This information is approved and/or reviewed by U-M Health System providers but it is not a tool for self-diagnosis or a substitute for medical treatment. You should speak to your physician or make an appointment to be seen if you have questions or concerns about this information or your medical condition. Exención de responsabilidad en Español | Complete disclaimer
Diarrhea is the sudden increase in the frequency and looseness of bowel movements (BMs). Mild diarrhea is the passage of a few loose or mushy BMs. Severe diarrhea is the passage of many watery BMs. Watery stools that occur every hour is definitely severe diarrhea. The best indicator of the severity of the diarrhea is its frequency or blood in the bowel movements.
The main complication of diarrhea is dehydration from the loss of too much fluid from the body. Symptoms of dehydration are a dry mouth, the absence of tears, infrequent urination (for example, none in 8 hours), and a darker, concentrated urine. The main goal of diarrhea treatment is to prevent dehydration.
No matter how they look, the bowel movements of a breast-fed infant must be considered normal unless they contain mucus or blood or develop a bad odor. In fact, during the first months, breast-fed babies normally pass very loose BMs, some green BMs, or even BMs with a water ring.
The frequency of bowel movements is also not much help in deciding whether your breast-fed baby has diarrhea. Breast-fed babies during the first 2 months pass from 4 BMs per day to 1 after each feeding. The BMs are normally liquid. However, if your baby's BMs abruptly increase in number, your baby probably has diarrhea. Other clues are poor eating, acting sick, and a fever.
Diarrhea is usually caused by a viral infection of the lining of the intestines (gastroenteritis). Sometimes it is caused by bacteria or parasites. Occasionally an infant has a food allergy or drinks too much fruit juice, which may cause diarrhea. If your child has just one or two loose bowel movements, the cause is probably something unusual your child ate.
Diarrhea caused by bacteria or a virus usually lasts several days to 2 weeks, regardless of the type of treatment. The main goal of treatment is to prevent dehydration. Your child needs to drink enough breast milk to replace the fluids lost in the diarrhea. Don't expect a quick return to solid bowel movements.
Increased fluids and dietary changes are the main treatment for diarrhea. One loose bowel movement can mean nothing. Don't start dietary changes until your child has had several loose bowel movements.
If your breast-fed baby has diarrhea, treatment is straightforward. Continue breast-feeding but at more frequent intervals. Don't stop breast-feeding your baby because your baby has diarrhea. For severe (watery and frequent) diarrhea, offer Pedialyte or other electrolyte solutions between breast-feedings for 6 to 24 hours only if your baby is urinating less frequently than normal.
You may have to stop breast-feeding temporarily if your baby is too exhausted to nurse and needs intravenous (IV) fluids for severe diarrhea and dehydration. Pump your breasts to maintain milk flow until you can breast-feed again (usually within 12 hours).
Foods that contain a lot of starch are more easily digested than other foods during diarrhea. If your baby is over 4 months old, continue with solid foods. Good choices are: any cereal, applesauce, strained bananas, strained carrots, mashed potatoes, and other high-fiber foods.
Remember that something in the mother's diet may cause a breast-fed baby to have more frequent or looser bowel movements--for example, coffee, cola, or herbal teas. If you suspect this, take it out of your diet and see what happens.
Diarrhea is very contagious. Always wash your hands after changing diapers or using the toilet. This is crucial for keeping everyone in the family from getting diarrhea.
The skin near your baby's anus can become irritated by the diarrhea. Wash the area near the anus after each bowel movement and then protect it with a thick layer of petroleum jelly or other ointment. This protection is especially needed during the night and during naps. Changing the diaper quickly after bowel movements also helps.
For children in diapers, diarrhea can be a mess. Place a cotton washcloth inside the diaper to trap some of the more watery BM. Use disposable superabsorbent diapers to cut down on cleanup time. Use the diapers with snug leg bands or cover the diapers with a pair of plastic pants. Wash your child under running water in the bathtub.
If your baby vomits once, make no changes.
If your baby vomits twice, continue breast-feeding but nurse on only one side for 10 minutes every 1 to 2 hours.
If your baby vomits 3 or more times, nurse for 4 to 5 minutes every 30 to 60 minutes. As soon as 8 hours have passed without vomiting, return to normal nursing on both sides.
Pedialyte or other electrolyte solutions are rarely needed for breast-fed babies. If vomiting continues, switch to Pedialyte for 4 hours. Spoon or syringe feed 1 tablespoon (15 ml) of Pedialyte every 5 minutes.
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