What's Giving Your Breastfed Baby Diarrhea?

As a parent, you're probably no stranger to dirty diapers, and quite familiar with your child's bathroom habits. Diaper duty is one of the more unpleasant and messier sides of parenting, but it's also super important because your baby's stool says a lot about their health. For this reason, it can be concerning when you notice that something looks a little funny.

In this article, we will be covering the differences between normal baby poop and diarrhea, what causes diarrhea in babies, and what to do about it!

Baby Diarrhea vs. Normal Baby Poop

Baby poop can come in lots of colours and textures depending on their diet and age, so first, let's talk about what infant diarrhea can look like.

Although frequent bowel movements or loose "pasty" stools can leave you wondering if something is wrong, these are not signs of infant diarrhea and are considered normal characteristics of breastfed baby poop.

Diarrhea in babies can be defined as at least three loose or watery stools in a 24-hour period. Parents also usually describe baby diarrhea as being particularly smelly and often passes more noisily than regular stool.

The most important thing to look out for is a change in the consistency or texture of your baby's stool, as just relying on the number of stools per day can be unreliable because some babies naturally poop more than others.

If a baby is formula-fed, their stools will have different characteristics than if a baby is solely being fed with breast milk, so a change in your baby's diet can alter the appearance of their poop. A formula-fed baby's stool can be yellow, green, or light bright and similar in texture to peanut butter. This is not considered diarrhea and is perfectly normal!

What Does Breastfed Baby Diarrhea Look Like?

To summarize, breastfed baby diarrhea can look like the following:

• An increase in the amount of stool and frequency of bowel movements • Stool has a stronger smell • Watery diarrhea caused by inflammation in the intestines • Sometimes includes mucus or blood • Your child may also appear sick, feverish, or lose their appetite with diarrhea

There is a chance that the only sign of diarrhea will be the frequency and amount of fecal matter, which is why it is important to observe what is typically normal for your baby and monitor for any changes to their bowel movements.

What is Considered Normal Poop in Breastfed Babies?

Normal baby poop can have many different characteristics such as:

• First poops, which are called meconium, will be black or dark green and tarry in consistency.
• Following the first poops, your baby's stool will change to a yellow-green colour.
• Breastfed newborns' stools can be loose and seedy in texture. It will also likely be a light mustard colour.
• Baby poop is usually the size of a loonie and can happen on average 8-12 times a day, with a minimum of 3 times a day. If your newborn is pooping less than 3 times in the first 6 weeks, they may not get enough breast milk.
• After the first 6 weeks, your baby might not poop every day. This is normal as long as they are gaining weight, passing stool easily and their poop looks normal.

Abnormal poop can look red or bloody, black several days after birth, and white or very watery. If you are concerned about your baby's bowel movements (or lack thereof), contact your pediatrician. 

What Causes Diarrhea in Infants?

It is no doubt that breastfed babies do poop a lot, often more than 6 times a day. This frequency can cause some parents to suspect diarrhea. Usually, this frequency is normal, but if your baby's stool appears looser, they are pooping more often than normal, and this lasts for at least 3 stools, then your baby does have diarrhea.

If your baby does have diarrhea, it is important to pinpoint the cause. The first step is determining if your baby's diarrhea is acute or recurrent, as each type has different causes.

Causes of Acute Diarrhea

Acute diarrhea is often caused by the following:

• Virus: A virus such as Rotavirus, Ronovirus, or Adenovirus is the most common cause.
• Bacterial Infection: Bacteria such as Salmonella, Yersinia, or Campylobacter can cause diarrhea that often has streaks of blood in it.
• Parasite: Parasites such as Giardia can cause diarrhea, which in most cases is caused by an outbreak in a child care center.
• Antibiotic Diarrhea: Some antibiotics can cause mild diarrhea, but this is usually not a cause for concern, and you can keep giving the antibiotic as directed.
• C. Difficile: This is one of the most serious causes, and can occur after being on strong antibiotics.
• Weaning: Your baby's stool may become looser while weaning. This is usually caused by increased fiber in their diet, but can also be indicative of a food allergy. If this is not an isolated case, it is best to discuss any concerns about allergies with your pediatrician. 

Causes of Recurrent Diarrhea

Recurrent diarrhea is often caused by the following:

• Cow's Milk Allergy: A cow's milk allergy can cause loose, slimy stools, that may or may not contain blood. This type of allergy starts within the first 2 months and can be managed by avoiding cow's milk formulas.

• Lactose Intolerance: Lactose intolerance is a common condition that can be genetic. It causes gas, loose stools, and stomach bloating.

• Food Sensitivity: Sometimes breastfed babies are sensitive to something in the mother's diet. To manage this, mothers can try altering their diet to take out anything that may be causing the sensitivity.

What are The Effects of Diarrhea on Your Baby?

