Diarrhea is an increase in the number of stools and/or a decrease in their consistency . The most common cause of diarrhea are infections that cause inflammation of the mucous membranes of the intestine and stomach: we call it gastroenteritis . It is frequently accompanied by nausea and/or vomiting, abdominal pain and/or fever.
Gastroenteritis is a very frequent reason for consulting a pediatrician in our environment and, in developing countries, one of the most frequent causes of infant mortality. We speak of acute diarrhea when the symptoms last less than two weeks and chronic or persistent diarrhea when it lasts more than two weeks.
What are the causes of diarrhea?
As we have said, the most common cause of diarrhea is an infection. Within infections , viruses are the ones that most frequently cause gastroenteritis. Rotavirus is the most common agent; Practically all children in their first two years of life suffer from an episode of diarrhea due to this virus.
Bacteria and parasites can also cause, although less frequently, infectious gastroenteritis in children . Among the non-infectious causes we have food allergies (such as allergy to cow’s milk protein), digestion disorders or taking some drugs.
bowel movements in babies
The first stool of the newborn is called meconium . It is a sticky, black substance found in the baby’s intestine during pregnancy; babies usually expel it in the first 24-48 hours of life.
Later there are some stools that are called transition, to pass, towards the fourth-seventh day of life, to the typical infant stools. It is common that, during the first weeks of life, babies, especially those fed with breast milk, make several stools a day and that these are of little consistency. It is due, in part, to the gastrocolic reflex : when food reaches the stomach, the intestine is activated.
Also, newborns and very young babies still have little strength in the anus. Thus, it is common for babies to have a bowel movement during the first weeks of life almost after each feeding and even during it. These stools are usually quite liquid and lumpy. Bottle-fed babies, on the other hand, tend to have fewer and more consistent bowel movements per day.
The color of the stool can be variable: mustard yellow, green, brown… The only stools that are not normal are black and white, as well as those with blood .
How is diarrhea treated? Should they diet?
Most infectious diarrhea is self-limiting, that is, it goes away on its own. Treatment should be aimed at replacing losses to prevent dehydration . For this, the best liquid is oral rehydration solution , which can be purchased at pharmacies. It has a very similar composition to what is lost in diarrhea. Other liquids such as Aquarius or homemade preparations are not recommended.
In addition to drinking whey, babies and children can have a normal diet, avoiding only foods with a lot of fats and/or sugars . Infants can, of course, continue to breastfeed or bottle feed on demand.
In the case of taking artificial formula, the way of preparing the bottle should not change. Food should be offered without forcing and respecting their satiety signals, as it is likely that they do not want to eat as much as usual.
Children usually do not need any drug to stop or reduce diarrhea . Only in very specific cases of diarrhea due to bacteria will they need to take an antibiotic.
What are the warning signs?
In the face of diarrhea, we must be alert to possible signs of dehydration .
If our son/baby pees very little, is very thirsty, has very dry mucous membranes (very dry mouth, cries without tears) and/or is very sleepy, we should consult . Also if the number of bowel movements is so high that it does not give us time to replace the losses (you cannot drink at the same rate as you have bowel movements).
If in addition to diarrhea there is abdominal pain and this is becoming more intense, continuous and located on the right side, we should consult. Also if the child is in poor general condition, the stools are completely black or have blood or if he vomits everything we give him by mouth.
Is it necessary to perform any additional tests?
Most cases of acute infectious diarrhea are, as we have said, self-limiting and generally do not require any additional tests . In cases where we suspect dehydration, an analysis may be necessary to check how the blood sugar is, the ions…
We will also perform a stool culture (coproculture) if we suspect a bacterial cause (for example, in bloody diarrhoea).
In the case of chronic diarrhea (lasting more than 15 days) as well as some non-infectious diarrhea (food allergy, surgical pathology , intolerance…), it is usual that we request complementary tests, which will vary depending on the symptoms and suspicion.
Can diarrhea be prevented?
Infectious diarrhea can be prevented with hygiene measures : correct hand washing, cleaning of toys and surfaces, proper handling of food… In addition, we have two vaccines against Rotavirus , one of the main causes of severe diarrhea in children. Both vaccines are administered orally starting at six weeks of age and no later than 12 weeks of age.