Infant Diarrhea - Diarrhea in Infants

Diarrhea is a condition in which loose, watery stools are passed with greater frequency than normal.

What is going on in the body?

Diarrhea occurs when the colon or large intestine becomes irritated. This can be caused by many things, including infection, chemical toxins, inflammation, stress, or anxiety. The colon responds to this irritation in the following ways:

What are the causes and risks of the condition?

Most of the time, diarrhea in children is caused by the viruses that cause gastroenteritis. Diarrhea is often associated with vomiting. Following are other causes of diarrhea:

What are the signs and symptoms of the condition?

Diarrhea in infants can cause the following conditions:

It is important to be able to tell the difference between diarrhea and the normal loose, watery stools of infants in the first 6 to 8 weeks of life. Breast-fed infants normally have stools that look like watery, yellow cottage cheese. Their stools also are frequent, often occurring during or after each feeding. Breast milk stools usually are sweet-smelling as compared to the stools of formula-fed infants.

Most infants, even those fed formula, have frequent, watery stools until they are six to eight weeks old. After that, the stools become firmer and less frequent. In fact, infants who are only fed breast milk beyond the first two months of life may have a stool only every three to five days. As long as the stool is soft, this is normal. Babies' stools are firmer once they start on solid food.

When severe, diarrhea can cause dehydration. Signs of dehydration include the following:

How is the condition diagnosed?

Diarrhea is diagnosed by the frequency and looseness of the stools. The cause of the diarrhea is diagnosed by considering other symptoms. These may include the presence of blood or mucus in the stool, the duration of the diarrhea, weight loss, or other signs of illness.

A healthcare provider will take a history of the infant's symptoms. He or she will then do a physical exam. The provider will look for signs of dehydration.

Labs tests, such as blood tests and tests on the stool, may be performed. Special X-rays may be taken, as well. Occasionally, an instrument known as a colonoscope is used to view the interior of the intestine. This can help determine the cause of the diarrhea.

What can be done to prevent the condition?

The best way to prevent diarrhea in infants is for the caregiver to wash his or her hands well before preparing feedings and especially after using the toilet. Other important steps to take are as follows:

Food poisoning can also be minimized by cleaning all utensils, cleaning cooking or preparing surfaces, and cooking meat until it is cooked through and no longer pink.

What are the long-term effects of the condition?

Usually there are no serious long-term effects if diarrhea in infants is effectively treated to avoid dehydration. In countries where access to intravenous fluids and medication is limited, babies may suffer from other diseases or diarrhea may be fatal.

If the illness is caused by a serious infection or the infant becomes extremely dehydrated, there may be more serious long-term effects. If an infant becomes severely dehydrated, the amount of fluid in the bloodstream decreases. This makes it difficult for the body organs to get enough oxygen and nutrients. If this is severe enough, it can cause death. Diarrhea is one of the leading causes of death in children around the world.

Diarrhea can last a long time. If it is accompanied by persistent loss of appetite, it can lead to nutritional problems. This, however, is unusual. Diarrhea can sometimes cause temporary problems with digesting milk products, a condition known as lactose intolerance. This usually resolves on its own. Diarrhea may also cause severe diaper rash.

What are the risks to others?

Diarrhea caused by a virus or bacterial infection may be contagious. It is important to wash hands well to prevent spreading germs. The elderly, young children, or others who have weakened immune systems are at increased risk. Diarrhea can cause more serious symptoms in these individuals.

What are the treatments for the condition?

Infant diarrhea is treated by replacing the fluid in the body. Usually this is done through oral feedings. But, if the infant is extremely dehydrated, it is done intravenously, by pumping fluid into the body through a vein.

Breast-feeding mothers should continue to breast-feed while the infant has diarrhea. Formula-fed infants can be treated best by using one of the commercially available rehydrating solutions, such as Pedialyte or Infalyte. Once the stool frequency decreases, or if the infant's appetite seems to improve, then the infant's usual formula feedings can be resumed.

What are the side effects of the treatments?

There are generally few side effects to the above treatments. If medications are needed for the underlying cause of the diarrhea, there may be side effects to the medications. These include further stomach upset or allergic reactions.

What happens after treatment for the condition?

A few days of diarrhea generally is not a cause for concern. The exception would be if the infant is not drinking enough fluid to compensate for the liquid lost in the diarrhea. If diarrhea continues despite treatment, the healthcare provider should be notified.

How is the condition monitored?

Most cases of diarrhea last three to five days. A healthcare provider should be called immediately if one of the following conditions applies:

Any other new or worsening symptoms should also be reported to the healthcare provider.

Author:Eileen McLaughlin, RN, BSN
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:03/30/01
Reviewer:Eric Berlin, MD
Date Reviewed:08/06/01