As parents of toddlers know, sometimes these small children have an enormous amount of stool. And often, it can be loose or runny. This is quite common, and even has a name: toddler diarrhea.
What Is It?
Toddler diarrhea is not a true illness or disease, but merely a symptom. It’s common among toddlers and poses no threat to their health. Toddler diarrhea usually has the following hallmarks:
- The diarrhea is painless.
- The diarrhea is often foul-smelling.
- The child has three or more episodes of large, unformed stool for at least four consecutive weeks.
- The diarrhea often contains undigested food and mucus.
- The diarrhea occurs during waking hours.
- Symptoms begin between 6 to 36 months old, but may last through preschool.
- Symptoms usually resolve by school age or earlier, and 90 percent of children are free of diarrhea by 40 months of age.
A common finding is that the diarrhea often starts after a bout of gastroenteritis. This is a viral infection of the stomach and intestines that usually causes fever, abdominal pain, vomiting, and diarrhea. After recovering from this acute, intense illness, the child may continue with painless frequent stools, as outlined above, but be acting perfectly well. In this situation, parents often feel like the “illness” is persisting, but the child is healthy, growing, eating, and feeling fine, in marked contrast to the way they appeared during the infectious illness.
What Causes It?
So if toddler diarrhea is different from an infectious illness, and the child is otherwise fine, what causes it? That’s not entirely known, but the latest theory is that a multitude of factors play a role, including the following.
- Diet: Toddlers often take in an excess of juice and other liquids with a high content of fructose and sorbitol, which have been linked to toddler diarrhea. A diet very low in fat and low in fiber has also been implicated.
- Increased intestinal transit time: For some toddlers, the food travels through the colon very quickly, leading to less absorption of water, which leads to looser stools.
- Increased physical activity: Physical activity has been linked to increased stooling in general.
- Individual intestinal microflora: Everybody’s intestines contain billions of germs, but these are necessary germs that aid in digestion. However, the exact makeup of this dense microbiome varies from person to person, and some toddlers have a collection of bacteria that promote looser stools.
What Can I Do About It?
Because the child with toddler diarrhea is, by definition, healthy and thriving, most experts recommend no pharmaceutical treatment at all.
That’s why there is no “cure” for toddler diarrhea, as it’s not really a disease. But there are some things you can do to make it better.
Keep a food diary and relate it to the amount, frequency, and timing of diarrhea. This may help your child’s doctor eliminate any other causes of diarrhea that are more concerning, like food intolerances or allergies.
Check for Bloody Stool
Ensure that there is no blood in the stool. This seems obvious for children still in diapers, but make sure to check the stool of those who are potty-trained, as they may not mention this to you. If you do find blood in the stool, see your child’s doctor right away.
Sometimes blood in the stool can be microscopic, so your child’s pediatrician may ask for a stool sample to test for blood if there is any concern.
In addition, talk to your doctor if your child has diarrhea along with weight loss or poor weight gain, vomiting, fever, abdominal pain, or stools that are greasy or oily.
Skip the Fruit Juices
Limit juice and other liquids with fructose and sorbitol, such as sports drinks and soda. Keep the total amount of juice, if any, to less than 8 ounces a day.
Up the Fiber Intake
More fiber may actually help firm up the stools. Choose whole-grain cereals and breads, beans, and fresh fruits and vegetables. And adding a little more fat to the diet may also help.
This might be surprising, as so much attention is paid to limiting fat intake. But if your toddler is not overweight and gets a good amount of exercise, as most do, then a little extra fat should be fine. Be sure to check with your doctor if this is appropriate for your child. If you do add fat, make it healthy fat like dairy, avocado, olive oil, or eggs.
Probiotics are available over the counter. Probiotics are live bacteria and yeasts that are beneficial to your body. These will most likely not harm the child, and may help. However, there are no studies that demonstrate these are effective.
If you’ve done all the above and your child is indeed growing, eating, and acting normally, but still having diarrhea, there’s no need to worry.
This is one of those problems of childhood that is much worse for the parent — or whoever has to clean up the child — than for the child. So if all else is fine, consider toddler diarrhea much like tantrums, teething, and thumb-sucking. This too shall pass.