The Ultimate Baby Diarrhea Guide: Causes, Symptoms, Treatments and Prevention
Occasional diarrhea is a common experience for many infants. How can you tell if your baby has it? Does runny poop mean a run to your doctor? Let’s explore what diarrhea could look like in your baby, when to be concerned, and strategies for helping your little one feel better.
What Does Baby Diarrhea Look Like? | Why Do Babies Have Diarrhea? | Diarrhea and Dehydration: How Do I Know If My Baby Could Be Dehydrated? | Managing Viral Diarrhea | Things to Avoid If Your Baby Has Viral Diarrhea | Baby Diarrhea Management Tips Due to Feeding or Diet Issues | When to See Your Pediatrician About Your Baby’s Diarrhea
What does baby diarrhea look like?
Diarrhea looks like loose, watery stools—and there’s a lot of it. It may occur numerous times throughout the day and may leak out your baby’s diaper
Breastfed and formula-fed babies’ stool usually differs in color and consistency, so knowing what to look for may help you identify diarrhea.1
Breastfed babies
Breastfed babies typically have slightly sweet-smelling stools that may be runny, seedy, and yellow. These soft stools often occur after every feeding, so it may be difficult to discern what’s diarrhea and what’s not. Keep an eye out for the following that could indicate diarrhea:
- Much looser stools three or more times a day
- Slimy, mucus-streaked or blood-tinged stools
- Whitish or clay-like stools
- Foul-smelling stools
Formula-fed babies
Formula-feeding babies typically have pasty, peanut-butter consistency stools. Healthy stools may be shades of yellow or brown and smell more odorous than a breastfed baby’s. Diarrhea in formula-fed babies commonly appears to be:2
- Runny
- Slimy, mucus-streaked or blood-tinged
- Bright yellow
- Whitish or clay-like
Diarrhea could be mild (3-5 watery stools per day), moderate (6-9 watery stools per day), or severe (10 or more watery stools per day).3
The most significant concern with diarrhea is that it could lead to dehydration, which babies are more susceptible to since they have a higher metabolic rate and body water content.4
Why do babies have diarrhea?
There are several potential reasons why your little peanut could have diarrhea. Some of the most common causes include:5
1. Virus
A virus is a typical cause of watery stools. Along with diarrhea, your baby may experience the following:
- Vomiting
- Fever
- Belly pain
- Bloody stools
If you suspect your baby has a virus, contact your pediatrician for guidance on how to manage it to ensure your baby remains hydrated and replenishes their vital fluids, salts, and minerals.6
2. Sensitivity to something in mom’s diet
If you’re breastfeeding, your little one’s diarrhea may be a reaction to something in your diet. Reach out to your pediatrician, who may suggest eliminating certain foods on a trial basis. You’ll likely be advised to keep a food diary and note your baby’s diaper habits when you consume certain foods. Often, you’ll have to forgo potential food sensitivities for two weeks to see if they’re the culprit.
3. Lactose intolerance
While not very common in children under three, some infants may be lactose intolerant and unable to digest lactose, the sugar primarily found in milk and dairy products.7 Lactose is found in breast milk and most everyday infant formulas. Babies who are lactose intolerant may have loose stools accompanied by:
- Gas and fussiness
- Nausea
- Abdominal pain and cramping
Suspected cases of lactose intolerance could turn out to be a temporary illness or other easily-managed digestive issue, but talk to your pediatrician to find out the root cause. If your baby is lactose intolerant, your doctor may recommend a change to mom’s diet or, if formula-feeding, switching to a plant-based formula or an infant formula designed for sensitive tummies.
4. Cow’s milk protein allergy
Recurrent diarrhea after all or most feedings could indicate cow’s milk protein allergy (CMPA). This dairy allergy occurs when the immune system mistakenly identifies a usually harmless protein within cow’s milk as harmful and triggers an allergic response. Babies with cow’s milk protein allergy may experience diarrhea as well as:
- Spit-up
- Colic
- Fussiness and gas
- Skin rashes
- Vomiting
- Wheezing
Cow’s milk protein allergy is the most common type of infant food allergy in the United States, affecting about 2-3% of infants.8
It's important to talk to your baby's doctor if you're concerned that an allergy could be causing your baby's diarrhea. Your doctor may recommend a dairy-elimination diet and perform additional tests to help identify CMPA.
