• Cereal

Do not give your baby food that may make diarrhea worse, such as:

• Apple juice
• Milk
• Fried foods
• Full-strength fruit juice

Preventing Diaper Rash

Your baby might get diaper rash because of the diarrhea. To prevent diaper rash:

• Change your baby's diaper frequently.
• Clean your baby's bottom with water. Cut down on using baby wipes while your baby has diarrhea.
• Let your baby's bottom air dry.
• Use a diaper cream.

Wash your hands well to keep you and other people in your household from getting sick. Diarrhea caused by germs can spread easily.

When to Call the Doctor

Call your provider if your baby is a newborn (under 3 months old) and has diarrhea.

Also call if your child has signs of being dehydrated, including:

• Dry and sticky mouth
• No tears when crying
• No wet diaper for 6 hours
• A sunken fontanelle (soft spot)

Know the signs that your baby is not getting better, including:

• Fever and diarrhea that last for more than 2 to 3 days
• More than 8 stools in 8 hours
• Vomiting continues for more than 24 hours
• Diarrhea contains blood, mucus, or pus
• Your baby is much less active than normal (is not sitting up at all or looking around)
• Your baby seems to have stomach pain

References

Kotloff KL. Acute gastroenteritis in children. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 366.

Ochoa TJ, Chea-Woo E. Approach to patients with gastrointestinal tract infections and food poisoning. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 44.

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