Originally published: August 28th/2018; Updated: May 21st/2019

 

A lot of changes happen in the first years of life. From milk feeding, to introducing solid food, and a balanced diet following the family meal structure. Baby is also learning and their bodies are adjusting to all of these changes.

Sometimes the change means constipation, sometimes it means diarrhea.

 

My child has loose stool: is it diarrhea?

 

Loose stool, a.k.a. diarrhea can be acute or chronic in children of all ages!

The thing is diarrhea is tricky. It’s one of those symptoms that’s linked to to everything and anything.

Yep, it can be a sign something is wrong, or that it’s transient and there’s nothing to worry about. Helps doesn’t it?

 

First off, let’s recognize the two time-related aspects of diarrhea:

Acute diarrhea

Acute diarrhea is sometimes referred to as gastroenteritis.

You may have a decrease in stool consistency (liquid or loose) and an increase in frequency (>3 times in 24hr). Furthermore, it can last for about 2 weeks until the stools return to normal.

Viruses like rotavirus and norovirus are often to blame for gastroenteritis in children. Also, it’s uncomfortable for the child and a lot of work for parents.

The most serious complication seen with acute diarrhea is dehydration. That is the one thing you want to keep an eye on and prevent.

If the symptoms become serious, a visit to your family doctor is always a good idea.

 

Chronic diarrhea

Chronic diarrhea refers to loose stool for at least 14 days. It’s usually marked by an increase in the frequency of stools.

If you suspect your child (infant, toddler, or teenager) has chronic diarrhea, go see your doctor. Furthermore, the cause of the problem needs evaluation to ensure that the right treatment is applied.

With chronic diarrhea, it’s important to ensure that baby is thriving. Your baby must receive the nutrients required for proper growth.

Equally important is your child’s quality of life. Diagnosing and treating the cause of diarrhea will help improve quality of life.

Acute and chronic diarrhea both result in your child having loose stool. Increased frequency of stool evacuation is also a symptom. Appropriate nutrition and enough fluid is key in both cases.

 

Pinterest image of blog post on the BRAT diet for toddlers

 

What can cause diarrhea in toddlers?

  • Taking antibiotics.
  • Being breastfeed while having a cow’s milk protein allergy without further adjustment in mom’s diet.
  • Being lactose intolerant.
  • Drinking too much fruit juice.
  • Having food allergies.
  • Suffering from food poisoning.
  • Having a viral infection.
  • Having a gastrointestinal infection.
  • Taking a new medication.
  • Suffering from a health condition: Crohn’s disease, ulcerative colitis, celiac disease, irritable bowel syndrome, small intestinal bacterial overgrowth.

Many things can cause a child to have diarrhea. Your doctor will diagnose the problem and suggest the appropriate treatment.

 

How to stop diarrhea in a toddler?

 

Sadly, there is nothing you can do. Focus on a lot of rest, a lot of fluids, eating balanced meals, and waiting.

Also, talk to your doctor before giving any medication to your toddler.

 

The BRAT diet won’t help your toddler with diarrhea. Instead, offer nutritious meals and a lot of water or milk.

 

 

Strategies to help with diarrhea

 

Maybe it’s something that’s spreading at daycare. If it isn’t too serious to go see the doctor, here are some strategies to help your little one recover.

 

Maintaining hydration in toddlers with diarrhea

 

When diarrhea hits, encourage your child to consume fluids, and give them a hydrating drink.

If your child is still breastfed, we encourage on-demand breastfeeding.

Importantly, there is no need to give juice, special formula, or diluted formula.

Stick to what your child has been drinking, or offer a rehydration solution you can buy at the drug store.

As soon as your child has diarrhea, offer plenty of fluid.

 

Should I put my toddler who has diarrhea on the BRAT diet?

 

No.

Once popular, the BRAT diet (banana, rice, applesauce and toast) is not recommended due to the low energy density and poor nutritional value.

Excluding all foods except these four items actually leads to  reduced intake of fat and proteins, nutrients that are essential for your child’s recovery.

You can offer foods that are well tolerated and that your child likes.

The BRAT diet is not suggested to treat diarrhea in children

 

What should I feed my toddler with diarrhea?

 

The boring answer: a balanced and healthy diet.

During an episode of diarrhea, you can offer foods that are well tolerated and loved.

Fibre consumption is the key to avoid future episodes of diarrhea (and constipation).

Fibres are essential to help stools get formed in the digestive tract. One easy way to do that is to offer the healthy plate. This includes whole grain products, fruits, and veggies, which are all excellent sources of fibres. 

