Mom feeds baby with spoon

Acute diarrhea in older babies and toddlers

What to Know

  • Common causes and management of acute diarrhea
  • Best fluids for hydration
  • Foods to emphasize and limit with diarrhea

Who knew that one of the first rules of motherhood is thinking and talking about poop around the clock? You’ll astutely follow your baby’s typical poop pattern, whether that’s moving bowels 3 times a day, once every 3 days or somewhere in between (all of which are completely normal). While the pattern may shift over time, especially as she transitions to solid food, deviations from her norm can be both uncomfortable for her and alarming for you, especially when that change involves diarrhea.

Mom feeds baby with spoon

Signs that your older baby or toddler has diarrhea include:

  • A sudden increase in how often your baby has stools
  • More than one stool per feeding
  • Stools that appear to be more watery than usual

Most diarrhea in children is short-lived. Common causes of acute diarrhea include:

  • A virus
  • A change in your baby’s diet or your diet if you’re breastfeeding
  • Antibiotic use by your child or, if you’re breastfeeding, by you
  • Bacterial food-borne illness, in which case medications may be needed for treatment (call your child’s healthcare provider immediately if you suspect food-borne illness)
  • Lactose intolerance (which could lead to chronic diarrhea)

It’s important to treat your child’s diarrhea promptly, as the most immediate risk for most children is dehydration. If your child has diarrhea, take a proactive approach by checking for these early symptoms of dehydration: more than 6 hours without a wet diaper, no tears while crying or a dry, parched mouth. More advanced symptoms of dehydration in your child can include: irritability, excessive sleepiness or fussiness, urine that looks darker and smells stronger than usual, sunken eyes, hands and feet that feel cold and look splotchy, sunken fontanels (the soft spots on your baby’s head) or deep, rapid breathing with a high heart rate.

Management

A first line of home management for diarrhea is additional fluids. Breastmilk, formula if your child is under 12 months, milk/milk alternative if your child is 1 year or older, and water can be sufficient, but if your child is suffering from prolonged or more severe diarrhea, your healthcare provider might recommend a rehydration drink.

In addition to hydration, attention to diet can be important. You don’t need to worry too much about altering your child’s diet but do look to emphasize naturally binding, nutritious, foods like oatmeal, bananas and applesauce, and easily digested fruits high in water content like honeydew, cantaloupe and watermelon.

Some probiotics, can potentially reduce the severity of the symptoms of diarrhea, ask your child’s healthcare provider before giving them to your child.

Anti-diarrheal medications are sold over the counter (as well as by prescription) but should not be used unless directed by your child’s healthcare provider.

What to Do

Make sure your child gets plenty of healthy fluids

Offer breastmilk, formula if your child is under 12 months, breastmilk milk/milk alternative (if your child is 1 year or older), or water and allow your child to drink until she is full.

If your child has worsening diarrhea and/or is showing little interest in her usual drinks, try these alternatives while also checking in with her healthcare provider:

  • Rehydration drinks
  • Smoothies – try blending banana, coconut water and ice or simply melon and water (but skip the berries until your child is feeling better)
  • Whole fruit-based popsicles – like smoothies, popsicles are another means for delivering fluids to a child resistant to drinking

Limit juice, sports drinks and soda

The sugar in juice, sports drinks and soda can worsen diarrhea. Sports drinks and soda especially (with their artificial sweeteners and caffeine content) should be avoided with babies and toddlers generally.

If juice is the only fluid your child will drink, dilute 1 ounce of juice with 4 ounces of water to increase her water intake.

Emphasize healthy foods

Focus on the following foods:

  • Binding foods like bananas, applesauce, toast, cereals (oatmeal, cream of wheat, corn flakes), skinless potatoes, white rice, pancakes and waffles
  • Easily-digested fruits with high water content like cantaloupe, honeydew and watermelon
  • Easily-digested proteins like eggs, white meat chicken and white flaky fish
  • A moderate amount of salty foods like pretzels, saltines and broth-based soups
  • Cooked (and peeled, where applicable), mild vegetables like carrots, green beans, squash, zucchini and potato

Restrict the following:

  • Food high in fat and sugar like fried foods, ice cream
  • Any foods you notice make your child’s diarrhea worse

Follow good food safety practices to lessen the risk of foodborne illness and read Storing baby food for all the specifics.

Protect against diaper rash (an all too common result of diarrhea)

Keep your little one’s tush comfortable and smooth by using damp cloths instead of baby wipes, rinsing her bottom with water, and patting dry, or better yet, air-drying, instead of wiping. Frequent diaper changes (or even some diaper-free time!) and protective ointments and creams may also help.

Call your child’s healthcare provider if you have concerns

If your child is experiencing any of the following, do not hesitate to call your healthcare provider:

  • Dehydration
  • Vomiting and an inability to keep any fluids down
  • Diarrhea containing blood, mucus, or pus, or that is black and tarry
  • A fever higher than 102*F or a fever and diarrhea lasting for more than 2 days
  • More than 8 stools in 8 hours
  • A significant change in her behavior concurrent with diarrhea
  • Other signs of illness
  • You suspect your child’s diarrhea is related to food-borne illness
Sources

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