Diarrhea In Newborns: What's Normal And What's Not?

Diarrhea is one of the most common childhood issues in the United States and worldwide. It can be challenging to distinguish between normal stools and diarrhea in newborns and young infants. Newborns frequently have soft and loose stools, and it is typical for them to have bowel movements with every feeding or even more often during their first few months. Diarrhea in babies is characterised by a sudden increase in the number of stools, with three or more watery or very loose stools. It is usually caused by a virus and goes away on its own, but it can also be caused by dietary changes, antibiotics, bacterial or parasitic infections, or rare diseases. Dehydration is a significant risk associated with diarrhea, and infants under three years of age can become dehydrated quickly, leading to serious health issues.

What does newborn diarrhoea look like?

Diarrhoea in newborns can be difficult to identify, as stools are typically soft and loose, and newborns often pass stools several times a day. However, there are some tell-tale signs that your newborn has diarrhoea.

Newborn diarrhoea is typically watery, with a higher volume than normal stools. The colour can vary from yellow to green to dark brown. It is important to note that exclusively formula-fed babies tend to have slightly firmer, tan-brown stools, while exclusively breastfed infants have looser, yellow, and seedy stools.

In addition to the appearance of the stool, a newborn with diarrhoea may experience an increased frequency of bowel movements, with two to three more bowel movements than usual. They may also exhibit other symptoms such as agitation, fussiness, or a decreased appetite.

If you suspect your newborn has diarrhoea, it is important to monitor them for signs of dehydration, which can occur quickly in young infants. Signs of dehydration include a decrease in the number of wet diapers, dry eyes and mouth, a lack of tears when crying, and a sunken soft spot on the top of the head. If you notice any of these signs, it is important to seek medical advice.

What causes newborn diarrhoea?

Diarrhoea in newborns can be caused by a variety of factors, and it is one of the most common childhood issues in the United States and worldwide. It is important to know what causes newborn diarrhoea to be able to address it effectively and prevent any health complications. Here are some of the most common causes of diarrhoea in newborns:

Infections: Viruses, bacteria, fungi, and parasites can cause infections that lead to diarrhoea. Rotavirus has historically been the most common cause of diarrhoea in children aged two and younger. Since the introduction of the oral rotavirus vaccine in 2006, the number of cases has significantly dropped. Other viruses, such as norovirus and adenovirus, might also trigger diarrhoea. Intestinal infections caused by parasites, such as giardia, are more likely to occur in infants attending daycare centres due to the increased risk of exposure to contaminated objects and surfaces.

Dietary Changes: Changes in a newborn's diet, such as the introduction of solid foods, can lead to diarrhoea. Dairy products, eggs, gluten, peanuts, and shellfish are common causes of food allergies and sensitivities that can result in diarrhoea. Additionally, if a breastfeeding mother makes dietary changes, it can also affect the newborn and cause diarrhoea. Some of the most common dietary triggers include cow's milk, chocolate, gassy foods, spicy foods, and caffeine.

Medications: Antibiotics are known to cause diarrhoea in children, and about 10% of children who take them experience diarrhoea, nausea, and stomach pain as side effects. Antibiotics can disrupt the balance of gut bacteria, leading to stomach upset or diarrhoea. It is important to consult a doctor before stopping or changing any prescribed medication.

Travel: Infants and young children, especially newborns, are at a higher risk of developing diarrhoea when travelling. This could be due to changes in water, food, or exposure to new environments and germs.

Medical Conditions: Certain medical conditions, such as inflammation of the bowels, can cause diarrhoea in newborns. Additionally, teething babies tend to put everything in their mouths, increasing the risk of ingesting germs that can lead to illness and diarrhoea.

Formula Feeding: Newborns who are formula-fed may develop diarrhoea due to allergies or sensitivities to the type of formula they are consuming. Many infant formulas are made from cow's milk, and the protein in cow's milk can trigger a food allergy. Sensitivity to soy-based formulas is also possible. Contamination of formula powder or water can also introduce germs that cause diarrhoea.

It is important to monitor newborns closely for any signs of dehydration, as they can become dehydrated quickly. Some signs of dehydration include fewer wet diapers than usual, dry eyes with little to no tears, lethargy, dry skin, and a sunken soft spot on the top of the head. If you suspect diarrhoea or dehydration in your newborn, it is crucial to seek medical advice from a healthcare professional.

How to treat newborn diarrhoea at home

Newborns tend to have soft and loose stools, often with every feed. It can be challenging to determine whether your baby has diarrhoea. However, if you notice sudden changes in their stool, such as a sudden increase in the number of stools or very watery stools, your baby may have diarrhoea. Diarrhoea in newborns is usually short-lived and often caused by a virus, which clears up on its own.

