Diarrhea
Your baby’s diarrhea may be caused by a viral infection, such as gastroenteritis, or a bacterial infection. The problem might also be a parasite, a course of antibiotics, a milk allergy, or, in an older baby, too much fruit juice.
Gastroenteritis
Gastroenteritis (often called stomach flu) is an inflammation of the stomach and the intestines that causes diarrhea in babies, children, and adults. It’s very common, and it can be caused by many different viruses. The most frequent culprit is the rotavirus, which is responsible for half of childhood hospitalizations for diarrhea. If your baby has diarrhea accompanied by stomach cramps, vomiting, and a low fever, it’s probably a form of gastroenteritis. Keep in mind that if he isn’t eating or drinking much, he can lose a lot of fluid.
Bacterial infection
Severe diarrhea — with or without vomiting — accompanied by cramps, blood in the stool, and a fever may be due to a virus or bacteria such as E. coli or salmonella. Some of these infections clear up on their own, but some, like that from the E. coli that can be found in undercooked meat, can be very serious. So if your baby has these symptoms, take him to the doctor. She’ll examine him and probably evaluate a stool culture for signs of a bacterial infection.
Parasites
Parasitic infections can also cause diarrhea. Giardiasis, for example, is caused by a microscopic parasite that lives in the bowel. Parasites are easily spread in group-care situations, and treatment involves special medicine. Good hygiene — such as regular hand washing after changing diapers — is the best way to stop the spread of infection.
Antibiotics
If your baby has diarrhea during or after a course of antibiotics, it may be related to the medicine. Talk to his doctor about alternatives and remedies.
Dietary causes
Too much juice (especially fruit juices containing sorbitol and high levels of fructose) or too many sweetened drinks can upset a baby’s tummy and cause him to have loose stools. Cutting back the amount should solve the problem in a week or so. The American Academy of Pediatrics (AAP) recommends that you not give your baby fruit juice before the age of 6 months. After that, give him no more than 4 to 6 ounces a day. Improperly mixed formula can also cause diarrhea, so make sure you’re adding the right amount of water when you make it.
Milk allergies
Milk allergies are rare, but they can cause diarrhea and sometimes vomiting. If your baby’s allergic, he can show symptoms anywhere from a few minutes to a few hours after drinking cow’s milk formula or eating food made with a dairy product (once he’s eating solid foods). If you suspect your baby’s diarrhea is linked to milk, talk with his doctor about it.
How should I treat my baby’s diarrhea?
While rarely serious when treated properly, diarrhea can send your baby to the hospital if he becomes dehydrated, so your first concern should be giving him enough liquids. If your baby isn’t also vomiting, continue to give him breast milk or formula. If he can’t keep that down, call his doctor, who may suggest that you start giving your baby a pediatric electrolyte solution, like Pedialyte, ReVital, or a generic brand. These solutions are available in drugstores and come in flavors that most babies will readily drink if they’re dehydrated. They’re generally easier to keep down than breast milk or formula, too.
Avoid sweetened fluids like sodas (including ginger ale), athletic drinks (like Gatorade), Jell-O, sugar water, and undiluted fruit juices. All of these contain sugar that will draw water into the intestine and make the diarrhea worse. Also, don’t use anti-diarrhea medicine unless the doctor prescribes it.
Doctors now advise continuing to feed solids to a baby with diarrhea who’s already made the transition to finger or table food. While there’s nothing wrong with feeding your child the classic BRAT diet (bananas, rice, applesauce, and dry toast), the AAP says any foods made up of complex carbohydrates, such as rice, wheat, potatoes, bread, and baby cereal, as well as lean meats, yogurt, fruits, and vegetables, are safe to eat. (If your baby temporarily refuses to eat, don’t worry. As long as he stays hydrated, his appetite should return in a day or two.)
Studies have shown that live bacterial cultures, found in yogurt, are a safe and effective way to cut down on the amount and duration of diarrhea. It’s an easy way to treat the problem, especially if your baby loves the taste of yogurt. Just be sure to buy yogurt with lactobacillus, or live cultures.
If your baby is uncomfortable during a bout of diarrhea, try to cuddle and comfort him as much as possible and keep him dry. Use care and tenderness — and diaper cream — at changing time, since it’s easy for a baby’s bottom to become red and irritated from the loose stools.
When should I call the doctor?
Call the doctor immediately if your baby is 3 months old or younger and he has diarrhea. If he is over 3 months, call the doctor if your baby has diarrhea and any of the following:
• vomiting
• signs of dehydration, such as dry mouth and not having had a wet diaper for six to eight hours or more
• blood in his stool or black stool
• a high fever — over 101 degrees Fahrenheit (38.3 degrees Celsius) if he is 3 to 6 months old; 103 degrees F (39.4 degrees C) if he is 6 months or older
• refuses to eat
How can I keep my baby from coming down with diarrhea?
Follow the suggestions above, depending upon the cause. As for infectious diarrhea, frequent hand washing is your best defense, because the microorganisms that cause diarrhea are easily passed from hand to mouth. (Your baby can catch a diarrhea-causing infection from putting his fingers in his mouth after touching toys or other objects that have been contaminated with the stool of an infected child.) So wash your hands thoroughly for at least 15 seconds with soap (it doesn’t have to be antibacterial soap) after handling soiled diapers or using the bathroom. Wash fruits and vegetables thoroughly before serving, because harmful bacteria can spread this way, too.
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