Your Baby's Diarrhea

Are you noticing extra watery poop in the diaper? Your little one may have a case of the runs—learn about what causes diarrhea and how to soothe baby's bum.

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It's normal for baby stools to be soft and loose, especially during an infant's first couple of months. But when your baby gets diarrhea, chances are that you'll know it. "The poop will have a watery consistency and bowel movements will occur more frequently," says Shaista Safder, M.D., a pediatric gastroenterologist at Arnold Palmer Hospital for Children in Orlando. Babies with diarrhea may also have a fever or seem disinterested in eating. Learn the potential causes for your little one's diarrhea and how to help her feel better fast.

Causes of Diarrhea

Common causes of diarrhea in infants include:

Viral infections. A rotavirus is the most common cause of diarrhea in children ages 2 and younger. Fortunately, the number of children who get this intestinal infection has dropped significantly since the introduction of the oral rotavirus vaccine in 2006. "Vaccinated children can still get rotavirus, but they tend to have milder symptoms and recover faster," says Dr. Safder.

Antibiotics. About one in 10 children who take antibiotics develop diarrhea, nausea, and stomach pain. "In addition to targeting bad bacteria, antibiotics kill off healthy bacteria in the gut, which can lead to stomach upset or diarrhea," says Iona Munjal, M.D., director of the Pediatric Antimicrobial Stewardship Program at The Children's Hospital at Montefiore Medical Center in Bronx, New York. If you think antibiotics are causing your baby's diarrhea, talk to your doctor before stopping the medication. Stopping antibiotics early can lead to antibiotic resistance and cause a bacterial infection to return.

Parasites. Infants in day-care centers have a higher risk of contracting giardia, an intestinal infection caused by parasites. Exposure occurs when babies put fecal-contaminated toys, food, their hands, or other objects into their mouths. Most children get better without special treatment.

Milk allergy. Up to 3 percent of children are allergic to milk proteins found in dairy products, including most formulas, and breastfed babies can develop allergies to milk proteins in the dairy products their moms consume. A baby with a milk protein allergy may vomit and develop hives as well as diarrhea. If your baby has a milk protein allergy, your pediatrician may switch him to a special formula. Nursing moms may have to forgo dairy or foods containing milk protein.

    Caring for a Baby with Diarrhea

    Because diarrhea is the body's way of getting rid of germs, it's best to let the illness run its course without medicine. "You should never give antidiarrheal medication to a baby," says Dr. Safder, because the U.S. Food and Drug Administration (FDA) has not approved these meds for babies. Instead, you can ease your little one's discomfort with these tricks.

    Offer lots of liquids. "Infants with diarrhea are especially susceptible to dehydration because, pound for pound, their small bodies lose liquids faster than [those of] older children or adults," says Rebecca Cherry, M.D., a pediatric gastroenterologist at Rady Children's Hospital in San Diego. Because your baby is losing fluids from the diarrhea and probably isn't eating as much, you should offer her the breast or bottle more often, as well as a pediatric oral rehydration drink, if your doctor says it's okay. "Don't switch formulas without your doctor's consent and don't give fruit juice. Sugary drinks like juice can worsen diarrhea symptoms," says Dr. Cherry, because some kids aren't able to digest the sugars easily.

    Serve healthy foods. Babies who are eating solids can continue with their normal foods. "There's no evidence that the BRAT diet [bananas, rice, applesauce, and toast], commonly given for those with intestinal issues, is truly helpful. Plus, it lacks protein," notes Dr. Cherry. Instead, doctors now recommend lean meats, such as chicken, in addition to starchier foods like oatmeal, whole-wheat bread, and crackers, as well as bite-size pretzels and crackers to help replenish lost sodium. "Probiotics found in yogurt or available in oral drops can help restore healthy bacteria in the digestive tract," says Dr. Safder.

    Protect the bum. Acid in diarrhea, continuously soiled diapers, and frequent wipings can lead to skin irritation and diaper rash. Dr. Cherry recommends changing your baby's diapers often; using a soft washcloth and warm water, instead of wipes; and patting dry or air-drying your baby's buttocks. Apply a thick coating of diaper ointment or other moisture barrier, like petroleum jelly or zinc oxide, at each changing. Let your doctor know if the rash doesn't improve or if it worsens after a few days. This often indicates a yeast infection, which requires treatment with a prescription or an over-the-counter antifungal cream.

    When to Call the Doctor

    Depending on the cause, your baby's diarrhea may last between five and 14 days. You should call your pediatrician if your infant has:

      • Signs of dehydration (a sunken fontanel, few wet diapers, dry eyes when crying, dry mouth, sunken eyes or lethargy)
      • Mucus or foul odor in three or more diarrhea stools (for infants one month of age or younger)
      • Blood in the stool
      • Severe diarrhea while taking antibiotics
      • Fever (above 100.4° for babies younger than 3 months; above 102° for ages 3 months to 12 months)

        When to Worry: Diarrhea

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