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Bottom Problems

When Should You Worry About Diarrhea?

By Lisa A. Goldstein

Paying attention to your baby's bottom can, quite literally, be a murky thing. When it comes to what goes in that diaper, how do you know what's normal and when to consult the doctor?

"Diarrhea is the frequent passage of unformed bowel movements," says Dr. Martin Belson, a pediatric emergency medicine physician who created KidEmergencies.com. "It's important to know what your child's stools usually look like. If the stools increase in number or become runnier than usual, this is considered an important change."

Babies' stools can vary greatly depending on the age of the baby and the diet, says Dr. Charles Shubin of Mercy Pediatrics at Mercy Medical Center in Baltimore, Md., who deals with this subject virtually every day. Newborns have dark, almost black stools called meconium, as they haven't eaten anything yet, he explains. This then changes to a yellow, seedy stool and finally to a formed brown stool. Dr. Shubin says what is not normal would be either watery stools or hard, rock-like stools.

Whether your baby is breastfed or formula fed will have an impact on what Baby leaves in his diaper. "As breastmilk is so much more completely digested, breastfed babies have much smaller and less formed stools," says Dr. Shubin. "They are rarely truly constipated. With the introduction of foods, there is much more waste and the stools will reflect what the baby eats and doesn't fully digest (green stools when eating green beans, for example)."

The most common cause of diarrhea is a viral infection of the intestines called rotavirus. "It affects nearly all children by age 4, causing over three million cases of illness in the U.S. each year," Dr. Belson says. "Most children are infected more than once, with the repeat infections usually being milder."

The other main cause of diarrhea is malabsorption – food intolerances – such as lactose intolerance or gluten intolerance (celiac disease). Antibiotic use can also result in diarrhea, as can food allergies.

Want to see more?

• Tummy Trouble? A Guide to Your Newborn's Digestive System
• Handling Little One's Bellyaches
• Fahrenheit 101: When Should You Fret Over Fever in Infants and Toddlers?
• Check out our Article Library.
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