Diarrhea in Newborn Infants: Signs, Causes, and Solutions

What Is Diarrhea in the Newborn?

Diarrhea in newborns is the passage of watery stools in babies at least three times a day. The first month of a baby’s life (the neonatal phase) is a time of great importance to their health because they are particularly vulnerable to environmental stressors and pathogens.  This is large because the baby’s immune system is immature and cannot mount a successful response to external pathogens and stressors.

Approximately 1.3 to 2.2 million children die each year due to diarrheal diseases because even relatively mild diarrhea in children can prove fatal without the right treatment.  That being said, if a child should develop diarrhea, measures should be taken immediately to support that child.

How Can I Identify a Baby With Diarrhea?

The intestinal function of newborns is immature, it does not process food the way the adult intestine does. As such a typical baby poop can assume different textures, colors, and consistencies; it is sometimes hard to tell diarrheic poop from non-diarrheic ones.

For Breast-Fed Infants

There is no cause for alarm if your baby poop is soft, thin, runny, yellow, and has things which appear like seeds in it. It is also very normal for your baby to defecate 7-9 times a day. This is because breastfed newborns have more bowel movements than their formula-fed counterparts. Some medical literature term this seeming diarrhea ‘false diarrhea phenomenon’

Collectively, all these factors blur the line between diarrheic newborns and non-diarrheic ones. Hence, differentiating normal from abnormal poop could be a tricky one.

For Formula Fed Infants

Infants who take formula feeds tend to have poops that are thicker, firmer, and brown.

Telltale signs of diarrhea include:

The signs below are almost absolute indicators of the underlying disease process[es] culminating in diarrhea. Notice any of these signs in your baby? If yes, you and your baby might need to see a pediatrician at the baby clinic immediately.

• Very loose, watery, and voluminous poop
• Containing blood or yellowish tinge[ mucus]
• Excessively offensive odor
• Green poop in breastfed infants or yellowish one in formula-fed infants

What Are the Common Causes of Diarrhea in Newborn Infants

1. Newborn diarrhea is a manifestation of a disease process triggered by a microorganism. These microorganisms include viruses notably Rotavirus; bacteria like Shigella, Salmonella, E.Coli; parasites like Entamoeba

2. Improper feeding habits, such as

• Formula feeding the baby concentrated meals

• Feeding babies with stored formula feed or breast milk that has overstayed its shelf life.

• Feeding babies with very cold meals.

All these can set the stage for diarrhea.

3. Changes in the child’s diet can also lead to diarrhea. A transition of the newborn feed from liquid[breast milk, formula feed] to semi-solid and solid can offset diarrhea. This is because those introduced feeds may have allergens the baby’s immune system can’t handle. It’s best to take the dietary change of your baby slow and easy

4. Certain drugs can also lead to diarrhea in the newborn. The thing with drugs is that their effect cuts both ways. So whereas a drug may perform its intended function, it could also have some unintended, unavoidable, and potentially harmful functions as well, especially in young children. Antibiotics have a notoriety for causing diarrhea in newborns. So don’t be so alarmed if your baby taking antibiotics suddenly develops watery stool.

5. Unhygienic practices both on the part of the child and the caregiver. I’m pretty sure you may notice that babies have this goofy habit of putting any object they can lay hands on into their mouth. This won’t be a problem if everything they touched were squeaky clean. But that is not always the case, especially in daycare centers or around the home. Consequently, the baby can ingest gazillions of microbes through those objects and may come down with diarrhea. Also if the baby formula is not prepared in a sterile environment there is a significant risk of harmful microorganisms being introduced into the body of the child.

6. Certain health conditions also lead to diarrhea among babies. For instance, babies with Inflammatory Bowel Disease (IBS) may come down with diarrhea if introduced to gluten-containing meals. The baby may have lactose intolerance, which a ‘no-no’ when it comes to milk ingestion. According to a study, every 2 to 7 babies in 100 have allergies to milk powder protein. Forthwith this allergy can manifest as diarrhea.

7. Allergies and dietary causes are also major factors. Not all the causes of diarrhea in newborns are baby-centric or due to microbes, some may simply be due to the nature of the meal itself. Some ingredients in your diet can trigger allergic reactions and by extension diarrhea. Watch out for such food as cow milk, caffeine, spicy meals, meals with too much sugar. Therefore if your child is having recurrent episodes of diarrhea pay attention to any particular triggers such as previous meals or particular ingredients.

How Can I Differentiate Between Normal Diarrhea and Harmful Diarrhea?

First of all, all forms of diarrhea should be considered harmful until told otherwise by a pediatrician. However, some signs are more specific to the underlying disease and may point to a more sinister cause. Here are some tips to help you different harmful diarrhea from normal diarrhea (Note: The term ‘physiological’ means the normal action of a healthy body.):

a. Physiological Symptoms

1. Loose, runny stools

2. Bowel movements of 7-12 times a day

As long as the baby is happy, and has a good appetite, is steadily gaining weight, and shows no signs of dehydration, you have nothing to worry about.

b. Pathological  Symptoms

In contrast to physiologic, pathologic is a term that denotes abnormality.

1. The stool:

The stool of a diarrheic newborn, in this case, maybe:

• Be loose and voluminous stool

• Contain foam, mucus, blood, particles of indigestion

• Overly offensive poop

• In rotavirus infection, the newborn’s poo is yellow, watery, or egg-flower soup-like. But there are no pus, blood in the stool.

