Diarrhoea in babies: 7 things you should know

January 08, 2019
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    Don’t be overly worried when your little one has runny stools. Here are seven things you should know about diarrhoea in babies.

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  • Frequent runny stools are normal in breastfed babies
    2 / 8 Frequent runny stools are normal in breastfed babies

    How much poo should you expect from a baby? The answer is a lot, especially if she is on breast milk, which has a natural laxative effect.

    Your baby’s bowel movements may be as frequent as seven to eight times a day. But it could also swing to the other extreme, and may be as infrequent as up to once a week as breast milk is so well-digested, there may not be much left to be excreted, says Dr Ong Ian, paediatrician at Thomson Paediatric Centre (Katong). 

    What’s important is your baby feeds well and gains weight, and that the stool remains soft when she does a bowel movement, she adds. 

    Breastfed babies also tend to have softer and runnier stools than formula-fed babies, who generally pass stools with a thicker consistency (think toothpaste texture), Dr Ong adds. 

    Related: Breastfeeding: 3 signs that your baby is getting enough milk

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  • It’s diarrhoea if Baby is passing a lot more watery stools than normal
    3 / 8 It’s diarrhoea if Baby is passing a lot more watery stools than normal

    If you’re a first-time parent, it can be hard to figure out if your little one is having the runs. First, consider what her normal bowel movements are like.

    An occasional bout of loose stools is not a cause for alarm. But if she starts pooping a lot more frequently and her stools look more watery than usual, she probably has diarrhoea. 

    See a doctor if she has watery stools for more than two days, or if she is showing signs of dehydration or other symptoms, Dr Ong advises. 

    But seek medical attention at once if:
    – the condition seems to be worsening, instead of improving.
    – your baby is younger than three months and has a fever above 38 deg C.
    – she is older than three months and has a fever above 39 deg C.
    – there is blood or mucus in her stools.
    – she appears to have severe tummy pain. Baby’s belly may look inflated or tensed. She may also cry nonstop, squirm a lot more than usual, or pull up her legs.

    Related: 3 medication mistakes parents make

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  • Chances are, it’s a tummy bug, not teething
    4 / 8 Chances are, it’s a tummy bug, not teething

    There are many reasons behind your child’s diarrhoea. But contrary to what Grandma says, there is no scientific proof that teething causes it.

    A child starts putting things into her mouth from five to six months of age, which coincides with the time teething begins, says Dr Zaw Lwin, a consultant from the department of emergency medicine at KK Women’s and Children’s Hospital

    “When children put anything into their mouth, most of which may not be clean, there is a good chance that virus and bacteria causing diarrhoea can enter the body,” he explains.

    In young children, diarrhoea and vomiting are usually due to a viral infection of the gastrointestinal tract, also commonly known as “stomach flu”, says Dr Zaw.

    Other culprits include side effects from medication such as antibiotics, which kill both good and bad bacteria in the large intestine and can cause a tummy upset. 

    Your baby’s diarrhoea could also be due to a food or milk allergy – watch for vomiting, loose stools and cramping during bowel movements, which may look similar to food poisoning.

    Related: 8 baby care myths you should care about (and know the truth)

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  • With diarrhoea, the greatest danger is dehydration
    5 / 8 With diarrhoea, the greatest danger is dehydration

    While distressing, diarrhoea usually clears up on its own. Most infants do not need medication, although doctors may occasionally prescribe a probiotic to help your child restore healthy gut bacteria,
    Dr Ong says. 

    Instead, the biggest concern is dehydration from excessive fluid loss. In babies and young children, this can be dangerous and sometimes fatal. The younger your little one is, the higher her risk of dehydration, she adds. 

    See a doctor when you spot danger signs like:
    – dry tongue and lips.
    – sunken eyes, few tears when crying.
    – fewer wet nappies.
    – lethargy.
    – an increasing heart rate.

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  • Offer lots of fluids, but hold the juice
    6 / 8 Offer lots of fluids, but hold the juice

    Encourage Baby to take plenty of fluids, but avoid giving just plain water. KKH’s Dr Zaw says this is because both fluids and electrolytes (salts) are lost when your baby has diarrhoea or vomiting.

    Instead, continue breastfeeding, but nurse your baby more frequently. “Even if Baby poos shortly after feeds, she would have retained some nutrients as breast milk is well-digested by the body. Breastfeeding provides comfort and natural antibodies in breast milk may help her recover faster,” Dr Ong says. 

    If your baby is on formula, carry on with her usual feeds – there is no need to dilute the formula to make it more watery.

    For babies above the age of six months, you may offer oral rehydrating solutions like Pedialyte or Hydralyte, rice or porridge water and barley water in small, frequent amounts, Dr Ong suggests.

    You could also give some watered down juice – dilute one cup of juice with four cups of water, she adds. But steer clear of concentrated juice and sugary drinks, which contain a non-digestible sugar known as sorbitol that can cause gastric discomfort and loose stools.

    Related: Singapore mum donates 120 litres of breast milk in 9 months

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  • Protect your baby’s bum
    7 / 8 Protect your baby’s bum

    Stools from diarrhoea tend to be acidic. Coupled with the continuously soiled diapers and frequent wiping, it can irritate your little one’s tender skin, Dr Ong says. 

    To prevent diaper rash, she recommends changing your baby’s diapers often. Use cotton wool and water, then pat dry.

    Apply a generous amount of barrier cream containing zinc oxide or petroleum jelly with every nappy change. Air your baby’s bottom every now and then.

    Related: Baby has a diaper rash after diarrhoea: what to do

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  • Diarrhoea can be prevented 
    8 / 8 Diarrhoea can be prevented 

    Last year, about one in seven children seen at the Children’s Emergency department at KKH had diarrhoea and vomiting. But you can take preventive measures to protect your little one.

    Half the battle is won if you are nursing your baby. Breast milk contains antibodies that provide immunity against infections causing diarrhoea and vomiting, Dr Zaw says.

    If you’re using bottles or other feeding equipment, be sure to sterilise them properly before use – boil them for at least five minutes. 

    Dr Zaw advises sterilising feeding equipment until Baby is one year old, when milk feeds are replaced with more solids. 

    Diarrhoea in young kids is often caused by germs that are transmitted from hand to mouth, so the best defence is good hand hygiene after using the toilet and before mealtimes. 

    In addition, consider giving your baby the rotavirus jab. Two doses of the vaccine before six months of age is another preventive measure, Dr Zaw says, as rotavirus is one of the more common viruses causing diarrhoea and vomiting in children.

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