Diarrhea In Infants

Diarrhea occurs when the colon or large intestine becomes irritated. This can be caused by many things, including infection, chemical toxins, inflammation, stress, or anxiety. The colon 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 the body
• decreases the amount of water it reabsorbs from the stool

Diarrhea in infants can cause the following conditions:

• abdominal distress and 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 between diarrhea and the normal loose, watery stools of infants in the first 6 to 8 weeks of life. Breast-fed infants normally have stools that look like watery, yellow cottage cheese. Their stools also are frequent, often occurring during or after each feeding. Breast milk stools usually are sweet-smelling as compared to the stools of formula-fed infants.

Most infants, even those fed formula, have frequent, watery stools until they are six to eight weeks old. After that, the stools become firmer and less frequent. In fact, infants who are only fed breast milk beyond the first two months of life may have a stool only every three to five days. As long as the stool is soft, this is normal. 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

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

• bacteria that invade the intestinal tract
• gastrointestinal disorders, such as irritable bowel syndrome
• inherited birth defects such as cystic fibrosis
• introduction of a new food
• toxins from contaminated food (such as apple juice, unpasteurized milk, fruits and vegetables)

The best way to prevent diarrhea in infants is for the caregiver to wash his or her 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 bottle nipples, clean.
• Keep other young children in the household who have diarrhea away from the infant.
• Refrigerate formula that is mixed in larger quantities and discard formula 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 all utensils, cleaning cooking or preparing surfaces, and cooking meat until it is cooked through and no longer pink.

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

A healthcare professional will take a history of the infant's symptoms. He or she will then do a physical exam. The professional 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 a colonoscope is used to view the interior of the intestine. This can help determine the cause of the diarrhea.

Usually there are no serious long-term effects if diarrhea in infants is effectively treated to avoid dehydration.

If the illness is caused by a serious infection or the infant becomes extremely dehydrated, there may be more serious long-term effects. If an infant becomes severely dehydrated, the amount of fluid in the bloodstream decreases. This makes it difficult for the body 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 in children around the world.

Diarrhea can last a long time. If it is accompanied by persistent loss of appetite, it can lead to nutritional problems. This, however, is unusual. Diarrhea can sometimes cause temporary problems with digesting milk products, a condition known as lactose intolerance. This usually resolves on its own. Diarrhea may also cause severe diaper rash.

Diarrhea caused by a virus or bacterial infection may be contagious. It is important to wash hands well to prevent spreading germs. The elderly, young children, or others who have weakened immune systems are at increased risk. Diarrhea can cause more serious symptoms in these individuals.

Infant diarrhea is treated by replacing the fluid in the body. Usually this is done 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 has diarrhea. Formula-fed infants can be treated best by using one of the commercially available rehydrating solutions, such as Pedialyte or Infalyte.

Once the stool frequency decreases, or if the infant's appetite seems to improve, then the infant's usual formula feedings can be resumed. Do not use flat sodas or any other sugary sodas or green tea or herbal teas or sports drinks.

There are generally few side effects to the above treatments. If medications are needed for the underlying cause of the diarrhea, there may be side effects to the medications. These include further stomach upset or allergic reactions. And may increase the risk of a potentially fatal condition called hemolytic-uremic syndrome (HUS).

A few days of diarrhea generally is not a cause for concern. The exception would be if the infant is not drinking enough fluid to compensate for the liquid lost in the diarrhea. If diarrhea continues despite treatment, the healthcare provider should be notified.

Most cases of diarrhea last three to five days. A healthcare provider should be called immediately 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
• bruising and anemia (seen with HUS)
• seizures

Any other new or worsening symptoms should also be reported to the healthcare provider.