Diarrhoea

How can I tell if my baby has diarrhoea?

Many parents worry that their baby has diarrhoea, because newborns tend to have a lot of bowel movements. How often your baby passes stools will depend very much on whether she's being breast or formula fed. The stools of breastfed newborn babies are usually yellowish, on the soft or liquid side, and she may fill her nappy up to five times daily.

Sometimes a breastfed baby will pass a stool during or immediately after each breastfeeding session. This happens because as her stomach fills up, the milk stimulates her entire intestinal tract, prompting a bowel movement. Within a month, most breastfed babies have one or two bowel movements a day. Formula-fed babies tend to pass stools once a day and these are fairly firm and smelly.

Occasional loose stools are normal. Your baby might have diarrhoea if:

• She passes smelly, watery, mucus-streaked stools (one doctor says it looks as if you have blown your nose in your baby's nappy) as often as she is fed after the first month.


• She has a fever or appears to be losing weight. See your paediatrician or family doctor if this is the case.

What causes diarrhoea?

The most common cause of diarrhoea is a virus called rotavirus. Nearly all children catch this virus by the time they are five. Rotavirus causes gastroenteritis, an infection of the gut. The infection damages the inner lining of the intestine. The injured lining leaks fluid and allows food to pass through without absorbing any nutrients.

Diarrhoea can also be caused by:

• allergies (find out more about milk allergy and intolerance and food allergies);
• formula feeds not being made up properly;
• colds;
• antibiotics;
• food poisoning;
• enzyme deficiencies, although these are rare.

How should I treat it?

Make sure your baby drinks plenty of fluids to ease her symptoms and to stop her dehydrating. If your baby is taking breast or formula feeds well, stick with them. You can try sips of oral rehydration solution (ORS), such as Dioralyte, a few times an hour.

An ORS helps to replace the fluids and salts your baby loses because of the diarrhoea. Keep giving her water and her usual breastfeeds or full-strength formula feeds, too. Don’t give her fruit juices, glucose drinks and fizzy drinks (unabsorbed sugar draws water into the intestine and can make diarrhoea worse).

Don’t give your baby anti-diarrhoeal medicine. It must not be given to children under 12 years old, as it could have serious side-effects.

To prevent your baby passing on her diarrhoea to other children, keep her away from childcare or nursery until at least 48 hours after her last episode, and don’t take her swimming for two weeks afterwards.

Are breastfed babies less likely to get diarrhoea?

Yes. Certain elements in breastmilk can inhibit the growth of the micro-organisms which cause diarrhoea.

Should I stop giving solid foods?

No. Unless your baby is vomiting frequently, you can still give her solids. If your child is six months or older you could try foods such as bananas, rice, apple puree and dry toast. For an older baby or toddler you could try small amounts of chicken and starchy foods, such as mashed potatoes and pasta. But don't worry if she doesn't want to eat. It's more important that she drinks to avoid dehydration.

When should I call the doctor?

Diarrhoea can be worrying if it lasts more than a few hours, but it will usually clear up on its own. If your child has loose, watery stools for more than a couple of days, call your paediatrician or family doctor. The biggest concern with diarrhoea is fluid loss, so don't delay in calling your family doctor or paediatrician if your baby shows these signs:

• dry skin or lips;
• listlessness;
• tearless crying;
• a sunken fontanelle;
• discoloured hands and feet;
• strong yellow urine;
• fewer wet nappies than usual .

You should also consult your doctor if your baby shows the following secondary symptoms, which are uncommon, but need attention:

• diarrhoea and vomiting which lasts more than 24 hours;
• fever which lasts longer than 24 hours;
• refuses to drink anything;
• has blood in her stools;
• has a swollen tummy.

How can I ease my baby’s discomfort?

If your baby is uncomfortable during a bout of diarrhoea, try to cuddle and comfort her as much as possible, and keep her dry. Use care and tenderness when changing nappies since it's easy for a baby's bottom to become sore with diarrhoea. Use a barrier cream to prevent irritation if the diarrhoea lasts more than a day. Rest assured, your baby will soon bounce back.

How can I prevent my baby from catching it again?

Proper hygiene can help reduce the chance of diarrhoea, because the micro-organisms which cause it can easily be passed from hand to mouth. So wash your hands thoroughly with soap after handling soiled nappies or using the toilet.