Diarrhea in babies and toddlers

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

Diarrhea in toddlers is when they have more than three thin (foul-smelling) stools per day. For babies (children in the first year of life) the limit is more than five such bowel movements. In general, diarrhea in young children is not uncommon and is often harmless. However, diarrhea in a child in the first few years of life can also be dangerous. Find out how you can relieve diarrhea in toddlers and babies, what causes it in the first place, and when you should see a doctor.

Brief overview

• What to do in case of diarrhea in babies and toddlers? Compensate for fluid and mineral salt loss, measure temperature, give low-fat and low-irritation, binding food
• Causes of diarrhea in babies and toddlers include: Food intolerance, infections, stress
• When to the doctor z. B. in persistent diarrhea, colic, high fever, blood in the stool

Caution!

• Diarrhea (and vomiting) can quickly dry out the body, especially in young children. Signs of this are e.g. dry mouth, dry lips, white, slack skin, decreased urine excretion and drowsiness.
• Children who can already drink from a cup on their own can often be motivated to drink if they put a straw into their drinking vessel.
• To compensate for the loss of fluid and salt in children under five, special electrolyte solutions from the pharmacy are better than self-made sugar-salt solutions.
• If the diarrhea is due to a bacterial infection, the little patient and all other household residents should wash their hands more often with soap and warm water (especially after using the toilet, changing diapers and before eating). This lowers the risk of infection.

What to do in case of diarrhea in toddlers and babies?

First of all: If you have diarrhea and other gastrointestinal problems in your child, do not use the home remedy cola and pretzel sticks! The high-sugar, caffeinated brown soda can make diarrhea worse. And salt sticks cannot compensate for the loss of salt because they lack important salts (such as potassium).

Better to do the following if your child has diarrhea:

• Measure his body temperature. If your child has a fever and / or is vomiting, an infection is likely causing the diarrhea.
• Don't give a toddler solid food for about six hours. Make sure, however, that it drinks a lot. The best way to compensate for the loss of fluid and salt is with a ready-made electrolyte-glucose mixture from the pharmacy.
• If you give your offspring milk formula, you can feed them again as you continue to build up their diet. But mix them with binding foods like bananas, potatoes, rice or grated apples.
• A baby who is breastfed can continue to breastfeed. However, you can also do something for a baby with diarrhea: Give special diarrhea food in the form of a rice gruel electrolyte solution (pharmacy) or tea (e.g. chamomile or fennel) for the first six hours.
• If the diarrhea improves and the child has an appetite again, offer them food that is low in fat and low in irritants (rusks, rice, toasted bread, mashed potatoes, etc.).

Because of the milk sugar (lactose) it contains, cow's milk (pure or in the form of quark, etc.) can cause gas and stomach ache, as diarrhea often causes a temporary deficiency in the lactose-splitting enzyme lactase.

Causes of diarrhea in babies and toddlers

If a young child or baby has diarrhea, this is not necessarily a cause for concern. Since the digestive system is still very sensitive at this age, infants, small children and school children often have diarrhea. If the child has no further symptoms, it may just be one food that they could not tolerate or they may have eaten too much fruit. Then the diarrhea in the toddler often only lasts for one to two days. The main triggers, which can be any of the following:

nourishment

Sometimes accelerated bowel evacuation is due to the consumption of certain foods, spoiled foods, or a generally poor diet. Sometimes this shows up in the color of the chair. If the diarrhea is yellow and light in the baby or toddler, this indicates that he has consumed (has) a lot of dairy products. Yellow diarrhea like this in toddlers or babies usually clears itself up if you adjust their diet.

Incompatibilities: Diarrhea in small children can be due to diet for another reason: Some people cannot tolerate certain ingredients of food and react with diarrhea and other symptoms. This is the case with lactose intolerance (milk sugar intolerance) and celiac disease (gluten intolerance). If the baby has a cow's milk protein intolerance, this can show up in the first months of life with slimy-bloody diarrhea.

Stress, psychological stress: Disturbances in the usual daily routine, traveling (possibly with a time difference), conflict situations in the family and fear of getting used to the daycare or kindergarten can change the texture of the chair in small children and trigger diarrhea.

Tooth Growth: Babies can also have diarrhea for a day or two when they are teething.

Bacteria and viruses: If the child not only has diarrhea, but also fever and vomiting, it is usually an intestinal infection (colloquially: the child has "gastrointestinal"). In toddlers vomiting usually lasts one to two days, the diarrhea is a little more persistent at two to ten days. Rotaviruses and noroviruses often cause diarrhea in babies and young children. Such infections are very contagious, the viruses spread via smear infection.

Bacteria that can cause diarrhea include colic bacteria, staphylococci, salmonella, and cholera bacteria, among others. Bloody, watery, slimy stool in toddlers can be a symptom of bacterial dysentery - an infection with Shigella from drinking water or food. Other signs of this disease are high fever and cramping abdominal pain.

Sometimes diarrhea is a side effect of certain medications (such as antibiotics) or a side effect of other medical conditions, such as a cold.

Chronic diarrhea

If the diarrhea lasts longer than fourteen days, it is considered chronic. The cause can be (comparatively harmless) disorders such as irritable bowel syndrome. Absorption disorders (absorption disorders; e.g. food intolerance) and serious illnesses can also be triggers.

Diarrhea in babies and toddlers: when to see a doctor?

The rule is: Better to see a doctor once too often than once too little. The smaller the child, the more dangerous diarrhea can become. Because with diarrhea, especially vomiting ("gastrointestinal"), babies and toddlers can lose a lot of fluids and electrolytes, which can be life-threatening.

You should also see a doctor with the offspring in the following cases:

• The diarrhea lasts longer than six (baby) or twelve (toddler) hours.
• Colic-like abdominal pain and / or high fever also occur.
• You notice blood in the child's stool.
• In a 24-hour period, a baby secretes more than four watery stools, and a toddler more than six watery stools.
• The stool is (more often) white (this may be due to a serious illness such as biliary obstruction or hepatitis).
• The child has dry tongue and lips and pees less than every six hours.
• You cannot get the child to drink.
• The child's abdominal wall is very tense.

Diarrhea in babies and toddlers: what does the doctor do?

The doctor will make up for the child's water and electrolyte loss as needed. Solutions with the optimal composition of substances that are lost in diarrhea (and vomiting), such as sodium and potassium, are used for this. They can be administered about a spoonful. In severe cases, the child needs infusions.

In addition, if necessary, doctors can treat diarrhea in toddlers with drugs that slow the passage of stool through the intestines. These should not stop the diarrhea abruptly, but gradually increase the intervals between the individual bowel movements.

In addition, diarrhea in babies and toddlers may require additional measures depending on the cause and severity. For example, antibiotic therapy may be useful in the case of bacterial infection.

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