5. Antibiotic use by the baby or breastfeeding mom
Antibiotics taken by your baby or passed through breast milk may cause mild diarrhea. Don’t stop taking the antibiotic, but call your doctor if you notice your baby has very watery stools or blood in their diarrhea.9
6. Infection or intestinal disease
Some less common causes of diarrhea include a parasitic infection such as giardia or an intestinal disease. Babies with these types of health issues typically have chronic diarrhea that lasts for a few weeks.10
Diarrhea and dehydration: How do I know if my baby could be dehydrated?
Diarrhea may cause your baby to become dehydrated quickly. This depletion of water and minerals called electrolytes can be dangerous, so watch for these potential dehydration indicators:
- No tears when crying
- Lack of wet diaper for 6 to 8 hours or only urinating a small amount of dark yellow urine
- Irritability
- Lethargy
- Grayish skin
- Sunken eyes
- Dry tongue and lips
- Sunken soft spot on the head
Since dehydration can have serious effects, avoiding it is an important part of managing diarrhea.11 If you suspect your baby may be dehydrated, contact your doctor immediately. They may suggest an electrolyte water solution if the dehydration is severe.
Managing viral diarrhea
Viral gastroenteritis is one of the most common causes of baby diarrhea. It’s an infection of the stomach and intestines and typically lasts between two and seven days. While it often goes away on its own, reach out to your doctor for guidance on how to best care for your baby. Keep in mind the following tips for helping your baby stay hydrated.
Top up formula or breast milk. Increase fluids by offering your little one additional breast milk or formula. Try giving small amounts of these at a time and increasing them gradually.12
Consider an electrolyte solution. Ask your doctor about giving your baby an oral rehydration solution. Electrolyte solutions may quickly replace water and electrolytes lost from diarrhea. The high amounts of electrolyte sodium and balance of carbohydrates help promote the absorption of both fluids and electrolytes. Since there's tummy turmoil, choosing one without artificial colors, flavors, or sweeteners is best.
Watch for diaper rash. Lots of loose stools can irritate your baby’s delicate skin. Change their diapers often, rinse their bottom with warm water when changing, and let the skin air dry. Apply diaper cream and ensure their diapers are secure but not so tight that they rub the skin.
Do NOT give your baby anti-diarrhea medications unless your pediatrician specifically calls for it.
Things to avoid if your baby has viral diarrhea
While it’s important to replenish your baby’s fluids when they have diarrhea, some fluids and foods could actually make issues worse. Avoid the following:
Plain water. Water does not contain enough sodium and other minerals needed to replace what was lost during dehydration.
Apple juice. Juices and other sweet drinks can worsen diarrhea due to their sugar content and acidity. On top of that, acidic diarrhea can be painful—definitely something you’ll want to avoid!
New foods. Since your baby’s tummy is feeling tumultuous, now isn’t the time to try new foods or introduce new beverages (unless specifically advised by your doctor.)
Most babies with moderate diarrhea should be able to consume a normal diet. If they eat solid foods or baby food, continue to give them those foods as you typically would. Cereals and more starchy foods like rice, crackers, and pasta are best because they are easy to digest.
Baby diarrhea management tips due to feeding or diet issues
If you think your baby’s diarrhea may be connected to a dietary issue, it’s important to keep your baby hydrated while also taking steps to help pinpoint the root of the problem.
Keep a food diary.
Take note of everything your baby is ingesting to help your doctor identify the possible reason for your little one’s issues.
If breastfeeding, ask your doctor about dietary changes.
Diarrhea accompanied by vomiting, colic, and other health issues could indicate cow's milk protein allergy, so check with your doctor. They may recommend eliminating dairy from your diet.
Inquire about switching formulas.
Whether your baby’s digestive tract seems a little sensitive or you suspect an allergy such as cow’s milk allergy, talk to your doctor about formula options. For instance, some hypoallergenic baby formulas, such as Enfamil Nutramigen with probiotic LGG Infant Formula, have specific proteins that are easier for babies to digest. Switching to this type of formula may be a simple baby diarrhea management option when the loose stools are associated with cow’s milk allergy.
Consider infant probiotics for diet issues.
You may have heard about probiotics or prebiotics and gut bacteria health. A healthy gut microbiome—home to many so-called good bacteria—is important at any age since it plays a role in a variety of bodily functions. Both prebiotics and probiotics are thought to help support your baby’s health by promoting the growth of good gut bacteria.
