Definition

• Diarrhea is the sudden increase in the number and looseness of stools
• Diarrhea means 2 or more watery or very loose stools.  Reason: 1 loose stool can be normal with changes in diet.

Causes

• Virus (such as Rotavirus). An infection of the intestines from a virus is the most common cause.
• Bacteria (such as Salmonella). Less common cause. Diarrhea often contains streaks of blood.
• Food-poisoning. This causes rapid vomiting and diarrhea within hours after eating the bad food. It is caused by toxins from germs growing in foods left out too long. Most often, symptoms go away in less than 24 hours. It often can be treated at home without the need for medical care.
• Giardia (a parasite). More likely in child care center outbreaks.

Diarrhea Scale

• Mild: 2-5 watery stools per day
• Moderate: 6-9 watery stools per day
• Severe: 10 or more watery stools per day
• The main risk of diarrhea is dehydration.
• Loose or runny stools do not cause dehydration.
• Frequent, watery stools can cause dehydration.

Dehydration: How to Know

• Dehydration means that the body has lost too much fluid. This can happen with vomiting and/or diarrhea. A weight loss of more than 3% is needed. Mild diarrhea or mild vomiting does not cause this. Neither does a small decrease in fluid intake.
• Dehydration is the most important complication of diarrhea.
• These are signs of dehydration:
• Decreased urine (no urine in more than 8 hours) happens early in dehydration. So does a dark yellow color. If the urine is light straw colored, your child is not dehydrated.
• Dry tongue and inside of the mouth. Dry lips are not helpful.
• Dry eyes with decreased or absent tears
• In babies, a depressed or sunken soft spot
• Slow blood refill test: Longer than 2 seconds. First, press on the thumbnail and make it pale. Then let go. Count the seconds it takes for the nail to turn pink again. Ask your doctor to teach you how to do this test.
• Fussy, tired out or acting ill. If your child is alert, happy and playful, he or she is not dehydrated.
• A child with severe dehydration becomes too weak to stand. They can also be very dizzy when trying to stand.

Diarrhea in Breastfed Babies: How to Tell

• Diarrhea in a breastfed baby is sometimes hard to tell.
• Normal breastfed stools are loose (often runny and seedy). Stools are yellow, but sometimes can be green. The green color is from bile. Runny stools can even be bordered by a water ring. These are all normal stools.
• Breastfed babies often pass more than 6 stools per day. Until 2 months of age, they may pass a stool after each feeding. But, if stools suddenly increase in number and looseness, suspect diarrhea. If it lasts for 3 or more stools, the baby has diarrhea.
• If the stools contain mucus, blood or smell bad, this points to diarrhea.
• Other clues to diarrhea are poor eating, acting sick, or a fever.

Diarrhea in Formula-Fed Infants: How to Tell

• Formula-fed babies pass 1 to 8 stools per day during the first week. Then it starts to slow down to 1 to 4 per day. This lasts until 2 months of age.
• The stools are yellow in color and thick like peanut butter.
• Suspect diarrhea if the stools suddenly increase in number or looseness. If it lasts for 3 or more stools, the baby has diarrhea.
• If the stools contain mucus, blood, or smells bad, this points to diarrhea.
• Other clues to diarrhea are poor eating, acting sick or a fever.
• After 2 months of age, most babies pass 1 or 2 stools per day. They can also pass 1 every other day. They no longer appear to have mild diarrhea.

Return to School

• Your child can go back to school after the stools are formed. The fever should also be gone. The older child can go back if the diarrhea is mild. The older child also needs to have good control over loose stools.

See More Appropriate Topic (instead of this one):

• Blood present and no diarrhea, see Stools - Blood In

When to Call for Diarrhea

First Aid - Shock

And remember, contact your doctor if your child develops any of the "Call Us" symptoms.