Diarrhea in Babies

What is diarrhea in babies?

Diarrhea is poop that’s extremely loose and watery. It’s normal for your baby’s poop to be softer than your poop. But they might have diarrhea if their poops are suddenly looser than usual and they’re going through diapers faster than normal.

Healthcare providers don’t consider one or two watery poops a concern. This might happen if your baby is adjusting to new foods, for example. But if your baby has three or more poops in a day that seem extra watery, they may have what providers call a diarrheal illness. This means they have an infection that’s causing diarrhea. Such infections are common and temporary.

If the diarrhea lasts longer than two weeks, your baby might have a digestive issue that needs diagnosis and treatment. 

How can I tell if my infant has diarrhea?

It might be hard to know if your baby’s poop is looser than normal — especially if you don’t yet know what normal looks like. Learning the typical colors and textures of baby poop can help you sort things out.

If you’re breastfeeding (chestfeeding), your newborn’s first week of life will be messy. They’ll make at least three to four poops per day. The poops will be yellow, seedy and loose. This is normal, and it isn’t diarrhea. After that, their poop will have a texture that’s a bit like applesauce. This is also normal and lasts until around 4 to 6 months of age. If you feed your baby formula, they’ll have thicker, pastier poops from birth.

Poops that are looser or more watery than usual could mean diarrhea. Another clue is that diarrhea typically can’t be contained in a diaper.

Are there different severity levels?

The more often you’re changing runny diapers, the more severe the situation. Healthcare providers use this scale to identify the severity of diarrhea. It’s based on how many episodes of watery poop your baby has per day:

• Mild diarrhea: 3 to 5
• Moderate diarrhea: 6 to 9
• Severe diarrhea: 10 or more

Diarrhea puts your baby at risk of dehydration.

Why does my baby have diarrhea?

Viral gastroenteritis (which you probably know as the “stomach flu”) is the most common cause of diarrhea in infants. Many different viruses can wreak havoc on your baby’s tummy, but norovirus and rotavirus are leading culprits.

Other common causes of diarrhea in infants include:

• Bacterial infections like salmonella or E. coli
• Parasitic infections like giardiasis (common in daycares)
• A side effect of antibiotics your baby needs for another reason

Infections typically cause other symptoms, too. Your baby might have it “coming out both ends.” Besides vomiting, they might also have a fever or seem uninterested in feeding

Most cases of diarrhea are temporary, or what healthcare providers call acute. Acute diarrhea goes away within two weeks. But some babies develop chronic diarrhea (sometimes called persistent diarrhea). This is diarrhea that lasts longer than two weeks.

Causes of chronic diarrhea in infants

Chronic diarrhea commonly happens because something is preventing your baby’s digestive system from working as expected. For example, your baby might be born with a condition that limits how well their intestines can absorb nutrients (malabsorption). Diarrhea is a common symptom of malabsorption.

Pediatricians and pediatric gastroenterologists can do tests to find the cause of chronic diarrhea. In general, possible causes include:

• Cow’s milk or soy protein intolerance. Cow’s milk protein and soy protein are common ingredients in formulas. If your baby’s digestive system has trouble breaking down one of these ingredients, they may develop diarrhea.
• Celiac disease. This autoimmune disease causes your baby’s digestive system to overreact to gluten. This reaction damages the lining of your baby’s small intestine and interferes with nutrient absorption.
• Cystic fibrosis (CF). CF damages your child’s pancreas and keeps it from sending digestive enzymes to their intestines. This causes problems with nutrient digestion and absorption.
• Short bowel (gut) syndrome. This is when part of your baby’s small intestine is missing. Diarrhea is the most common symptom.
• Congenital diarrheas and enteropathies (CODEs). This is a group of rare genetic conditions that cause chronic diarrhea. Diarrhea often starts within the first few months of life.

How do you stop diarrhea in babies fast?

We hate to break the news, but there’s no way to get rid of diarrhea instantly. In most cases, an infection has caused your baby’s diarrhea, and you simply have to wait things out. Diarrhea due to a virus usually lasts five to 14 days. But the first couple of days are the worst.

Babies can’t use the same diarrhea treatments as older children and adults. Over-the-counter medications may be dangerous for them. Don’t give your baby an electrolyte drink (like Pedialyte®) unless your pediatrician tells you to.

If your baby has chronic diarrhea, your pediatrician will recommend the best treatment for their specific condition.

What can I do at home to treat infant diarrhea?

There aren’t specific treatments for newborns or infants who have diarrhea. But here are some things you can do to keep your baby comfortable and lower their risk of dehydration:

• Keep your baby hydrated by continuing to breastfeed (chestfeed) or give them formula as usual. You may need to feed them more often to keep up with what they’re losing.
• If your baby is eating solid foods, it’s OK to keep giving them these. Starchy foods like cereal are ideal because your baby’s tummy can easily break them down.
• You can help prevent diaper rash by gently washing your baby’s bottom with warm water after each diaper change.

If your baby becomes dehydrated, they may need care at a hospital for a couple of days. Providers can give them fluids through an IV to help their body recover.

How can I prevent infant diarrhea?

There’s no magic wand that can keep diarrhea away forever. But taking steps to prevent infections can help your baby get diarrhea less often. Here are some tips:

• Keep your baby up to date on vaccines. Follow the schedule your pediatrician recommends. For example, giving your infant the rotavirus vaccine can protect them against one of the most common causes of diarrhea.
• Wash your hands. Washing your hands at important times — like before feeding your baby or after changing their diaper — can limit the spread of germs that cause diarrhea.
• Breastfeed (chestfeed). Breastfeeding has many benefits, including passing along antibodies to your baby while their immune system is still developing. These antibodies can help protect your baby against infections that could cause diarrhea.

When should I call my pediatrician about newborn or infant diarrhea?

Call your pediatrician as soon as possible if your baby has diarrhea and any of the following are true:

• Your baby has a fever.
• Your baby is vomiting.
• The diarrhea seems severe.
• Your baby is 3 months of age or younger.

Your baby loses a lot of water and electrolytes when they have diarrhea. This can make them get dehydrated. Call your pediatrician immediately if you notice any of these signs of dehydration in your infant:

• They have fewer than six wet diapers in 24 hours.
• They’re extra sleepy.
• They’re more irritable than usual.
• The soft spot on their head (fontanelle) seems sunken in.
• They have few or no tears when crying.

Some babies get diarrhea off and on with no rhyme or reason. If your baby seems to have watery poops often, tell your pediatrician. It’s possible your baby has a digestive condition that needs treatment.