Diarrhoea in toddlers

When is a loose stool more than a loose stool, and what should be done to treat diarrhoea?

How do I know when my toddler has diarrhoea?
There are all kinds of stool variations that are within the normal range, and some toddlers have looser stools than others. But there are a couple of give-aways that a loose, watery stool is diarrhoea. The first is if there’s a change in how often your child poohs each day, and he passes stools more often. The second is if the stools smell particularly nasty.

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What do I do about my toddler’s diarrhoea?

How you handle diarrhoea really depends on whether the illness is causing your child to be dehydrated. In most cases a bout of diarrhoea isn’t serious and will often clear up on its own within a few days, but sometimes a doctor’s visit is necessary.

If your child otherwise seems fine and is playing as normal then it’s probably enough to make sure that she gets plenty of extra water, to avoid dehydration. It makes sense to avoid those drinks that can cause loose stools such as too much fruit juice and sweetened drinks, and stick instead to water and milk.

In terms of food, you can continue to give her a range of complex carbohydrates (rice, bread, cereals, potatoes) alongside fresh fruit and veg, but choose fruits that will be easier on the tummy (eg. avoid citrus fruits) and avoid stewing fruits. Foods that are renowned for causing constipation, like bananas, may help firm up stools.

Calling the doctor

If your toddler has any of the following, as well as diarrhoea, then you should call your doctor:

  • A high temperature (over 38 degrees)
  • Dehydration – Signs of mild dehydration include: peeing less, having dry lips and playing for only short periods at a time. Severe dehydration may lead to very infrequent peeing, having a dry mouth, as well as lips, listlessness.
  • If she has very dark stools or blood in her stools
  • If she is completely off her food
  • If she is vomiting
  • If she isn’t keeping down any fluids
  • If she seems very unwell
  • If the diarrhoea alternates with constipation

You should also call your doctor if your toddler has severe diarrhoea (more than eight loose stools a day) or the upset doesn’t clear itself up in a couple of days.

If your toddler is mildly dehydrated your doctor will probably prescribe rehydration salts that you make up and give as a drink to your baby. In cases of severe dehydration a trip to the hospital may be necessary. If your toddler has been vomiting then you should still give her fluids, but wait until her stomach has settled and her appetite returns to re-introduce food. When re-introducing food it’s a good idea to stick to easily digestible foods, doctors often recommend the BRAT diet: bananas, rice (or rice cereal), apples and toast (white).

Caring for your toddler
Whatever the cause or degree of your child’s diarrhoea, there are several things that you should do to help her recover and be more comfortable meanwhile.

  • Fluids – Give your toddler plenty of fluids – water and breastmilk are
    best (providing lactose intolerance isn’t the cause).
  • Bottom care – Loose stools can make your child’s bottom sore very quickly, particularly after certain foods (like fruit juices). You’ll need to be sure to change your child as soon as possible after a stool and clean thoroughly. Cotton wool or cotton wipes and plain water are best – baby wipes may irritate the sensitive skin. Make sure the skin is very dry after cleaning and use a barrier cream if the skin is sore.
  • Careful hygiene – Be even more thorough than usual when it comes to washing your hands before and after a change, when handing soiled nappies and clothing, before touching food and when using the bathroom yourself.

What causes diarrhoea?

There are several different causes of diarrhoea.

Gastroenteritis

Viral infection is a common cause of diarrhoea. There are many different viruses which inflame the lining of the stomach and gut and may cause vomiting, stomach pain and a fever, along with diarrhoea. The infection may take as long as a week to clear up, though it often clears up within a few days, and it may appear to get better before getting worse again.

Bacterial food poisoning

Blood and mucous in the stools are both signs of food poisoning, as are stomach cramps, vomiting and a fever. When food hasn’t been prepared or stored properly there are several different kinds of bacteria that may cause a nasty infection. The most common bacterial culprits usually produce an illness that clears up in a day or two, but a serious infection from E.coli is also possible and would require immediate medical attention, so you should take your toddler to the doctor if she’s suffering from food poisoning.

Parasitic infection

Parasites such as Giardia can cause diarrhoea. They are usually transmitted through infected water, but can also spread from person to person through poor hygiene.

Medicines & allergies
Food allergies can also lead to loose stools, for example both lactose and cow’s milk allergies can both cause diarrhoea. Your doctor can test for allergies if you suspect that may be at the root of the problem.

Antibiotics sometimes produce diarrhoea as a side-effect.

Diet

A toddler’s diet can cause her stools to be loose, sticky and explosive (although these won’t usually be the foul-smelling stools of true diarrhoea), and there may sometimes be signs of undigested food in teh stools. This is often called ‘toddler’s diarrhoea’. With ‘Toddler’s diarrhoea’ the child may have these loose stools for weeks or months, but will otherwise be perfectly fine. A common cause is drinking too much fruit juice and/or sugary drinks: Some of the sugars in juices can interfere with the function of the large bowel, where most of the water from stools should be absorbed. If your child is still having a lot of breastmilk this can also loosen her stools. Some babies simply have loose, watery stools but this will usually clear up by the time they are four years olf.

You may need to look at your child’s diet and cut back on juices. You also need to make sure that she’s getting plenty of fat and fibre, which although used to treat constipation is also important for loose stools as it helps to soak up water in the bowel.

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While toddler’s diarrhoea isn’t anything serious, it’s a good idea to get it checked out by your doctor in case there may be another underlying cause or a dietary connection that your doctor could identify.

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