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Overview
Diarrhea means having bowel movements more often or having ones that are more watery and loose than normal. Diarrhea has many causes.
Changes in diet
A child may get diarrhea from a diet change. A baby's or child's digestive tract may not tolerate large amounts of juice, fruit, or even milk. Diarrhea may be caused by an increase in the amount of juice or fruit a child drinks or eats. This type of diarrhea usually isn't serious.
Infection
Diarrhea is often caused by a viral or bacterial infection. These include rotavirus, gastroenteritis, and food poisoning. Diarrhea is the body's way of quickly clearing any viruses, bacteria, or toxins such as botulism from the digestive tract. Most cases are caused by a viral infection. They will usually clear up in a few days.
Diarrhea may also be caused by a parasitic infection, such as Giardia lamblia. This parasite, as well as other viral and bacterial infections, may be spread by drinking untreated water or unpasteurized dairy products, or by poor hand-washing.
Diarrhea can also occur from an infection passed on by animals or while traveling to a foreign country.
Other causes
In rare cases, diarrhea can be a symptom of a more serious condition. These include:
- A problem in the digestive tract, such as inflammatory bowel disease or intussusception.
- Diseases that interfere with the normal digestion of food (malabsorption). Examples are cystic fibrosis and celiac disease.
Children, especially those younger than 6 months of age and those with other health risks, need special attention when they have diarrhea. They can quickly become dehydrated. To help prevent problems, closely watch your child's appearance and how much fluid your child drinks.
Normal stool during infancy may be runny or pasty, especially if the baby is breastfed. Sometimes there is mucus in the stool. Unless there's a change in your baby's normal habits, loose and frequent stools aren't diarrhea.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:
- Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
- Steroid medicines, which are used to treat a variety of conditions.
- Medicines taken after organ transplant.
- Chemotherapy and radiation therapy for cancer.
- Not having a spleen.
What you are looking for is a change in your child's usual bowel habits.
- Diarrhea means that the child is having more stools and looser ones than usual.
- Constipation means that the child is having fewer stools than usual and stools are harder to pass.
Every baby and child has different bowel habits. What is "normal" for one child may not be normal for another. In general:
- Many newborns have at least 1 or 2 bowel movements a day. By the end of their first week, they may have as many as 5 to 10 bowel movements a day. They may pass a stool after each feeding.
- By 6 weeks of age, your baby may not have a bowel movement every day. This usually isn't a problem as long as the baby seems comfortable and is growing as expected, and as long as the stools aren't hard.
- By about 4 years of age, it's normal for a child to have as many as 3 bowel movements a day or as few as 3 a week.
Anywhere in these ranges can be considered normal if the habit is normal or usual for your child.
Babies can quickly get dehydrated when they lose fluids because of problems like vomiting or fever.
Symptoms of dehydration can range from mild to severe. For example:
- The baby may be fussy or cranky (mild dehydration), or the baby may be very sleepy and hard to wake up (severe dehydration).
- The baby may have a little less urine than usual (mild dehydration), or the baby may not be urinating at all (severe dehydration).
You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever.
Symptoms of dehydration can range from mild to severe. For example:
- You may feel tired and edgy (mild dehydration), or you may feel weak, not alert, and not able to think clearly (severe dehydration).
- You may pass less urine than usual (mild dehydration), or you may not be passing urine at all (severe dehydration).
Severe dehydration means:
- The baby may be very sleepy and hard to wake up.
- The baby may have a very dry mouth and very dry eyes (no tears).
- The baby may have no wet diapers in 12 or more hours.
Moderate dehydration means:
- The baby may have no wet diapers in 6 hours.
- The baby may have a dry mouth and dry eyes (fewer tears than usual).
Mild dehydration means:
- The baby may pass a little less urine than usual.
Severe dehydration means:
- The child's mouth and eyes may be extremely dry.
- The child may pass little or no urine for 12 or more hours.
- The child may not seem alert or able to think clearly.
- The child may be too weak or dizzy to stand.
- The child may pass out.
Moderate dehydration means:
- The child may be a lot more thirsty than usual.
- The child's mouth and eyes may be drier than usual.
- The child may pass little or no urine for 8 or more hours.
- The child may feel dizzy when he or she stands or sits up.
Mild dehydration means:
- The child may be more thirsty than usual.
- The child may pass less urine than usual.
Symptoms of serious illness in a baby may include the following:
- The baby is limp and floppy like a rag doll.
- The baby doesn't respond at all to being held, touched, or talked to.
- The baby is hard to wake up.
Symptoms of serious illness may include:
- A severe headache.
- A stiff neck.
- Mental changes, such as feeling confused or much less alert.
- Extreme fatigue (to the point where it's hard for you to function).
- Shaking chills.
If you're not sure if a child's fever is high, moderate, or mild, think about these issues:
With a high fever:
- The child feels very hot.
- It is likely one of the highest fevers the child has ever had.
With a moderate fever:
- The child feels warm or hot.
- You are sure the child has a fever.
With a mild fever:
- The child may feel a little warm.
- You think the child might have a fever, but you're not sure.
A baby that is extremely sick:
- May be limp and floppy like a rag doll.
- May not respond at all to being held, touched, or talked to.
- May be hard to wake up.
A baby that is sick (but not extremely sick):
- May be sleepier than usual.
- May not eat or drink as much as usual.
Temperature varies a little depending on how you measure it. For children up to 11 years old, here are the ranges for high, moderate, and mild according to how you took the temperature.
Oral (by mouth), ear, or rectal temperature
- High: 104° F (40° C) and higher
- Moderate: 100.4° F (38° C) to 103.9° F (39.9° C)
- Mild: 100.3° F (37.9° C) and lower
A forehead (temporal) scanner is usually 0.5° F (0.3° C) to 1° F (0.6° C) lower than an oral temperature.
