Diarrhoea

How can I tell if my baby has diarrhoea?

Many parents worry that their baby has loose motions because newborns tend to have a lot of bowel movements. Your baby's potty will depend very much on whether she's being breastfed or formula fed. The stools of breastfed newborn babies are usually yellowish, on the soft or liquid side and may occur up to five times daily. The stools of formula-fed babies, on the other hand, tend to occur once a day and are fairly firm. Check out our baby potty visual guide for more information. 

Sometimes a breastfed baby will do potty during or immediately after each breastfeeding session. Within a month, most breastfed babies are down to one or two potties a day. Occasional loose stools are normal for both breastfed as well as formula-fed babies. But your baby may have diarrhoea if:

• she is passing stools more frequently than usual
• her stools are smelly, watery, and mucus-streaked (one doctor says it looks like you've blown your nose in your child's nappy)
• she has a fever or appears to be losing weight

In addition to this, your baby may be cranky and not eating well. See your doctor if you suspect your baby has diarrhoea. 

What causes diarrhoea in a baby?

The most common cause of loose motions is a virus called rotavirus. Rotavirus infects the gut causing gastroenteritis. This damages the inner lining of the intestine. The injured lining leaks fluid and allows food to pass through without absorbing any nutrients. Most children get affected by this virus a couple of times before they turn five. Children aged between 6 and 24 months are more likely to catch this virus as it gets tougher to maintain hygiene once they begin crawling.

Diarrhoea in babies can also be caused by:

• formula feeds, if they are not properly diluted
• colds
• antibiotics
• allergies
• food poisoning
• enzyme deficiencies in rare cases
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Can diarrhoea in a baby be prevented?

The organisms that cause diarrhoea can easily be passed from hand to mouth. So, proper hygiene can help prevent diarrhoea. Wash your hands thoroughly for at least 15 seconds with an antibacterial soap after handling soiled nappies or using the toilet. Keep non-alcoholic wipes handy and wipe your baby's hands frequently when she is crawling around. You could also use a damp washcloth for this purpose. 

How should I treat my baby's diarrhoea?

Make sure your baby drinks plenty of fluids to stop her from dehydrating. If your baby is taking her breast or formula feeds well, stick with them. In addition, older babies may be given sips of water, oral rehydration solution (ORS) or electrolyte solution. Coconut water (elaneer/naariyal pani) is a rich source of electrolytes. 

You can prepare ORS at home as well. Take one litre of water, boiled and then cooled. Stir in 8 teaspoons of sugar and one teaspoon of salt. Give her sips of this mixture every time she vomits and passes stool or urine. 

Babies older than 9 months can also have well-diluted fruit juices. Juices made with 1 part juice added to 10 parts water are ideal. If your child is reluctant to drink, she may prefer homemade ice lollies instead. But it is best not to use any artificial flavouring or food colours when you are making them. Avoid glucose drinks, fizzy drinks and undiluted fruit juices (concentrated sugar draws water into the intestine and can increase diarrhoea). 

Check with your paediatrician before giving your baby anything. Remember that you should not give any anti-diarrhoeal medicine to children below 12 years as they could have serious side-effects. Also avoid herbal remedies without consulting your paediatrician. 

Are breastfed babies less likely to get loose motions?

Yes. Breast-fed babies are better protected from infections that might come from drinking water or feeding bottles. Also, certain elements in breast milk can hinder the growth of the organisms that cause diarrhoea. 

Should I stop giving my baby solid foods if she has diarrhoea?

No. Unless your baby is vomiting frequently, you can continue giving her solid foods. If your child is six months or older you could try foods like bananas, rice, apple puree and dry toast. For an older baby or toddler you could try small amounts of chicken soup and starchy foods like mashed potatoes and pasta. Boiled rice and moong dal would work too. But don't worry if she doesn't want to eat. It's more important that she keeps taking fluids to avoid dehydration. 

When should I call the doctor if my baby has diarrhoea?

Diarrhoea can be worrying if it lasts more than a few hours, but it will usually clear up on its own. If your child is continually passing loose, smelly and watery stools more than 3-4 times in a few hours, call your doctor immediately. The biggest concern with diarrhoea is dehydration, so don't delay in calling your doctor if your child shows these signs of fluid loss:

• dry skin or lips
• listlessness
• tearless crying
• a sunken fontanelle
• discoloured hands and feet
• dark yellow urine or fewer wet nappies than usual

You should also consult your paediatrician if your child shows the following symptoms:

• refuses to drink water, milk, or any other fluid
• has a fever which lasts longer than 24 hours
• has blood in her stools
• has diarrhoea accompanied by vomiting, which lasts longer than 12 hours 
• has a swollen abdomen
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If your baby's uncomfortable during a bout of diarrhoea, try to comfort her as much as possible. Keep her dry. Be gentle when changing nappies since her delicate bottom may be raw from the frequent passing of stools. Use a barrier cream to prevent irritation if the diarrhoea lasts for more than a day. And try not to worry too much, with the right care, your baby will soon bounce back.