Diarrhoea in Babies and Infants

Your baby’s poo changes over time with your little one’s diet, and it can even vary from one nappy to the next, so the occasional loose stool is not usually anything to worry about. However, if your baby passes a runny, watery stool several times in a row it’s most likely diarrhoea. Read on to learn what to do and how you can care for your newborn, infant or older baby if they have diarrhoea.

What Is Baby Diarrhoea?

Baby poo comes in all sorts of colours and consistencies. Diarrhoea is the name for a discharge of runny or watery poo, often several times a day. In babies and young children, it’s often caused by a viral infection. Because infant diarrhoea is usually caused by germs that affect the stomach, it may be accompanied by vomiting.

Diarrhoea happens when the digestive system becomes overstimulated due to some kind of irritation, for example a viral or bacterial infection. When this happens, waste product passes through the intestines so fast that the bowel doesn’t have time to absorb the water it contains.

Diarrhoea usually stops in a few days with home care and treatment, but it can easily lead to dehydration, so it’s important to keep up your child’s fluid intake. See a doctor if your baby has diarrhoea. Young babies can become dehydrated more easily than older children, especially under the age of 6 months old.

Infant and Baby Diarrhoea and Related Symptoms

Diarrhoea consists of very loose or watery stools that occur frequently. Depending on what’s causing the diarrhoea, it may be accompanied by other symptoms. Other common symptoms that can accompany baby diarrhoea include:

• High temperature or fever

• nausea (your older toddler may be able to tell you they feel sick)

• Vomiting

• Not wanting to eat or feed

• Headache (your toddler may complain that their head hurts)

• Tummy ache (something your toddler may be able to tell you they feel)

• Urgent need to poo (something your toddler may tell you)

• Dehydration.

Causes of Baby Diarrhoea

In newborn babies, toddlers young children, diarrhoea is usually caused by viruses (such as norovirus or rotavirus). Other causes of diarrhoea can include:

• Food poisoning

• Bacterial infection

• Food intolerance or allergy

• Some medicines you might give your child

• A parasite

• Coeliac disease or inflammatory bowel disease.

Baby Diarrhoea Treatment and Care

The kind of treatment your baby’s doctor recommends will depend on their diagnosis of what is causing the diarrhoea in the first place and how severe it is.

There is no medication for diarrhoea triggered by a virus, which is the most common cause of baby diarrhoea. Diarrhoea caused by a virus tends to clear up on its own with time. With diarrhoea – besides keeping your baby comfortable and treating other symptoms like fever or tummy ache – it’s important to keep your child hydrated.

In some cases, your child's doctor may want to run tests, for example by sending a stool sample to a laboratory to find out what kind of virus or bacteria is causing the illness.

If the doctor suspects that your baby’s diarrhoea has a cause other than a viral or bacterial infection, they may conduct further tests or refer your child to a specialist who can investigate the causes and recommend suitable treatment.

If a Food Allergy Is Suspected

If there’s a chance your baby’s diarrhoea is triggered by a food allergy or intolerance, you may be referred to an allergy clinic for blood or skin tests and/or an elimination diet. This means no longer giving your child the foods that might have caused the diarrhoea for a period of time to see if that resolves the diarrhoea.

It’s important to check with your doctor or a qualified dietician before withdrawing certain foods or types of food from your child’s diet, to make sure your baby continues to get all the nutrition needed to grow and develop.

Medicine for Diarrhoea in Babies

If you’re wondering what to give babies for diarrhoea, keep in mind that over-the-counter anti-diarrhoea medicines are not recommended for children under the age of 12 years old. Check with your child's doctor before giving your little one any medication for diarrhoea.

In some cases, medicine could be prescribed or recommended to treat or ease the other symptoms of an illness that’s causing the diarrhoea. For example, your doctor may recommend a medicine suitable for your baby to relieve tummy pain and discomfort and/or help bring down a fever.

Keeping Your Child Hydrated

Rehydration is really important during a diarrhoea spell, to prevent your child from becoming dehydrated. The best way to do this depends on how you are feeding your baby or toddler.

Here are some tips for keeping your baby or toddler hydrated during a spell of diarrhoea:

• If you are breastfeeding, don’t stop giving feeds but it may help to give small amounts more frequently than you usually do.

• If you feed your baby with formula milk, give extra small sips of water between feeds. Don’t add extra water to the formula – make it up in the usual way following the manufacturer’s instructions.

• If your baby is on solid food, stick to their usual diet and offer frequent sips of water throughout the day. If your older child doesn’t feel like eating, don’t force it – the most important thing is to get enough fluid.

• Don’t give your child fruit juice or fizzy drinks. These can make the diarrhoea worse.

• Your doctor may recommend a rehydration solution to replace the important minerals, salts and sugars that are washed out of your child’s system by the diarrhoea. Use this as directed by your doctor or pharmacist.

When to See the Doctor

Babies and toddlers can become dehydrated more easily than older children, especially under the age of 6 months old, so it’s always a good idea to visit the doctor if your child under 5 years old has diarrhoea, even if it’s only mild.