Armpit (axillary) temperature
- High: 103° F (39.5° C) and higher
- Moderate: 99.4° F (37.4° C) to 102.9° F (39.4° C)
- Mild: 99.3° F (37.3° C) and lower
Note: For children under 5 years old, rectal temperatures are the most accurate.
An illness plan for people with diabetes usually covers things like:
- How often to test blood sugar and what the target range is.
- Whether and how to adjust the dose and timing of insulin or other diabetes medicines.
- What to do if you have trouble keeping food or fluids down.
- When to call your doctor.
The plan is designed to help keep your diabetes in control even though you are sick. When you have diabetes, even a minor illness can cause problems.
It is easy for your diabetes to become out of control when you are sick. Because of an illness:
- Your blood sugar may be too high or too low.
- You may not be able take your diabetes medicine (if you are vomiting or having trouble keeping food or fluids down).
- You may not know how to adjust the timing or dose of your diabetes medicine.
- You may not be eating enough or drinking enough fluids.
Blood in the stool can come from anywhere in the digestive tract, such as the stomach or intestines. Depending on where the blood is coming from and how fast it is moving, it may be bright red, reddish brown, or black like tar.
A little bit of bright red blood on the stool or on the toilet paper is often caused by mild irritation of the rectum. For example, this can happen if you have to strain hard to pass a stool or if you have a hemorrhoid.
A large amount of blood in the stool may mean a more serious problem is present. For example, if there is a lot of blood in the stool, not just on the surface, you may need to call your doctor right away. If there are just a few drops on the stool or in the diaper, you may need to let your doctor know today to discuss your symptoms. Black stools may mean you have blood in the digestive tract that may need treatment right away, or may go away on its own.
Certain medicines and foods can affect the color of stool. Diarrhea medicines (such as Pepto-Bismol) and iron tablets can make the stool black. Eating lots of beets may turn the stool red. Eating foods with black or dark blue food coloring can turn the stool black.
If you take aspirin or some other medicine (called a blood thinner) that prevents blood clots, it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.
Many prescription and nonprescription medicines can cause diarrhea. A few examples are:
- Antibiotics.
- Antidepressants.
- Antacids.
- Proton pump inhibitors, such as omeprazole (Prilosec) and lansoprazole (Prevacid).
- Medicines used to treat cancer (chemotherapy).
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Self-Care
Caring for your baby who has diarrhea
Here are some tips for caring for your newborn or baby younger than 1 year of age who has diarrhea.
- Don't let your baby get dehydrated.
Don't wait until you see signs of dehydration in your baby. These signs include your baby having fewer or no wet diapers and a dry mouth and dry eyes (fewer tears than usual).
- If you breastfeed, nurse your baby more often. Offer each breast for 1 to 2 minutes every 10 minutes.
- If you use a bottle to feed your baby, increase the number of feedings to make up for lost fluids. The amount of extra fluid your baby needs depends on your baby's age and size. For example, a newborn may need as little as 1 fl oz (30 mL) at each extra feeding. A 12-month-old baby may need as much as 3 fl oz (90 mL) at each extra feeding.
- Ask your doctor if you need to use an oral rehydration solution (ORS) if your baby still isn't getting enough fluids from formula or the breast. The amount of ORS your baby needs depends on your baby's age and size. You can give the ORS in a dropper, spoon, or bottle.
- If your baby has started eating solid foods, you can continue feeding your baby if they feel like eating.
- Protect the diaper area with zinc oxide or another cream.
Diaper rash is common after diarrhea.
- Learn how to clean up diarrhea safely.
Protect your hands with gloves while cleaning up. Wash your hands after you are done cleaning up.
- Think about whether you can take your baby to day care.
Until you know that your baby's diarrhea isn't a symptom of an infectious illness, your baby should not attend day care.
- Be careful with medicines.
Don't give your baby prescription or nonprescription medicine to stop diarrhea. You may need to check with your baby's doctor about what is safe to give.
Caring for your child who has diarrhea
Here are some tips for caring for your child (age 1 through 11 years) who has diarrhea.
- Don't let your child get dehydrated.
- Make sure that your child drinks often. Frequent, small amounts work best.
- Allow your child to drink as much fluid as your child wants. Encourage your child to drink extra fluids or suck on flavored ice pops, such as Popsicles. But don't give your child fruit juice or soda pop. They contain too much sugar and not enough of the essential minerals (electrolytes) that are being lost. And diet soda pop lacks calories that your child needs.
- If your child drinks cow's milk, your child may still drink it.
- Cereal mixed with milk or water may also be used to replace lost fluids.
- If your child still isn't getting enough fluids, you can try an oral rehydration solution (ORS).
- Don't withhold food from your child.
- Start to offer small amounts of food when your child feels like eating.
- Protect the diaper area with zinc oxide or another cream.
Diaper rash is common after diarrhea.
- Learn how to clean up diarrhea safely.
Protect your hands with gloves while you clean up. Wash your hands after you are done cleaning up.
- Think about whether you can take your child to school or day care.
Until you know that your child's diarrhea isn't a symptom of an infectious illness, your child should not attend school or day care.
- Be careful with medicines.
Don't give your child prescription or nonprescription medicine to stop diarrhea. You may need to check with your child's doctor about what is safe to give.
When to call for help during self-care
Call a doctor if any of the following occur during self-care at home:
- Dehydration.
- New black or bloody stools.
- A fever.
- Severe diarrhea.
- Symptoms occur more often or are more severe.
Learn more
Preparing For Your Appointment
You can help your doctor diagnose and treat your condition by being prepared for your appointment.
Related Information
Credits
Current as of: October 19, 2023
Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
Current as of: October 19, 2023
Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.