2. Other gastrointestinal symptoms like vomiting and loss of appetite

3. Diarrhea caused by allergy may also be accompanied by hives, skin eczema, wheezing, etc. In Rotavirus infection, the baby may have a cold and this should be properly treated

4. Signs of dehydration may be present and should be looked out for. Diarrhea causes a baby to lose fluid and electrolytes to the external environment. This is particularly dangerous for newborns because they have a small volume of body fluids. Below is a list of symptoms you should keep your eyes peeled for:

• Irritability

• Dry lips and mouth

• Loss of appetite

• Weak cries

• Crying without producing tears

• With decreased urine production, the baby maintains a dry diaper for more than 8 hours.

Dial 911 immediately if you notice any of these symptoms.

5. Others:

Diarrhea of bacterial origin is accompanied by vomiting, fever. In neonatal epidemic diarrhea, microbiota from the mother’s birth canal is transferred to the newborn. The resultant disease has a short incubation period and symptoms like vomiting, abdominal distention, diarrhea, yellow-green poo, etc

What You Can Do to Manage Diarrhea in a Newborn

1. In the case of physiological loose stools, no special treatment is needed. You only need to keep feeding the baby well and make sure the baby is in good spirits. However, keep a close eye on the child for any signs of dehydration or infection.

2. Correct improper feeding practices

3. Pay special attention to your baby’s bowel habits when you introduce formula feed. Or when you start eating certain food substances. If the change is marked, then that’s a big red flag in our book. You could also reduce the amount of milk and replace it with rice soup, sugar, and saltwater. If there is no improvement, see your doctor.

4. For mild cases of dehydration following diarrhea, you can rehydrate via the oral method. This is very important and can be potentially life-saving for the child. You can try any of the following methods:

• by formula feeding but preferably breastfeeding
• Giving your baby prescribed baby electrolyte drink

5. Take prescribed baby medication given to you by your pediatrician to control the infection.

6. In the event of moderate to severe diarrhea talk to your doctor and let the professionals take care of the situation.

How Can I Prevent Diarrhea In My Child?

1. Promote breastfeeding: According to research, the incidence of diarrhea is greatly reduced in breastfed infants. Nevertheless, breastfeeding mothers should maintain a light diet. They should also steer off spicy, oily, and cold meals, as these can aggravate the condition.  Do not wean the baby abruptly. In the case of formula feeding, give the infant skimmed milk.

2. Maintaining proper dietary hygiene: The milk source should be fresh and clean. And whatever utensils are used to feed the baby must be washed immediately after use. Also, boil and disinfect them at least twice daily.

3. Always make sure your baby is happy: Amongst the simultaneous events occurring when a baby cries, intestinal food accumulation is most dangerous. This is because it can cause shifts in the body water that results in diarrhea.

4. Avoid stressors in your baby’s life: Try taking your baby out from time to time. Let the baby adapt naturally to its environment.

5. Do not abuse baby medications especially antibiotics.

6. Record your observation of changes in stool color, consistency, frequency, but, and volume. This might be very helpful to the doctor in time.

7. Always keep the baby conveniently warm. This can contribute to its quota in stemming diarrhea.

8. Pay special attention to the hygiene of your baby’s buttock: After every baby poo session, wash the baby’s buttock with warm water and medicated baby soap. Dry the butt gently with a clean dry towel. You can also apply diaper lotion to protect the skin from drying. Else, your baby could have sores, ulcers, and urinary tract infections.

What Are the Possible Consequences of Diarrheal in Newborn Infants?

The effects of diarrhea are multi-systemic. They range from relatively mild disorders to life-threatening

1. Extra-intestinal viral and bacterial infections

Diarrhea reduces the body resistance levels, this foils the combative efforts of the immune system to fend off pathogens. As such the newborn is particularly vulnerable in these periods to opportunistic pathogens that ordinarily cannot cause harm.  Common infection following diarrhea includes:

• Skin infections like boils
• Bronchitis
• Pneumonia
• Upper respiratory tract infection
• Urinary tract infections
• Myocarditis can complicate the viral infection

2. Oral Thrush

A long-standing diarrheic condition can be complicated by oral thrush. Oral thrush is a fungal [candida] infection which causes the mouth to look moldy: somewhat like decaying bread. Newborn diarrheics are particularly prone to thrush after long-term use of broad-spectrum antibiotics.

3. Hepatitis

This implies inflammation of the liver tissue. It is commonplace in the protracted course of diarrhea caused by E.coli  with concurrent malnutrition. The inflammation is due to toxins released by E.coli which disrupt liver functions. This can lead to a mirage of symptoms including jaundice [yellowish discoloration of the skin, eyes]. it could also cause hiccups in the normal clotting process, hence bleeding

4. Malnutrition and deficiency states

A protracted course of diarrhea can lead to undernutrition and imbalances in the newborn. Since electrolytes are like minions that maintain the normal functioning of every organ in the body, you do not want your baby to have insufficient amounts. The effects of electrolyte imbalance include arrhythmias, seizures, cardiac failure, improper muscle functioning, the ability to release insulin, etc.

A diarrheic newborn is truly skating thin ice.  Furthermore, these imbalances can culminate in various developmental and neurologic deficits in the baby. Everything possible should be done to stem the progress of the diarrhea process.

5. Others

Diarrhea has also be associated with medical conditions such as:

• Acute renal failure
• Intestinal bleeding
• Gastric dilation
• Intussusception

The Bottom Line

Diarrhea in newborns means the passing of watery stool in babies more than 3 times a day. It is a condition that should be addressed with urgency and with proper medical methods. This is because the outlook for untreated cases is quite bleak, including deficits and in severe cases, death.

To blow this ‘diarrhea thing out of the water, you need to pay attention to anything the baby eats. Make sure they all pass through some type of formal or informal screening. And in the cases that the disease is ongoing apply adequate measures to stem it. Don’t forget to call your doctor for expert management and counseling

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