Call your doctor or 111 straight away if

• your baby has diarrhoea and is less than 1 year old

• your child has diarrhoea six or more times in 24 hours

• your baby stops breastfeeding or bottle feeding

• Your baby has a fever

• the diarrhoea is accompanied by vomiting

• you see blood in your child’s poo

• the diarrhoea lasts longer than 7 days

• you notice signs of dehydration:

  • weeing less frequently (fewer wet nappies or no wet nappies)

  • dark or smelly pee

  • dry mouth

  • sunken eyes

  • no tears

  • sunken fontanelle (the soft spot on top of a young baby’s head).

Call 999 or go to A&E immediately if your child

• is difficult to rouse, floppy or unresponsive

• has trouble breathing

• might have swallowed something poisonous

• vomits blood or what looks like coffee grounds

• has sudden, severe or constant tummy pain

• has green or yellowy-green vomit

• has a stiff neck or shows signs of pain when looking at bright lights.

Preventing Diarrhoea

Diarrhoea isn't something you can prevent outright, but there are ways to lessen the chances of your baby or older child getting diarrhoea associated with viruses, bacteria, or food poisoning:

• Check that your child is up-to-date with the rotavirus vaccine, which can guard your little one against this specific virus. This vaccine is usually offered at 8 weeks, with a second booster 4 weeks later, although the first dose can also be given at up to 15 weeks. This vaccine is given in the form of liquid drops for your baby to swallow, not as an injection. Talk to your health visitor if you have any questions about the rotavirus vaccine

• Frequently wash your baby's hands (or use hand wipes when washing isn't an option), especially before meals. Viruses can be transferred from the hands to the mouth easily, which is especially true for babies and toddlers who are constantly putting their hands in their mouths

• Don’t give your child food or drinks while they’re sitting on the potty

• Teach your older toddler or child to properly wash their hands after using the toilet or handling pets.

Food safety

Food poisoning is a potential cause of diarrhoea in babies and older children alike. By following good food safety habits, you can lower the risk of diarrhoea caused by bacteria or parasites found in food. Here are some examples of good food safety habits:

• Wash your hands before and after preparing food, and especially after touching raw meat, chicken, fish and shellfish, eggs and raw vegetables

• Make sure surfaces where food is prepared or eaten are always clean, and keep pets away from them

• Wash all bowls, spoons and other cutlery in hot soapy water (or in a dishwasher), and do the same for chopping boards and kitchen utensils

• Thoroughly clean all kitchen equipment and countertops after handling raw meat, especially poultry

• Keep raw meats and eggs in a covered container, separately from other foods (including cooked or ready-to-eat meats) in the fridge – at the bottom, to prevent and drips from falling onto other food

• Cook food right through, then cool to a safe temperature before giving it to your child

• Don’t save your child’s half-eaten food for later

• Only give your child lightly cooked eggs or food containing raw eggs – such as homemade mayonnaise or uncooked cake mixture – if the eggs are stamped with the ‘red lion’ mark. All other eggs must be cooked until the yolk and white are firm

• Make sure any shellfish or other seafood that your child eats is thoroughly cooked

• Avoid giving your child unpasteurised milk, which can contain bacteria, viruses, and parasites

• Thoroughly wash and peel fruit and vegetables (apples or carrots, for example) before offering them to your baby or toddler

• Immediately refrigerate meats after bringing them home from the supermarket

• Cool any leftover foods within 1 or 2 hours and refrigerate or freeze it right away to prevent contamination that can lead to food poisoning. Rice should be cooled as quickly as possible – within 1 hour – and eaten within 24 hours. Never reheat rice more than once. This is because rice sometimes contains bacteria that can survive cooking, which can produce harmful toxins if the rice is left to stand too long at room temperature.

How to Stop Diarrhoea From Spreading

The germs that can cause diarrhoea are often infectious, so it’s important to take steps to prevent the diarrhoea spreading. Here are some ways to lower the risk of diarrhoea making other people ill:

• Wash your and your child’s hands carefully with soap and warm water after using the toilet and before eating or making food

• Clean the toilet (including the seat and handle) or potty with disinfectant after every bout of diarrhoea

• Wash any soiled clothing and bedclothes separately from other clothes at the highest temperature possible for the given fabric (check the label if you’re unsure)

• Don’t share towels, flannels, plates, cups, other crockery or utensils

• Keep your little one home from nursery, preschool or other group activities until at least 48 hours after the last watery stool.

The Bottom Line

Although there’s plenty you can do to lower the risk of diarrhoea in your baby, the infections that cause it are very common so sooner or later you may encounter some runny poo in your baby’s nappy despite your best efforts.

While diarrhoea is uncomfortable for your baby and it can be worrying for you (and sometimes unpleasant to clean up the mess), it usually only lasts a few days. In the meantime, check in with your child’s doctor and take extra care to keep your child hydrated and to prevent the diarrhoea from spreading. Before you know it your little one will be back to their old self again.