When your children are little, there are lots of unexpected and somewhat gross things you’ll have to tackle. Things like spit-up, snotty noses and yes, diarrhea. No one likes to have diarrhea, but it can be especially worrisome when it happens to your baby or child. As a parent, you want to help them feel better and keep them healthy.
Here’s what to know about the possible causes of your child’s diarrhea and what to do (and NOT to do) to help them feel better.
Is it loose stools or diarrhea?
As adults, it’s a little more obvious when we have diarrhea, but it can be hard to tell the difference between diarrhea and normal stools in children.
“Stools (or bowel movements) are considered to be diarrhea when they are not only looser than usual but also occur more frequently,” said Alyson Boone, CPNP-PC, a certified pediatric nurse practitioner in primary care with Banner Children's. “Diarrhea can vary from loose to watery stools.”
What causes diarrhea in children?
Your child’s diarrhea may last one to two days and go away. If diarrhea lasts more than two days, they could have a more serious problem.
“Diarrhea can be acute (usually with illness) or chronic due to a health problem like irritable bowel syndrome or an intestinal disease, malabsorption (where the body is not able to properly absorb nutrients) or other autoimmune issues,” Boone said. “I would not be worried about it if it is a one-time loose stool.”
Causes of diarrhea in children may include but are not limited to:
- An illness (viral and bacterial)
- Trouble digesting food (food intolerance, such as lactose intolerance)
- Intestinal disease (ulcerative colitis, celiac disease or Crohn’s disease)
- A food allergy
- Excessive juice intake (usually more common in toddlers)
- A problem with how the stomach and bowels work (functional bowel disorder)
- Side effects from taking an antibiotic and medication
- Traveler’s diarrhea (visiting some foreign countries)
What are the symptoms of diarrhea in children?
Depending on its cause and each child, symptoms may occur a bit differently. If your child has diarrhea, they may have large, runny, frequent or watery poop. The color of their poop also might vary from shades of brown and green.
Other symptoms that can accompany diarrhea are stomach pain and cramping, an urgency to go, upset stomach, nausea and vomiting.
“In addition to diarrhea, I would encourage parents to watch for a set pattern, whether it occurs after eating/drinking certain foods or activity/stress, or for additional symptoms of an illness including fever, vomiting, fatigue or dehydration,” Boone said.
Acute diarrhea can often be treated at home. However, diarrhea is concerning if:
- Blood is present, including both bright red or black tarry appearing stools (regardless of how long diarrhea has been present or how many stools in a day).
- It results in decreased urine production, dry mouth and no tears when your child cries (a sign of dehydration).
- Or it lasts longer than one to two weeks.
How is diarrhea treated?
Treating your child’s diarrhea will depend on many factors, including their symptoms, age, general health and severity, but at this age range hydration is very important.
“One of the most important things to remember with any illness (including diarrhea) is hydration,” Boone said. “If your child doesn’t want to eat but is willing to drink that is the best thing.”
But not all drinks are created equal. Pedialyte is formulated with the proper fluid and electrolytes to help with hydration. You should avoid giving your child drinks like Gatorade and fruit juices as the sugar content can often make diarrhea worse.
“With diarrhea, you can also become temporarily lactose intolerant so I usually recommend avoiding dairy products (including milk and cheese),” Boone said.
Avoid products like Imodium (unless you know it is not infectious as it could make it worse) and if you choose to use Pepto Bismol, make sure it’s the pediatric version.
Boone also encourages giving your child food, but a bland diet, avoiding spices, greasiness, sugar and lactose/dairy. Starchy and soft foods are digested best. These foods include cereals, grains, crackers, rice, bananas and pasta.
For breastfed babies, Boone said to keep breastfeeding. “This is always best for diarrhea,” said Boone. If your baby is formula-fed, keep feeding them baby formula, unless it seems to be making them gassy or bloated. In this case, you should contact their provider to see if it should be avoided.
When should I reach out to my child’s health care provider?
Contact your child’s provider if your child has diarrhea and:
- The diarrhea lasts more than a few days.
- Blood is present in the diarrhea.
- They have an uncontrolled high fever (meaning it doesn’t go below 102 degrees even with treatment or is consistently over 103 when the treatment wears off).
- They haven’t had a wet diaper in at least eight hours or gone pee less than three to four times in a day.
Does my child need electrolytes?
Electrolyte solutions are very helpful for moderate to severe diarrhea but may not be required with mild diarrhea.
“These fluids have the right balance of water, sugar and salts,” Boone said.
Diarrhea dos and don’ts:
Do wash your hands often. Always wash your hands after changing diapers or your child’s hands after using the toilet. This is important in keeping the family safe, especially if diarrhea is related to a virus.
Do get your child to drink. Dehydration can occur quickly in young children. Ensure they are staying well hydrated.
Don’t give them sugary drinks. Gatorade, Kool-Aid and sodas contain too much sugar and not a lot of salt. Give them water and sugar-free fluids.
Do protect against diaper rash. Your baby’s skin can become irritated by diarrhea. Wash the area after each stool and protect it with a layer of petroleum jelly or ointment. Changing the diaper quickly after stools helps as well.
Don’t drink and eat certain things when you travel. If you’ll be visiting certain countries, especially those in developing nations, travel safety tips include:
- Not giving them or brushing their teeth with tap water.
- Not using ice made from tap water.
- Not drinking unpasteurized milk and juices.
- Not eating raw fruits and vegetables, unless they’ve been washed AND peeled by you.
- Not eating from street vendors or food trucks.
Dehydration is a major concern at these ages, so make sure you’re helping your child replace lost fluids by drinking plenty of water.
If you have questions or concerns, contact your child’s provider right away.