Normal bowel habits differ among children. Breast-fed infants normally have liquid bowel movements (stools) that are bright yellow in colour and contain bright yellow ‘curds.’ The frequency of bowel movements can be anywhere from five to six times a day to once a week. As long as the colour and texture remain unchanged, be reassured that things are normal.
Infants on formula or cow’s milk usually have stools that are pale yellow, with the texture of paste. Infants cannot absorb all of this type of milk, so there are leftover solids. Frequency should be once every one to three days. Older infants and children eating solid food will have bulkier stools that will be brown in colour and softly formed. Again, they should appear every one to three days.
Diarrhea is any change in the bowel pattern that causes one or more of the following:
Finding the cause of an episode of diarrhea requires a bit of detective work. Clues are in the accompanying signs, and in the stool itself.
Infection is by far the most common cause, with viruses the major culprit. It is probably a virus if:
It is often bacterial if:
Common bacteria include Salmonella, Shigella, Campylobacter, Yersinia or E. coli (hamburger disease). Infection usually comes from contaminated food or water. Parasites are another common cause of diarrhea. Parasites may be present if:
Common parasites include Giardia (beaver fever) and Entameba.
Milk sugar (lactose) intolerance is now known to be a frequent cause of diarrhea. Often, there is little cramping and no fever, nausea or vomiting. The child is not sick and has no loss of appetite. Watery or very soft brownish stools, sometimes mixed with mucus, are often worse after large amounts of dairy products have been eaten. The problem settles when dairy products are withheld.
Other possible causes of diarrhea in children include:
Any one of these requires medical attention.
When reintroducing solids to a child who eats table food, try bananas, rice, applesauce, toast, cereal and potatoes. These are easily digested and do not irritate the bowel.
Frequent small meals will be handled better. Begin offering solids and dairy products after 24 to 48 hours to avoid ‘starvation diarrhea.’ If the diarrhea starts again, see your family doctor. Do not give medicines (such as Kaopectate™ or Imodium™) to stop diarrhea, unless your doctor tells you to do so.
Contact your doctor right away if your child seems dehydrated. This can happen with diarrhea from any cause, and means the body is lacking important fluids and electrolytes (body salt). Watch for:
Seek medical help if your child seems well but diarrhea lasts longer than four days, blood is in the diarrhea or stools, or if there is persistent vomiting, high fever, or pain in the abdomen or rectum.
Diarrhea is the bowel’s way of ridding itself of irritations. It is common, usually short-lived, and not dangerous. Most cases can be dealt with at home and do not require medical care. However, ignoring danger signs can lead to serious illness and even death. If your child seems sick, follow the guidelines above and get help from your doctor.