Diarrhea
Diarrhea is the word often used to describe looser or more-wet-than-normal poops in a child and/or an increase in the number of poops per day. Wet poops in different age groups can mean a lot of different things, so let’s break it down, shall we?
Diarrhea in a Kiddo Under 1:
Babies and infants are allowed to have wet poops, even explosive ones, because most of their nutrition is from a liquid source and is often accompanied by varying amounts of gas depending on their age. We consider a baby to be having diarrhea if they are having more than 11 wet, fill-up-the-diaper–type poops a day. At that stage, we may see signs of early dehydration in babies such as dry, tacky mucous membranes like the mouth or tongue. If this is the case, they should see their pediatrician straight away. If a baby has diarrhea due to a viral stomach bug, there is not much that we do other than frequent diaper changes to avoid irritation to their bottom and monitoring of their hydration level at home. If we have a baby who is also throwing up with diarrhea, then sometimes they do need an extra pick-me-up of hydrating fluids in the pediatrician's office or emergency room.
If the diarrhea is due to a stomach bug, the crummy thing is the younger baby is or the more reliant they are on milk or formula for nutrition, the longer the diarrhea will last as one of the first things most stomach viruses do is to knock out enzymes that help process dairy. If your gut is running low on those enzymes due to a viral insult, you will get looser stools with each dairy introduction.
When can a kiddo with a stomach bug go back to preschool? They can go back as long as they are fever-free for over 24 hours off of fever medicine, are eating and drinking well, and if they do have residual diarrhea, the diarrhea stays in the diaper and does not leak out.
Diarrhea in a Kiddo Over 1 Year of Age:
Diarrhea in an older kiddo is usually easier to recognize as they usually have more normal adult stool to begin with. Anything more than 4ish stools in a day can be considered diarrhea in an older kiddo. Most of these cases of diarrhea can be due to eating something that did not agree with them or a kid passing around a stomach virus. These are mainly treated by monitoring hydration and increasing good electrolyte fluids like Pedialyte, half water–half Gatorade, apple juice, coconut water, etc. But if there is a high fever with diarrhea, blood, or intense stomach pain +/- vomiting, we should see the kiddo in clinic to make sure it is only a viral stomach bug and not something more. If the kiddo is otherwise eating and drinking well, we can usually monitor them at home until the resolution of symptoms over the next week or so. If the diarrhea lasts longer than 2 weeks, though, we should see them in clinic for a stool test and culture to make sure we did not pick up some bacteria or parasites when we went camping or to the zoo or played with the neighbor’s new puppy.
You often hear of using the BRAT diet to help with diarrhea in kids. BRAT stands for bananas, rice, apple sauce, and toast. These foods don’t treat the diarrhea or get the virus out of the body any faster, but what they are good at is acting like cement mix to help solidify the stools and decrease their frequency. The BRAT diet is also devoid of dairy, which usually makes diarrhea worse in the setting of stomach viruses.