Diarrhoea is common in children and babies and normally resolves on its own. In its mildest form, it can be something new that they ate, such as something spicy, or teething in young babies. It’s common for them to pick up viral infections from food or from each other at nursery and school – these are usually short-lived and they recover within a few days.
This is acute diarrhoea, and the main risk is dehydration. If it lasts longer than two weeks, it’s called chronic diarrhoea and is worth a discussion with your doctor, even if they appear well – toddler's diarrhoea is one cause of chronic diarrhoea.
We will talk you through the different causes, when to worry and when to seek medical help.
Gastroenteritis describes an infection in the gut and is mostly due to viruses like rotavirus, adenovirus and norovirus, which spread between them from infected stool to fingers to mouth, or from infected food. They will often say their tummy hurts, pain may come in waves or cramps, they may have a temperature and they may have some vomiting or feeling sick. They will usually be off their food for a few days.
Bacterial gastroenteritis is less common, and often comes from food, contaminated water or poor hygiene, and is more often associated with travel abroad to certain countries. The diarrhoea is sometimes bloody and your child might be quite unwell with a fever. Infection with parasites is also possible to bring home from certain parts of the world.
Prolonged or repeated courses of antibiotics can change the gut’s natural protective bacteria – the microbiome – and allow certain bacteria to overtake and cause gut disruption and diarrhoea. And those children on medication or with conditions that suppress the immune system are particularly vulnerable to gastroenteritis.
Children may have food intolerances like or allergies that cause diarrhoea, such as gluten or lactose intolerance, and this may additionally come with stomach cramps, bloating and - in babies - poor feeding or failing to gain weight.
Occasionally children may present with colitis, an inflammation of the gut that sometimes indicates a long-term condition like inflammatory bowel disease. In this case, mucus and blood might be mixed with the stool, they may feel quite tired and they may be losing weight.
With infective gastroenteritis, your child or baby is contagious from the time they get the first symptoms of diarrhoea until they have recovered. They should stay off school and avoid pregnant or immune-compromised people until their symptoms have resolved for 48 hours.
If you have more than one bathroom, try to keep one just for them to use, and avoid them sharing cutlery or cups, clothes or towels with anyone else in your household. Everyone in the house should follow strict hand hygiene, including washing hands with soap and water after toileting and before preparing or eating food.
The main thing to do is to keep the child or baby hydrated. Babies should continue to feed as usual, and you can supplement with a little water between feeds. Older children should be encouraged to have regular, small but frequent sips of water to prevent dehydration. Keep a monitor of this and how much they’re passing urine.
Diarrhoea can cause salts and minerals to be lost from the body alongside water, especially potassium. This can make them feel even worse, and can be dangerous with large losses. Oral rehydration treatments can help to replace any lost salts and keep their body in balance.
Don’t force food unless they’re interested, and start off with bland foods like dry toast or watered-down soups. Avoid dairy, spicy foods, sugary or fizzy drinks, or acidic foods like fruits or fruit juice, until they’re fully recovered.
If you have travelled abroad or there is any suspicion that a bacterial or parasitic infection is to blame, your doctor may send off a stool sample – if proven, they will offer antibiotics.
You should contact your doctor urgently if your child is not keeping fluids down and they are not feeding as you would expect. Signs of dehydration include fewer or lighter wet nappies (less than half their normal is worth taking note of and seeking advice), persistent diarrhoea or vomiting with no signs of improvement, crying without tears, persistent fevers, increased fussiness and difficulty waking them or keeping them awake.
Blood and mucus in the stool and severe stomach pains need an urgent review by your doctor.
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