If your newborn has diarrhoea, it is important to take steps to prevent dehydration, as this is the most significant risk associated with the condition. Here are some ways to treat newborn diarrhoea at home:

• Breastfeed your baby: Breastfeeding helps prevent diarrhoea and aids in faster recovery. Continue breastfeeding your baby as much as they want.
• Offer formula: If you are formula-feeding, prepare the formula as usual and offer it to your baby frequently. The formula contains enough water and does not need to be diluted.
• Give oral rehydration solutions (ORS): If your baby still seems thirsty, consult your healthcare provider about giving them an ORS like Pedialyte or Infalyte. These solutions contain electrolytes and can be given in small amounts every 30 to 60 minutes. Do not dilute ORS with formula or water, and ensure they are not the only fluid source for more than 6 hours.
• Try the BRAT diet: If your baby is eating solid foods, offer bland, starchy foods like rice, cereal, crackers, and strained bananas, applesauce, or rice cereal. These foods are easy to digest and can help soothe diarrhoea.
• Avoid certain foods and drinks: Do not give your baby fruit juices, sports drinks, teas, broths, or high-sugar liquids like Hawaiian Punch, Hi-C, Kool-Aid, sodas, or syrups, as these can worsen diarrhoea. Also, avoid dairy products, high-fibre foods, and sweets.
• Change diapers frequently: Newborns with diarrhoea may need more frequent diaper changes to keep their bottoms clean and dry. Wash their bottom with water, and let it air dry to prevent diaper rash.
• Practice good hygiene: Wash your hands thoroughly and frequently to prevent the spread of germs. Ensure the diaper-changing area is clean and disinfected.
• Call your doctor: If your baby is a newborn (under 3 months old) and has diarrhoea, contact your healthcare provider. Also, seek medical attention if you notice any signs of dehydration, such as no tears when crying, no wet diaper for 6-12 hours, lethargy, or a sunken soft spot on the head.

When to seek medical help for newborn diarrhoea

Diarrhea is a common issue for newborns and infants, and it's not always easy to tell the difference between normal poop and diarrhea. However, if you suspect your newborn has diarrhea and exhibits any of the following symptoms, it is important to seek medical help.

Firstly, contact your doctor immediately if your newborn is exhibiting any signs of dehydration, which include:

• A decrease in the number of wet diapers, fewer than six per day (24 hours).
• Dry mouth and lips.
• Lack of tears when crying.
• Sunken or curved downward soft spot on the head.
• Dark-coloured urine.
• Dry skin that does not spring back to its usual shape after being pinched.
• Acting fussy or irritable.
• Unusual drowsiness or sluggishness.

Secondly, call your doctor if your newborn has diarrhea and:

• A fever or other symptoms accompany the diarrhea.
• There is blood, mucus, or pus in your baby's poop.
• Your baby appears to be in pain or is excessively sleepy.
• The diarrhea does not go away within 24 hours.
• Your baby is not eating well or is vomiting.
• Your baby has recently travelled.
• Your baby has been exposed to bacterial diarrhea or has been in close contact with reptiles in the past 14 days.
• Your baby has a weak immune system.

Remember, diarrhea in newborns can lead to dangerous dehydration and weight loss, so it is always better to be cautious and seek medical advice if you are concerned.

How to prevent newborn diarrhoea

Newborns have stools often, and they are usually soft and loose, so it can be hard to tell if your baby has diarrhoea. However, if you notice changes in your baby's stool, such as a sudden increase in the number of stools or very watery stools, your baby may have diarrhoea. Diarrhoea in newborns can be caused by various factors, and understanding these causes can help you prevent it. Here are some ways to prevent newborn diarrhoea:

Breastfeed your baby

Breastfeeding helps prevent diarrhoea, and your baby will recover quicker if they do have it. If you are breastfeeding, be mindful that changes in your diet can trigger diarrhoea in your baby. For example, consuming spicy foods or sugary desserts can alter your breast milk and cause diarrhoea. Additionally, certain medications, such as antibiotics, can get into your breast milk and trigger diarrhoea.

Keep your baby hydrated

It is essential to ensure your baby gets enough fluids to prevent dehydration. Continue breastfeeding or offering formula milk as usual. If your baby seems thirsty after or between feedings, consult your healthcare provider about giving them oral rehydration solutions like Pedialyte or Infalyte, which contain electrolytes.

Be cautious with solid foods

If your baby has started solid foods, be cautious about introducing new foods that can trigger diarrhoea. Avoid high-fibre foods, dairy products, and sweets such as cake, cookies, and soda. Instead, opt for bland, starchy foods like strained bananas, applesauce, and rice cereal until the diarrhoea stops.

Practice good hygiene

Diarrhoea can be caused by infections with viruses, bacteria, or parasites. To prevent the spread of these germs, wash your hands thoroughly with warm water and soap each time you change your baby's diaper. Keep the diaper-changing area clean and disinfected. Additionally, avoid sending your child to daycare until they have fully recovered from diarrhoea to prevent the spread of infection.

Consult your doctor

If your baby is less than six months old and has diarrhoea, or if they display any signs of dehydration, such as a dry mouth, lack of tears when crying, or a sunken soft spot on their head, call your doctor immediately. Your healthcare provider can advise you on the best course of action to treat and prevent further diarrhoea.

Frequently asked questions