Treat Diarrhea in Newborns

Newborn diarrhea can be a cause for concern in new parents. Often, depending on the underlying cause, the condition is easily rectified with proper home care. Knowing what to do when your newborn comes down with a bout of diarrhea and understanding when it is necessary to seek professional assistance can help calm nervous new parents. By following some simple tips and educating yourself about diarrhea in newborns, you can feel confident in helping your newborn baby to overcome the condition if it were to develop.

Steps

Seeking Help

1. Call your doctor. Call your baby’s healthcare provider if you have questions that you need to have answered or if you are in any way unsure about your baby’s condition.
   • Newborns are very fragile, and can become quickly dehydrated. If you suspect that your baby is dehydrated, or if he has any of the following symptoms, call the pediatrician immediately:
     • Fever. Call the doctor for any temperature above 100.4 F in babies under two months, or any temperature over 101.5 F in babies over two months.
     • Vomiting. While vomiting and diarrhea commonly occur together during bacterial or viral illnesses, newborns are already at risk of dehydration and that risk increases when both factors are present.
     • Symptoms of dehydration including dry mouth, less than six wet diapers per day, lethargy, sunken eyes, a sunken fontanelle (soft spot), no tears when crying, or dry skin.
     • Diarrhea that has lasted for 24 hours or more or if there is blood in either the vomit or stool.
     • If the baby refuses to eat, is very irritable, or is very sleepy or difficult to wake up.
2. Make an appointment to address sores. Have your baby seen by her healthcare provider if her bottom develops open sores that are not helped by any of your attempts to sooth them, or if the irritation does not appear to be getting better.
   • Sores on the bottom as a result of diarrhea are very common, but open sores can become infected if not treated properly. The pediatrician can prescribe an ointment to sooth the baby's discomfort and prevent infection, as well as helping improve the diarrhea so that the sores do not worsen.
3. Make an appointment to discuss ongoing issues. If you find that your baby has recurrent bouts of diarrhea, even if they are not severe or accompanied by other issues, it is a good idea to schedule an appointment to discuss the issues with the doctor. That way, the doctor can help to pinpoint the underlying cause and prescribe a plan to prevent future issues.
   • Ongoing issues with diarrhea could signal intestinal problems, food intolerances or allergies (in newborns, this can include sensitivities to foods that mother eats if the baby is breastfed, or an allergy to ingredients in formula).
   • A pediatrician can also help to ease your mind if you are not sure whether or not your baby has diarrhea. Feel free to save a representative soiled diaper in a large ziplock bag and take it to your next appointment. The pediatrician should be able to tell if the baby is truly struggling with diarrhea.

Determining if it is Diarrhea

1. Know what is normal. Newborn stools come in a variety of textures depending on the baby's age and diet, and loose, watery bowels are not always a direct indication that diarrhea is present.
   • Because every baby's stooling patterns differ slightly, it's important to keep track of your baby's patterns so that you can recognize if something is not normal. Most hospitals will give you a chart to keep track of your baby's feeding, urination, and stools, but if they don't, be sure to keep track in a journal or notebook. Simply write down the date every morning, and list the start and end time of any feeding sessions, the time you change diapers that are wet only, and the time you change diapers that are soiled with feces throughout the day.
   • In the first days of life, newborn stools are known as meconium, and are sticky, black or green, and similar to tar in consistency. These stools are composed of substances the baby swallowed while in utero, amniotic fluid containing body cells.
   • As the meconium is cleared from the baby's system, it is replaced by the first stools resulting from the baby's diet. A breastfed infant and a formula fed infant will have different bowel patterns, and the stools of the two will be different in appearance.
2. Do not expect newborn stools to resemble adult stools. While you would be shocked if your stools were mustard yellow or seedy, loose stools like these are normal for newborns.
   • A breastfed newborn's stools are usually bright yellow and seedy in appearance, similar to dijon-style mustard or yellow colored small curd cottage cheese. All babies' digestive systems differ (depending in part on the mother's diet and the baby's muscle tone), and so some breastfed newborns will pass stools after every nursing session while others may only defecate every few days, or more rarely, even once a week! This is because breastmilk is used very efficiently by the newborn's body, and there isn't much waste to eliminate.
   • A formula-fed newborn's stools are typically tan or yellowish in color and firmer than a breastfed baby's. They are typically the consistency of smooth peanut butter. They are also generally smellier. Formula-fed babies usually stool several times a day to several times a week.
3. Recognize diarrhea in newborns. If you have kept familiarized yourself with your baby's typical stooling patterns, it should be easier to recognize a deviation from the norm. In general, diarrhea in newborns has the following features:
   • Increased frequency of stools (generally more than one per feeding).
   • Increased amount of liquid or mucus in the stool. Call the pediatrician immediately if there is any blood in the stool.
   • Often a larger volume of stools.

