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diarrhoea in infants

Alternative Names 
infantile diarrhoea, infant diarrhoea

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

What is going on in the body? 
Diarrhoea occurs when the bowel or large intestine becomes irritated. This can be caused by many things, including infection, chemical toxins, inflammation, or stress and anxiety. The bowel responds to this irritation in three ways.

It:
  • increases the amount of water and mucous in the stool.
  • decreases the amount of water it reabsorbs from the stool.
  • increases the frequency that the intestine empties the stools from the body.
What are the signs and symptoms of the condition? 
Diarrhoea in infants can cause:
  • belly cramping or pain, which may disrupt sleep.
  • vomiting.
  • loss of appetite.
  • frequent, watery stools. In more serious situations, stools may contain pus or blood.
  • fussiness.
  • sluggishness and less activity than usual.
  • less interest in feeding.
It is important to be able to tell the difference between diarrhoea 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, although a greenish colour can be noted on occasions. 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 6 to 8 weeks old. After that, the stools become firmer and less frequent. In fact, infants that are only fed breast milk beyond the first 2 months of life may have a stool only every 7 to 10 days. As long as the stool is soft, this is normal. Babies' stools are firmer once they start on solid food.

What are the causes and risks of the condition? 
Most diarrhoea in infants is caused by stomach viruses, This condition is viral gastroenteritis. Although diarrhoea is common, there are side effects that can become serious if left untreated.

Diarrhoea results in more fluid than normal going into the stools. This can leave a baby's body without enough fluid to meet its needs, a condition called dehydration. Infants are small and do not have a lot of fluid in their bodies.

Diarrhoea can cause severe nappy rash.

Diarrhoea, especially in toddlers, can last a long time. If it is accompanied by persistent loss of appetite, it can lead to nutritional problems, although this is unusual.

What can be done to prevent the condition? 
The best way to prevent diarrhoea in infants is for the caregiver to wash his or her hands well before preparing feedings and especially after using the toilet. It also is important to:
  • keep other young children in the household who have diarrhoea away from the infant.
  • keep all items placed in the infant's mouth, such as pacifiers or bottle nipples, clean.
  • use clean water when preparing infant formula.
  • wash bottles and nipples well in hot, soapy water.
  • discard any unused formula in the bottle after the infant has finished feeding.
  • refrigerate formula that is mixed in larger quantities and discard formula that is not used in 24 hours.
How is the condition diagnosed? 
Doctors usually diagnose infant diarrhoea by the baby's medical history and the appearance of the stools. Sometimes, samples of the stool or blood are taken for other tests if the infant looks ill or dehydrated, or has a persistent fever.

What are the long-term effects of the condition? 
Usually there are no serious long-term effects of infant diarrhoea, unless the illness is caused by a serious infection or the infant becomes extremely dehydrated.

What are the treatments for the condition? 
Infant diarrhoea 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 diarrhoea. Formula-fed infants can be treated best by using one of the commercially available rehydrating solutions, such as gastrolyte. Once the stool frequency decreases, or if the infant's appetite seems to improve, then the infant's usual formula feedings can be resumed.

How is the condition monitored? 
Most cases of diarrhoea last between 3 to 5 days. A doctor or nurse should be called if:
  • diarrhoea lasts more than 5 days.
  • there is blood or pus in the stool.
  • there is a persistent high fever.
  • the infant seems more that just a little bit sick.
Author: 
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 20/1/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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