Infant Diarrhea: Symptoms, Causes, and Treatment

Although infant diarrhea may resolve on its own within a few days, monitoring for symptoms and rehydration are important to avoid complications.

Diarrhea is one of the main reasons for medical consultation worldwide. It’s more common in the pediatric population and is responsible for a high number of hospitalizations. Are you interested in learning more about infant diarrhea? In the following article, we’ll tell you what you need to know.

Diarrheal disease in children is a condition characterized by an increase in the number of daily bowel movements associated with a decrease in the consistency of the stool. It usually sets in quickly and can be accompanied by other symptoms, such as nausea, vomiting, fever, and abdominal discomfort.

Research by the Spanish Association of Pediatrics (AEP) affirms that this is the most common disease among healthy children in Europe. The annual incidence varies from 0.5 to 2 episodes in children under 3 years of age. The most common cause is gastrointestinal inflammation.

Symptoms of infant diarrhea

In most cases, infant diarrhea occurs with 2 or more stools of less consistency per day. Stools can be soft, liquid, or semi-liquid. In the same way, it can consist of a single evacuation of less consistency accompanied by visible blood in a 24-hour period.

Stool volume, frequency, and consistency vary from child to child. In children under 3 months, bowel movements are more frequent, however, this may change according to their diet. In addition, depending on the duration of the diarrhea, the following forms can be distinguished:

• Acute: Lasts less than 2 weeks and the condition is self-limited.
• Prolonged: Lasts for 2 to 4 weeks.
• Chronic: The situation persists for more than 4 weeks with episodes of remission.

At the same time, some develop other symptoms related to gastrointestinal inflammatory symptoms. Some of the signs that can accompany them are the following:

• Fever equal to or greater than 100.4 F°
• Nausea and vomiting
• Decreased appetite
• Rapid weight loss
• Distension of the abdomen
• Abdominal cramps

In general, cases of infant diarrhea tend to resolve spontaneously and children recover after a couple of days. However, young children are prone to complications from dehydration.

When to seek medical attention?

It’s important to seek professional advice when a child exhibits any of the above symptoms. Dehydrated newborns and infants can lead to seizures and brain damage. Warning signs that require immediate medical attention are as follows:

• Decreased urine volume
• Crying without tears
• Dry mouth and mucous membranes
• Persistent diarrhea for 2 to 3 days
• More than 6 or 8 bowel movements in one day
• Persistent vomiting
• Blood in the stool

The causes of infant diarrhea

Diarrhea is the result of an accumulation of water and electrolytes in the intestine that exceeds the absorption capacity and is eliminated through frequent evacuations. Some research estimates that more than 80% of cases of infant diarrhea are associated with infectious processes.

Rotavirus is the main viral agent responsible for these types of conditions. Similarly, adenovirus, astrovirus, and caliciviruses are some of the most common etiologies of diarrhea in pediatrics, especially in the first years of life and during cold seasons.

On the other hand, bacterial and parasitic infections are also associated with a large number of cases of diarrhea. Within this group, Salmonella , Shigella, Campylobacter, and Escherichia coli infections stand out, as well as the parasitic infections caused by Giardia lamblia, Crytosporidium, and Entamoeba hystolitica.

In addition, there are other conditions associated with acute, persistent, or chronic infant diarrhea. Some of the main non-infectious causes are as follows:

• Food allergies
• The use of antibiotics, such as erythromycin and amoxicillin
• Intestinal malabsorption syndrome.
• Lactose intolerance
• Celiac disease
• Inflammatory bowel disease

The diagnosis of infant diarrhea

In most cases, the diagnosis of infant diarrhea is based on data obtained from the medical history and a detailed examination of the child. In this sense, a doctor should inquire about the evolution of the symptoms, diet, and history of other conditions.

Similarly, a thorough physical exam can detect painful abdominal areas and signs of dehydration. These data are useful to determine the severity of the disease and select the treatment plan.

In general, mild diarrhea for less than 2 weeks and without warning signs doesn’t require further testing. However, severe symptoms, accompanied by blood in the stool and dehydration, warrant other complementary tests:

• Stool examination
• Blood tests
• Serum electrolyte levels
• Urine tests

Treatment

The treatment of childhood diarrhea focuses on correcting the specific cause. Viral infections are usually self-limited and resolve within 1 to 2 weeks. The approach is based on rehydration and diet.

Hydration is carried out using oral rehydration solutions (ORS). These are powdered preparations that are diluted in 1 liter of water. However, sodas, juices, and sports drinks shouldn’t be used.

In cases of infant diarrhea accompanied by frequent vomiting, it’s best to administer a teaspoon of 5 milliliters of liquid every 5 minutes. The amount should be increased progressively according to the child’s tolerance. If severe dehydration occurs, intravenous fluid replacement is necessary.

The child’s diet should be readjusted as soon as dehydration and vomiting are corrected. Lactating babies can return to breast milk or formula without any problem. In older children, it’s best to start with a diet rich in macronutrients and vitamins, avoiding processed products.

Medications that inhibit intestinal motility, such as loperamide and secretion modifiers, are contraindicated in children. At the same time, antibiotics should only be used under strict medical supervision.

The prevention of infant diarrhea

The main objective of preventing infant diarrhea is to avoid infection by harmful microorganisms. To achieve this, it’s important to follow the indications below:

• Maintain proper hygiene of the child’s hands and feet.
• Clean toys and objects handled by the infant.
• Follow vaccination protocols.
• Offer exclusive breastfeeding in the first 6 months.
• Use purified and filtered water for consumption and sanitation of food.

One of the most common diseases in children

To conclude, infant diarrhea is one of the main reasons for pediatric consultation worldwide. In general, it’s due to inflammation of the intestinal mucosa due to a virus, with rotavirus being the most common cause.

Dehydration and the presence of blood in the stool are warning signs that indicate the need for professional attention. Most diarrhea in children clears up spontaneously without treatment. Rehydration and diet are the main therapeutic guidelines.