Understanding Possible Causes

1. Note the mother's diet. While rare, the diet of a nursing mother can affect her breastfed baby enough to cause a temporary bout of diarrhea.
   • Pay attention to what was eaten by mom in the day before her baby had a bout of diarrhea. If the baby has another bout of diarrhea after her mom has once again consumed that same food, eliminate that food from mom’s diet while she continues to nurse her baby. Wait and see if the condition clears up. Common culprits include dairy, soy, wheat, or peanuts.
2. Consider any recent changes to the baby's feeding. Know that a change from breastfeeding to formula feeding can lead to the development of diarrhea in newborns. Your baby’s digestive system is still immature and as such is sensitive to the introduction of new foods.
   • If you have recently introduced a new formula into your baby’s diet and he appears to develop diarrhea shortly after the introduction of that food, it may be that your baby's digestive system is reacting to the sudden change. If this happens, you can make a choice:
     • Stop feeding your baby formula. Wait until your baby’s digestive system matures a little more before introducing the formula again, and breastfeed in the meantime.
     • Try to introduce the new formula at a slower pace. Slowly combine more and more formula with less and less breast milk until your baby is able to digest the desired amount of formula.
3. Consider any other additions the baby's diet. While a newborn should not be fed any solid foods before the age of six months, any introduction of new food to your baby’s diet can disrupt the intestinal tract for a short period of time.
   • Pay close attention to the way that your baby reacts to any new foods and always introduce only one new food at a time for at least three to four days at a time. This may be the only way to determine if your baby is suffering a reaction from the new food.
   • Be sure to talk to the pediatrician before introducing new foods to your baby's diet, or before introducing any foods but breastmilk or formula before the age of six months.
4. Look for signs of illness. Keep a very close eye on your baby and watch for other signs to develop that may indicate illness.
   • A fever and a runny nose or vomiting usually indicate that the diarrhea is the result of some type of underlying bacterial or viral illness. In a young newborn age two months or younger, you should call the pediatrician immediately about any fever. A fever coupled with diarrhea is particularly dangerous, since a very young baby can dehydrate quickly.
   • In addition, if other family members also have diarrhea, it is likely caused by an infection, or less likely, food poisoning.
5. Know other factors that can cause changes in stools. A change in stool frequency and texture is most likely diarrhea, but other changes indicate other possible causes.
   • An infant that is on medication, including vitamins or supplements, may have a change in bowel texture or frequency. Antibiotics often cause diarrhea. If diarrhea continues or worsens, you may have to discontinue using that medication and begin another.
   • You should never give an infant under six months water or juice (they get all the water they need from breastmilk or formula, and too much additional water can dilute their blood and damage their kidneys, resulting in severe complications or even death). However, giving an infant water or juice is also known to cause a change in bowel patterns.
   • Teething can also cause diarrhea, which is thought to be triggered by the excessive production in saliva during the teething process. While uncommon, newborns can experience early teething resulting in diarrhea.