But, fibres without fluids is risky, we recommend your child drinks water as main source of fluid.

High amounts of juice can lead to diarrhea in children because of the sugar type it contains. There is little-to-no health benefit in drinking juice, so offer water (or milk) instead of juice most of the time.

A healthy diet with a lots of fibres will help prevent diarrhea in children

 

Should I give probiotics to my toddler who has diarrhea?

 

Probiotics are healthy and friendly bacteria that live and grow in our guts. The amazing thing is, many many many strains exist.

Research links specific strains to different health benefits. That means you cannot generalize the benefit of one probiotic strain to another.

So how does this relate to diarrhea? Such gastro-intestinal discomforts may stem from a gut microbiome imbalance.

Probiotics may help the microbiome return to a stable and healthy state.

In the end, it’s important to ensure that baby is thriving.

 

Probiotic strains that may help with diarrhea

Much research has gone into identifying beneficial probiotic strains. Two strains have shown promise in reducing diarrhea in children. These strains are Lactobacillus rhamnosus GG (LGG) and Saccharomyces boulardii.

Other work has shown L. reuteri DSM 17938 can reduce the incidence of diarrhea in children who go to daycare.

If you wish to give probiotics to your child, check in with your pharmacist.

Yes, we agree that probiotics are promising and might be of value for some children. But, it’s also important to realize that our understanding probiotics is adolescent. There’s a lot we don’t know; however, research efforts continue to uncover new findings, and the future is promising.

All probiotics are not created equal! Pick the right one to help diarrhea in toddlers.

 

How to prevent my toddler from getting diarrhea?

 

Children are particularly vulnerable to food poisoning (just like pregnant women). Why? because their immune system is not quite fully ready to defend them from pathogens.

As most diarrhea episodes are causes by viruses, it is important to adopt appropriate food handling habits.

It includes all steps from buying, storing, cooking, handling raw and cooked food, and cleaning. Adopting good hygiene habits will reduce the risks of food poisoning.

Oh, and The Government of Canada has a great resource on food safety for children.

Preventing food poisoning by adopting top notch handling habits is a way to prevent diarrhea in children.

 

Is it possible that my toddler has simply “soft stool” without problem?

 

As with anything, you are the expert of what is “normal” for your child. Has your child always had that type of soft stool? Or, is this new? Is the diarrhea following something your kid has eaten? Also, are all the members of your family having diarrhea, or is it just your child?

The Bristol stool chart might be helpful in identifying if your child has abnormal stool and report it to your health care practitioner.

It is also possible that if your child is still young and adapting to the change in the diet from exclusively milk feeding to a variety of solids food. Children gastro intestinal tracts will mature and find their “normal”. If you are concerned or feel something is off, talk to your doctor.

You know better than anyone your child! If you are concerned about your child’s stools, visit your doctor to make sure all is normal.

 

 

References

 

 
 

 

Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997;32(9):920–4.
 

 

Carson RA, Mudd SS, Madati PJ. Clinical Practice Guideline for the Treatment of Pediatric Acute Gastroenteritis in the Outpatient Setting. J Pediatr Heal Care; 2016;30(6):610–6.
 

 

Dupont HL. Persistent diarrhea a clinical review. JAMA  2016;315(24):2712–23.
 

 

Szajewska H, Canani RB, Guarino A, Hojsak I, Indrio F, Kolacek S, et al. Probiotics for the prevention of antibiotic-associated diarrhea in children. J Pediatr Gastroenterol Nutr. 2016;62(3):495–506.
 

 

Siniewicz-Luzeńczyk K, Bik-Gawin A, Zeman K, Bąk-Romaniszyn L. Small intestinal bacterial overgrowth syndrome in children. Gastroenterol Rev. 2015;1(1):28–32.
 

 

 

 

 

 

 

 

Koletzko S, Niggemann B, Arato A, Dias JA, Heuschkel R, Husby S, et al. Diagnostic approach and management of cow’s-milk protein allergy in infants and children: Espghan gi committee practical guidelines. J Pediatr Gastroenterol Nutr. 2012;55(2):221–9.
 

 

Guarino A, Lo Vecchio A, Berni Canani R. Chronic diarrhoea in children. Best Pract Res Clin Gastroenterol. 2012;26(5):649–61.

BRAT diet for toddlers

BRAT diet for toddlers

BRAT diet for toddlers

BRAT diet for toddlers

BRAT diet for toddlers

Food to give toddlers with diarrhea

Food to give toddlers with diarrhea

Food to give toddlers with diarrhea

Food to give toddlers with diarrhea