Normal or healthy baby stools are soft and loose. Babies have frequent stools during the first 1 - 2 months. Because of this, it may be difficult to tell when your baby has diarrhea.
Most babies have a stool pattern that is typical for them. This pattern may change slowly over time. Look for the following to help decide whether your baby has diarrhea:
A sudden increase in how often your baby has stools
More than one stool per feeding
Stools that appear to be more watery
If your baby is feeding poorly, or has nasal congestion or a fever, the changes you notice are more likely to be diarrhea.
Most diarrhea in children is short-lived. It is usually caused by a virus, and goes away on its own. Other causes of diarrhea include:
A change in the baby's diet or the breast-feeding mother's diet
Use of antibiotics by the baby or breast-feeding mother
Rare diseases such as cystic fibrosis
Infants and young children (under age 3) can dehydrate quickly, so they should be watched very carefully. Dehydration means that the body does not have enough water or liquids.
Signs of mild dehydration:
Dry eyes and crying with few tears or no tears
Fewer wet diapers than usual
Less active than usual or irritable
Slightly dry mouth
Signs of moderate dehydration:
Dry skin that is not springy
Sluggish or lethargic
Sunken appearing eyes
Signs of severe dehydration:
No urine output in 8 hours
Skin that is pinched between fingers fails to spring back to its original shape
Sunken fontanelle (the soft spot on top of the head) in infants
Very lethargic or possibly unconscious
Make sure the child gets plenty of liquids.
If you are nursing, the doctor will probably recommend that you continue nursing. Breast-feeding helps prevent diarrhea, and it also speeds recovery.
If your baby still seems thirsty after or between nursing or feeding sessions, you can add an oral rehydration solution, such as Pedialyte. Often, your pediatrician will recommend extra fluids that contain electrolytes. Follow the doctor's instructions. Do not use sports drinks for young infants.
Talk to your pediatrician right away if there are signs of dehydration. If the infant develops signs of moderate or severe dehydration, he or she should be seen right away.
The following can help prevent diaper rash:
Frequent diaper changes
Protective ointments and creams, such as Desitin
Rinsing the bottom with water
Cut down on baby wipes during diarrhea.
Call your pediatrician if:
A newborn (under 3 months old) has diarrhea
Diarrhea contains blood, mucus, or puss
Fever and diarrhea last for more than 3 days
The child appears dehydrated
The child has more than 8 stools in 8 hours
The diarrhea does not go away in older infants or lasts in children for 2 days or longer
Vomiting continues for more than 24 hours
Canavan A, Arant BS Jr. Diagnosis and management of dehydration in children. Am Fam Physician. 2009;80:692-696.
Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.