Diarrhea In Infants

Overview, Causes, & Risk Factors

Diarrhea is a condition in which loose, watery stools are passedwith greater frequency than normal.

What is going on in the body?

Diarrhea occurs when the colon or large intestine becomes irritated. This canbe caused by many things, including infection, chemical toxins, inflammation,stress, or anxiety. Thecolon responds to this irritation in the following ways:

  • increases the amount of water and mucous in the stool
  • increases the frequency of emptying the stools from thebody
  • decreases the amount of water it reabsorbs from the stool
  • What are the causes and risks of the condition?

    Most of the time, diarrhea in children is caused by the viruses that causegastroenteritis. Diarrhea is often associated with vomiting.Following are other causes of diarrhea:

  • bacteria that invade the intestinal tract
  • gastrointestinal disorders, such as irritable bowelsyndrome
  • inherited birth defects such as cystic fibrosis
  • introduction of a new food
  • toxins from contaminated food
  • Symptoms & Signs

    What are the signs and symptoms of the condition?

    Diarrhea in infants can cause the following conditions:

  • abdominal distressand cramping, which may disrupt sleep
  • frequent, watery stools, and in more serious situations,pus or blood in the stools
  • irritability
  • less interest in feeding
  • loss of appetite
  • sluggishness and less activity than usual
  • vomiting
  • It is important to be able to tell the difference betweendiarrhea and the normal loose, watery stools of infants in the first 6 to 8weeks of life. Breast-fed infants normally have stools that look like watery,yellow cottage cheese. Their stools also are frequent, often occurring duringor after each feeding. Breast milk stools usually are sweet-smelling ascompared to the stools of formula-fed infants.

    Mostinfants, even those fed formula, have frequent, watery stools until they are sixto eight weeks old. After that, the stools become firmer and less frequent. Infact, infants who are only fed breast milk beyond the first two months of lifemay have a stool only every three to five days. As long as the stool is soft, this isnormal. Babies’ stools are firmer once they start on solid food.

    When severe, diarrhea can cause dehydration. Signs of dehydration include the following:

  • absence of tears when crying
  • decreased urination
  • dry mouth
  • sluggishness and lethargy
  • Diagnosis & Tests

    How is the condition diagnosed?

    Diarrhea is diagnosed by the frequency and looseness of the stools. The causeof the diarrhea is diagnosed by considering other symptoms. These may includethe presence of blood or mucus in the stool, the duration of the diarrhea,weightloss, or other signs of illness.

    A healthcare provider will take a history of the infant’s symptoms. He or shewill then do a physical exam. The provider will look for signs of dehydration.

    Labs tests, such as blood tests and tests on the stool, may be performed.Special X-rays may be taken, as well. Occasionally, an instrument known as acolonoscope is used to view the interior of the intestine. This canhelp determine the cause of the diarrhea.

    Prevention & Expectations

    What can be done to prevent the condition?

    The best way to prevent diarrhea in infants is for the caregiver to wash his orher hands well before preparing feedings and especially after using the toilet.Other important steps to take are as follows:

  • Discard any unused formula in the bottle after the infant is finished feeding.
  • Keep all items placed in the infant’s mouth, such as pacifiers or bottlenipples, clean.
  • Keep other young children in the household who have diarrhea away from the infant.
  • Refrigerate formula that is mixed in larger quantities and discardformula that is not used in 24 hours.
  • Use clean water when preparing infant formula.
  • Wash bottles and nipples well in hot, soapy water.
  • Food poisoning can also be minimized by cleaning allutensils, cleaning cooking or preparing surfaces, and cooking meat until it iscooked through and no longer pink.

    What are the long-term effects of the condition?

    Usually there are no serious long-term effects if diarrhea in infants iseffectively treated to avoid dehydration. In countries where access to intravenous fluids andmedication is limited, babies may suffer from other diseases or diarrhea may befatal.

    If the illness is caused by a serious infection or the infant becomes extremelydehydrated, there may bemore serious long-term effects. If an infant becomes severely dehydrated, theamount of fluid in the bloodstream decreases. This makes it difficult for thebody organs to get enough oxygen and nutrients. If this is severe enough,it can cause death. Diarrhea is one of the leading causes of death inchildren around the world.

    Diarrhea can last a long time. If it is accompanied by persistent loss ofappetite, it can lead to nutritional problems. This, however, isunusual. Diarrhea can sometimes cause temporary problems with digesting milkproducts, a condition known as lactose intolerance. This usuallyresolves on its own. Diarrhea may also cause severe diaper rash.

    What are the risks to others?

    Diarrhea caused by a virus or bacterial infection may becontagious. It is important to wash hands well to prevent spreading germs. Theelderly, young children, or others who have weakened immune systems are atincreased risk. Diarrhea can cause more serious symptoms in theseindividuals.

    Treatment & Monitoring

    What are the treatments for the condition?

    Infant diarrhea is treated by replacing the fluid in the body. Usually this isdone 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 hasdiarrhea. Formula-fed infants can be treated best by using one of thecommercially available rehydrating solutions, such as Pedialyte or Infalyte. Once the stool frequency decreases, or if the infant’sappetite seems to improve, then the infant’s usual formula feedings can beresumed.

    What are the side effects of the treatments?

    There are generally few side effects to the above treatments. Ifmedications are needed for the underlying cause of the diarrhea, there may beside effects to the medications. These include further stomach upset orallergic reactions.

    What happens after treatment for the condition?

    A few days of diarrhea generally is not a cause for concern. Theexception would be if the infant is not drinking enough fluid tocompensate for the liquid lost in the diarrhea. If diarrhea continues despitetreatment, the healthcare provider should be notified.

    How is the condition monitored?

    Most cases of diarrhea last three to five days. A healthcare provider should be calledimmediately if one of the following conditions applies:

  • behavior changes in the infant
  • blood or pus in the stool
  • decreased fluid intake or frequent diarrhea
  • decreased urination
  • diarrhea that lasts more than five days
  • the infant seems to be having abdominal pain
  • more that just a mild case of sickness
  • no tears when crying
  • persistent high fever
  • vomiting and the inability to keep fluids down
  • weight loss
  • Any other new or worsening symptoms should also bereported to the healthcare provider.

    Article type: xmedgeneral