Prolonged diarrhea can be especially concerning, as it can lead to health issues such as dehydration. Some cases of diarrhea are worse than others, so make sure to monitor your little one and follow your pediatrician's recommended treatment plan for more severe cases.

Let's discuss the most common effects of diarrhea.

Dehydration

Dehydration is one of the main concerns accompanying a bout of diarrhea because it can affect infants much more quickly than adults.

If your baby has diarrhea, these signs can indicate that they are dehydrated and require medical attention:

• A sunken soft spot (fontanelle) on top of their head or sunken eyes
• Crying without producing tears
• Decreased urine output
• Drowsiness or irritability
• Dry skin

Diaper Rash

Diarrhea can cause diaper rash around your baby's bottom due to their loose stools irritating the skin (source).

If your baby has diarrhea, these signs can indicate that they are experiencing diaper rash:

• Inflamed, itchy, or tender skin around your baby's bottom.
• Sores around the diaper area
• Discomfort, crying, or increased fussiness during diaper changes 

Weight Loss

Weight loss can happen when your baby is dehydrated. Although mild cases of vomiting or diarrhea would not cause this. Instead, weight loss may be indicative of malabsorption and malnutrition caused by recurrent or severe diarrhea.

Diarrhea and Dehydration: Is Your Baby Dehydrated?

Some cases and causes of diarrhea are worse than others. In cases of acute diarrhea, if any of the following can be applied to your baby, they likely require medical assessment.

• If they are under 6 months

• If they weigh under 18 lbs

• If they were born premature or have a history of chronic medical conditions

• If they are under 3 months and have a fever over 38 °C (100.4 °F)

• If they are 3-36 months and have a fever over 39 °C (102.2 °F)

• If their stool contains mucus or blood

• If they have had diarrhea more than 6 times in a 24-hour period

• If they have vomited more than 3 times in a 24-hour period

• If they are showing signs of dehydration

• If there is a change in behaviour or mental statuses such as irritability, apathy, or lethargy

• If they have been traveling abroad recently

• If they have had diarrhea for more than one week

If any of these symptoms are severe take your baby to a hospital immediately, especially in cases of severe dehydration, stomach pain, having a high fever that will not break, or if symptoms are quickly worsening.

What to Do if Your Baby Has Diarrhea

Diarrhea is not always a bad thing and is actually the body's way of getting rid of germs. This means it does not need to be stopped, but it is important to keep your baby hydrated to avoid dehydration. To keep your baby hydrated you can offer them breast milk more frequently or offer a few sips of water to babies who are older than 6 months.

You should not give your baby any medications or try home remedies to stop diarrhea. This can worsen the problem and increase the severity of the virus or bacteria.

Here are a few more ways to care for your baby if they have diarrhea.

Protect Their Bum

• Change diapers often and remove soiled diapers as soon as possible. Since you might not always be the one changing their diapers, remind childcare staff, other family members, or caretakers to do the same.

• During each diaper change, rinse your baby's bottom with warm water in the sink, tub, or with a water bottle. Make sure to be gentle while doing this to avoid further irritation.

• Avoid using wipes that contain alcohol or fragrance, and only use mild soaps.

• Allow their skin to air dry before putting on a new diaper, or gently pat it dry with a towel.

• Apply diaper cream, paste, or ointment regularly to help with rashes.

• Wash your hands well after each diaper change to prevent the spread of bacteria.

• Do not fasten diapers too tightly to allow airflow.

• Let your baby go without a diaper when possible to let them dry. 

Practice Good Hygiene

To prevent the spread of contagious diarrhea follow these guidelines:

• Have access to safe drinking water

• Wash hands with soap

• Exclusive breastfeeding for the first six months of life when possible

• Practice good personal hygiene and food hygiene

• Get the rotavirus vaccination

• Avoid shaking hands during outbreaks

Avoid Certain Foods

Certain foods can make diarrhea worse such as:

• Spicy food
• Sugary foods such as chocolate or candy
• Fried and greasy foods
• Foods with lots of fibre
• Soft drinks
• Tomato and tomato sauce
• Raw vegetables

When your child is ready to eat again, here are some foods to start with:

• Bananas
• Crackers
• Chicken
• Pasta
• Rice cereal

Tips on Preventing Your Baby from Getting Diarrhea

To avoid your baby getting diarrhea in the first place, try following these tips. Remember that sometimes diarrhea in infants is inevitable and most of the time will not be serious or require a trip to the doctor.

• Consider your diet while breastfeeding and make changes if you suspect your child has a food sensitivity

• When starting solids, offer your baby easy-to-digest foods first

• Always wash your hands before and after breastfeeding

• Consider infant probiotics and prebiotics

Conclusion

It is no doubt that diarrhea can be alarming, especially in infants. Most of the time, the cause is nothing serious and it will resolve in time with proper at-home care. For more severe cases, medical intervention may be necessary.

Now that you know what to look out for, you can monitor your little one for any changes in their stool while on diaper duty.