When to see your pediatrician about your baby’s diarrhea
Many infants experience diarrhea once in a while. However, if your baby is three months or younger, or if you recognize the following, call your pediatrician right away:
- Vomiting along with the diarrhea
- Severe diarrhea or diarrhea that lasts several days
- Lack of wet diapers (or other indicators of dehydration, including dry mouth)
- Rectal temperature of 100.4 F or higher
- Diarrhea that contains blood or mucus or that looks whitish
- Seems to be in pain
Before you see your pediatrician about baby diarrhea
To help your doctor identify your little one’s health issue, call the office and ask if you should do anything to prepare for your visit. Here are some things you can do in advance to help you make the most of your appointment:
- Write down all your baby's issues and your concerns, including answers to these questions:
- When did you first notice your baby's diarrhea?
- How often is your baby experiencing diarrhea in a day?
- Is it explosive diarrhea?
- What are their other behaviors: crying, fussiness, or spitting up?
- Has your baby had any indications of an allergic reaction: skin rashes, hives, or breathing trouble?
- Is your baby refusing to eat?
- Does anything seem to improve their issues or make them worse?
- Make a list of any medications, foods, or formulas your baby is consuming.
- Note any changes in your baby’s sleep pattern, eating habits, or illness.
8 questions to ask your pediatrician about baby diarrhea
While it's not uncommon for babies to have occasional bouts of loose stools, call your baby's doctor anytime for information, advice, and assurance. Here are eight key questions to consider asking your pediatrician if your baby is experiencing diarrhea:
- What are the typical causes of diarrhea in babies?
- What are the indications of a virus?
- Could the loose stools indicate a feeding issue or food allergy?
- Should I change my baby's formula or diet? What should I add? What should I take out?
- I'm breastfeeding; could something in my diet be causing my baby's diarrhea?
- What can I do at home to ease my baby’s diarrhea?
- How do I help avoid diarrhea in my baby in the future?
- Could infant diarrhea be an indication of a more serious problem?
Your doctor’s guidance can give you peace of mind as you work together to get your baby’s bowel movements back on track so your little one can start feeling better.
References:
1“Diarrhea.” Seattle Children's. https://www.seattlechildrens.org/conditions/a-z/diarrhea/↗. Accessed October 20, 2022.
2“12 Types of Baby Poop & What They Mean (Infographic).” Blank Children’s Hospital UnityPoint Health. August 15, 2014. https://www.unitypoint.org/blankchildrens/article.aspx?id=40567710-74c7-4ef2-a040-847be9fbd35a↗. Accessed October 20, 2022.
3“Diarrhea.” Healthychildren.org. https://www.healthychildren.org/English/tips-tools/symptom-checker/Pages/symptomviewer.aspx?symptom=Diarrhea↗. Accessed October 20, 2022.
4Vega, Roy M., Avva, Usha. “Pediatric Dehydration.” National Library of Medicine. August 1, 2022. https://www.ncbi.nlm.nih.gov/books/NBK436022/↗. Accessed October 20, 2022.
5“Diarrhea in infants.” MedlinePlus. https://medlineplus.gov/ency/patientinstructions/000691.htm↗. Accessed October 20, 2022.
6“Diarrhea in Babies.” Healthychildren.org. https://www.healthychildren.org/English/ages-stages/baby/diapers-clothing/Pages/Diarrhea-in-Babies.aspx#:~:text=Diarrhea%20isn't%20just%20a,pieces%20that%20look%20like%20seeds↗. Accessed October 20, 2022.
7Porto, Anthony, MD, MPH, FAAP. “Lactose Intolerance in Infants & Children: Parent FAQs.“ Healthychildren.org. https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Lactose-Intolerance-in-Children.aspx↗. Accessed October 20, 2022.
8Moreno Villares, J.M, Oliveros Leal, L., Torres Peral, R., Luna Paredes, C., Martínez-Gimeno, A., García-Hernández, G. ”Growth in infants with cow's milk allergy.” March 2006. https://pubmed.ncbi.nlm.nih.gov/16527091/↗. Accessed October 20, 2022.
9“Antibiotic Prescriptions for Children: 10 Common Questions Answered.” Healthychildren.org. https://www.healthychildren.org/English/safety-prevention/at-home/medication-safety/Pages/Antibiotic-Prescriptions-for-Children.aspx↗. Accessed October 20, 2022.
10”Diarrhea in Children.” John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/diarrhea-in-children↗. Accessed October 20, 2022.
11“Diarrhea in Children: What Parents Need to Know.” Healthychildren.org. https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/Diarrhea.aspx↗. Accessed October 20, 2022.
12“Viral Diarrhea (Infant/Toddler).” Fairview. https://www.fairview.org/patient-education/115963EN↗. Accessed October 20, 2022.
