Diarrhoea (babies and infants)
Diarrhoea (babies and infants)


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Gastro-intestinal system
Diarrhoea in babies can be distinguished from a normal dirty nappy by the production of very watery, smelly, mucus-streaked, green-coloured poo, occurring far more frequently than the baby usually poos.

Diarrhoea in babies can be life-threatening and should not be taken lightly. There is a serious risk of babies quickly becoming dehydrated as so much of their small volume of body fluids can be lost with each poo. The risk of a baby becoming dehydrated is even more dangerous if the baby also is vomiting or is sweating because of a high temperature or hot weather. Low birth-weight babies who have not yet made up their weight are at particular risk of suffering dehydration because of diarrhoea.

Urgent medical help should be obtained if a baby has diarrhoea and is refusing feeds, or is showing signs of abnormal drowsiness, or signs of dehydration such as sunken eyes, sunken fontanelles (the soft spots on a baby's head), dry lips, dry tongue, dark-coloured urine, or if the poo is blood-stained.
Diarrhoea in babies who are breast fed may be caused by something in the mother's diet. Foods such as spicy foods or dairy products eaten by the mother, or alcohol drunk by the mother, can make their way into breast milk, upsetting the baby's tummy. A similar effect can occur if the mother takes laxatives such as senna tablets to relieve her constipation. Small amounts of the laxative can end up in breast milk and cause diarrhoea in the baby. A change in the mother's diet, or the mother avoiding things known to upset the baby previously, soon prevents the problem.

In formula fed babies, diarrhoea may occur because of an intolerance to cow's milk protein. If this occurs, it may be necessary to change to a formula milk based on soya.

At the time of weaning, as solid foods start to be introduced to the baby's diet, it is quite common for babies to develop diarrhoea as their digestive system gets used to new types of food. Some foods rich in fibre or fruit may be particularly troublesome. This type of diarrhoea will clear up as soon as the infant becomes used to the new type of food or the infant's diet is changed.

The most common causes of severe diarrhoea in babies and infants is a virus called rotavirus. Nearly all children catch this virus by the time they are five. Rotavirus cause gastroenteritis, an infection of the child's digestive system. The infection damages the lining of the intestines allowing fluids and salts to leak into the bowel, increasing the watery consistency of the poo and stimulating vigorous contractions of the muscles in the wall of the intestine that increase the frequency of pooing.

Bacterial infections can also cause diarrhoea. Food contamination, due to undercooked or poorly stored food is a major culprit in introducing these germs into the gut. Water, if it has not been filtered or treated, can also carry germs that cause diarrhoea. Not washing hands after going to the toilet can also pass diarrhoea-causing bacteria from parents to babies, or can be picked up by infants who are toilet-trained.

If diarrhoea persists for more than two weeks it is said to be chronic. In this case, the chronic diarrhoea is usually a symptom of some other long term illness such as sensitivity to gluten or to lactose.
Extremely loose and watery poo, passed at frequent intervals throughout the day or night. The poo is often smelly, green coloured and may be streaked with mucus. The baby or infant may also experience tummy pains and vomit. In severe cases, the child may be abnormally drowsy or listless or may show signs of dehydration such as sunken eyes, sunken fontanelles, dry lips, dry tongue, dark-coloured urine or infrequent weeing. The baby may stop breast feeding or refuse feeds. In all such cases, medical help should be obtained immediately.
It is essential that the fluids lost by babies and infants as a result of diarrhoea are restored as soon as possible to avoid dehydration. Breast fed and formula fed babies should be encouraged to feed as normal. They should also be given extra fluids, either in the form of freshly boiled and cooled water or as oral rehydration supplements. Rehydration supplements replace lost water and also help replace lost salts and sugars.

Infants should be encouraged to drink as much fluids as possible, preferably in the form of water or rehydration supplements. Caffeinated drinks such as cola and tea, fruit juices and fizzy drinks should be avoided as they may make dehydration worse by stimulating urination. Infants should also be encouraged to eat. Small amounts of easily digestible plain foods, such as boiled rice or dry toast, given at intervals, are better than large meals. Dairy products and fresh foods should be temporarily avoided as they may stimulate the bowel.

Anti-diarrhoeal medicines are not recommended for babies or infants.

Nappies should be changed as soon as they are soiled and the area cleaned gently to avoid the baby's or infant's bottom becoming sore. Creams such as zinc and castor oil, Drapolene, Metanium or Sudocrem should be applied at each nappy change to help protect the child's skin.

To avoid spreading the risk of diarrhoea to other children, babies and infants should be kept away from play groups, nursery or swimming pools for 48 hours after diarrhoea has stopped. Particular care should be taken with personal hygiene, washing hands thoroughly after each nappy change, after going to the toilet and before food preparation.
When to consult your pharmacist
Your pharmacy stocks a wide range of rehydration supplements that can be purchased without a prescription. It is a good idea to keep a supply of the products at home in case they are suddenly needed.

When purchasing these items always let your pharmacist know your age of your baby or infant and whether they have any other illnesses or are taking any other medicines.
When to consult your doctor
Seek urgent medical help if your child is showing any of the symptoms described above, particularly if you have a young baby or if your baby is refusing feeds.

If your child gets persistent attacks of diarrhoea, visit your doctor to find its cause.
Useful Tips
  • Continue to breast feed or bottle feed babies and give them extra fluids or rehydration supplements
  • Do not use anti-diarrhoeal medicines for babies or infants
  • Adopt good food hygiene in the kitchen - minimise the spread of bacteria by covering foods kept in the fridge and cleaning work surfaces thoroughly
  • Wash hands before handling food
  • Wash hands after changing nappies or after using the toilet


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