Deciding a Course of Action

1. Change your baby's formula. Speak with your healthcare provider if your newborn baby is on a diet of formula and develops diarrhea. It may be that your baby just needs to find a formula that works for her.
   • Often, parents have to try out several different types of formulas before they find the right fit for their baby. While most babies thrive on dairy-based formulas, others must special formulas, including lactose-free and soy-based formulas. In general, babies who have a sensitivity to their formula are also gassy and fussy.
   • For babies who have a weak or undeveloped digestive system or a true milk allergy, there are specific formulas that are developed for sensitive tummies. These include formulas made from broken-down proteins or an elemental formula. Speak with your doctor to get a recommendation. Some require a prescription.
   • Talk to your pediatrician before changing your baby's formula.
2. Keep your baby hydrated. Whether your baby is formula-fed or breastfed, it is important that you increase the milk that you offer while a baby is sick with diarrhea or vomiting, as both can quickly lead to dehydration in such a small body.
   • If you normally nurse or offer a bottle every three hours, try offering every two or even every hour. A newborn cannot drink too much formula or breastmilk, especially while sick.
   • If your baby is vomiting, offer smaller amounts at each feeding, but offer it more frequently.
   • Do not offer the baby water or water down the formula. This is very dangerous for newborns, as it can dilute the blood and cause kidney failure. To increase hydration, you must increase breastmilk or formula intake only.
3. Monitor your baby closely. Diarrhea can cause dehydration to occur rather quickly. Any bouts of diarrhea that last for more than 24 hours indicate that your baby needs medical assistance. Any signs of dry diapers for longer than six hours or the absence of tears when your baby cries are clear indications that your baby has become dehydrated. Seek medical assistance promptly.
   • Discuss with your baby’s healthcare provider the possibility of giving your baby an electrolyte solution as a way to rehydrate her for the time being. These include Pedialyte and Enfalyte as well as other brands. They are especially useful if your baby is vomiting.
   • Your baby's pediatrician may also suggest a probiotic to help replenish the natural bacteria in her gut.
4. Understand that your baby’s bottom may become intensely sore and irritated. It is not uncommon for bouts of diarrhea to leave a baby’s bottom literally raw with open sores. Extra attention is needed to prevent this from happening.
   • Coat the baby's bottom and genital area with a thick diaper rash cream or petroleum based product like Vaseline or Aquaphor to prevent further irritation.
   • Keep your baby’s bottom clean and dry. Sometimes, regardless of how often you change your baby’s diaper baby, he will still develop a red, sore bottom. Diarrhea can be harsh on sensitive skin. Promptly remove the diaper and gently cleanse diarrhea from the skin. The less time the skin is exposed to the irritant, the better it is for the skin.
   • Remove baby's diaper, clean the baby's bottom, and allow your baby to rest on a blanket with no diaper on. Fresh air may help clear up the diaper rash. Avoid excessive wiping of your baby’s bottom. His sensitive skin can become very tender when wiping is increased drastically.
   • Call your healthcare provider if you notice a rash developing in the genitals, skin folds or thigh areas as this could be a sign of a yeast diaper rash. This is often very red, and may have red bumps spreading out from the red areas. You will need to get prescribed medication to treat a yeast diaper rash.
   • Refrain from using unnecessary cleansers on your baby’s bottom right now. Try to purchase a cleanser that is specifically designed to sooth sensitive skin. Organic products, even if you don’t usually use them, are worth a try to help alleviate irritation.
   • Switch to extra soft chemical-free baby wipes for the duration of the diarrhea. You can also try soaking your current wipes in clear water to remove some of the irritating ingredients before wiping your baby’s bottom with them, or using soft squares of flannel fabric from the fabric store soaked in water and a tablespoon of coconut oil. You can also use a clean washcloth with warm water to cleanse the diaper area.

Tips

• Breast milk is known to help treat diarrhea.

Warnings

• Remember to never give any medications to a newborn without consulting the baby's doctor first.

Related Articles

• Prevent Infant Diarrhea
• Analyze a Baby's Health by Poop or Stool Colors
• Care for a Child With Diarrhea
• Prevent Infant Dehydration

Sources and Citations

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• Analyze a Baby's Health by Poop or Stool Colors