Toddler Diarrhea - How to Cope
Toddler Diarrhea or TD is not a diagnosis that many parents know about until it is given to their own child. It is not what you may think. Of course diarrhea in toddlers can happen for many of the same reasons as other age groups but TD is a specific disorder.
Your child will have frequent episodes of diarrhea but otherwise they will be happy and healthy. The cause is not known but there are things that can be done to improve the situation. Read on to find out how parents can cope with this misery.
Fortunately it is much more of an ordeal for the parents than it is for the young child concerned, who usually does not worry that they are having several bouts of loose stool per day. This type of chronic diarrhea is very common, although most parents have never heard of it until their child’s doctor or pediatrician says its ' toddler diarrhea ' also known as chronic non-specific diarrhea.
Although this is a distressing disorder fortunately it does not have any serious consequences. The bowel is actually normal but the motility is thought to be affected making transit times faster than they should be. It is a self-limiting disorder and your toddler will grow out of it.
Toddler Diarrhea Symptoms and Diagnosis
- It usually starts around the age of one year and can last for several months or even years, up to the age of five
- Your toddler will have three or more loose bowel movements per day over a prolonged period of time lasting longer than two weeks
- They may have some days with normal bowel movements but the diarrhea will return
- Their stools will often contain undigested food from a recent meal
- Your child will otherwise be well and will grow and thrive normally
- There will not be any blood or pus in their stools
- Usually your toddler will not be distressed or suffer from abdominal pain although in some rare cases mild abdominal pain may be present
- Tests may be carried out to rule out food allergies such as cow’s milk allergy, celiac disease or an infection or bowel disorder; these will be negative
- It is slightly more common in boys than girls
The exact cause of toddler diarrhea is not known but it is thought that in some children the intestines are immature and cannot cope very well with certain dietary elements. As your toddler grows older and their bowels mature they will grow out of this problem. This happens at different times depending on the child but nearly all children will be problem free by the age of five.
Toddler Diarrhea Case Study
Jack was two years old when his bowel habits changed. He started to have 6-8, loose and watery bowel movements a day containing bits of undigested food such as carrot.
His mother assumed it was a stomach bug but although he did not seem unwell Jack continued to have diarrhea. She took him to see the doctor to have a check-up and the doctor diagnosed toddler diarrhea. As there was a history of allergies in Jack’s family tests were done to rule this out but they came back negative.
Jack had reached the 62th percentile for his weight and the 64th for his height and he had not been losing weight. He seemed happy and well.
The biggest problem was for his parents who had to cope with the frequent bouts of diarrhea. To begin with this meant many changes of diaper (nappy) and all the expense and time that entailed. In Jack's house the shower attachment got a lot of use!
Another problem was that when when he was toilet trained he had accidents more than the other children at the nursery and then at the pre-school he attended on the few days his mother worked.
The biggest problem was that his mother would often get phone calls from the pre-school asking her to pick him up, as children with diarrhea are not allowed to attend for fear of cross-infection. Eventually a letter from his doctor reassured them that Jack was not infectious.
Dietary changes helped to reduce the frequency and severity of his symptoms and he grew out of this difficult problem by the time he was four.
Although Jack's parents were reassured by the medics that there was nothing seriously wrong with him they still found this time in his life difficult to cope with.
Dietary Changes That Help Reduce Symptoms
Certain dietary changes have been found to reduce the frequency and severity of the toddler diarrhea symptoms. There are four things to remember; the 4 Fs, fruit juice, fluid, fat, and fiber.
- Fruit Juice: Reduce the amount of fruit juice and fruit squash that your toddler drinks as the sugars in these drinks seem to adversely affect some children. Clear apple juice has been found to be a particular problem in these cases, although cloudy is not as bad as it does contain some fiber. Try to offer water as an everyday drink and only offer juice as an occasional treat. If your child is used to drinking lots of juice and finds the transition difficult, then withdraw the juice gradually by progressively diluting it. Avoid other foods with high levels of fructose.
Drinking lots of fruit juices has also found to be a problem for another reason. Some children have a reduced appetite for solid food, as much of their calorie requirement is being met by the sugars in juices. They are not eating enough of the high fat food and fiber than can help reduce symptoms.
- Fluid: Fluids can be important for another reason. If children are drinking excessively this can blunt their appetite but can also give your toddler loose stools. We are told as parents to give our children extra fluid if they have diarrhea but with this type of chronic non-specific diarrhea this can actually make the situation worse! It is important to achieve a happy balance. Not too much but not too little. See Fluid Chart.
- Fat: Make sure that your toddler is eating high fat foods. It has been found that the inclusion of high fat foods in the diet will reduce the symptoms. As adults we are told to reduce the amount of fat in our diets but this is not appropriate for young children who are growing. The fat content of a young child’s diet should be about 30-40%. By high fat foods this does not mean high fat snack foods and chocolate, good foods to concentrate on are full fat milk, yoghurt and cheese. Live yoghurt is best as it will help support the good flora in your child's gut.
- Fiber: Getting the right amount of fiber in your child’s diet can help a great deal. A high fiber diet is not recommended as this can make the diarrhea worse but equally a low fiber diet causes problems. Give your toddler foods with natural fiber like small amounts of whole fruit, vegetables and wholemeal bread. The fiber in these foods act like a kind of blotting paper to soak up excess fluid in the large bowel.
Some people try experimenting with their child's diet to see if certain foods are causing the problem. Great care must be taken and exclusion diets should not be attempted without proper medical supervision. Young children are at a vulnerable time in their life when they are growing fast. Cutting out foods can have a detrimental effect. Before considering switching away from cow's milk or other foods for example it is important to get proper advice.
Children with toddler diarrhea should not be given anti-diarrheal medications.
Using the Holliday-Seagar Calculation
This fluid chart gives a guide to a child's fluid needs during a 24 hour period calculated according to their weight. It is only for use with healthy, well children in normal (not extreme) weather conditions. A child who is vomiting, overheated or ill in any other way may have different fluid needs and should have medical supervision.
Up to 10kg a child needs 100ml per kg, at 10-20kg a child needs 1000ml + 50ml per additional kg, over 20kg a child needs an extra 20ml per additional kg on top of this.
6kg (13.2 lbs)
7kg (15.4 lbs)
8kg (17.6 lbs)
9kg (19.8 lbs)
10kg (22 lbs)
11kg (24.2 lbs)
12Kg (26.4 lbs)
13kg (28.6 lbs)
14kg (30.8 lbs)
15kg (33 lbs)
16kg (35.2 lbs)
17kg (37.4 lbs)
18kg (39.6 lbs)
19kg (41.8 lbs)
20kg (44 lbs)
25kg (55 lbs)
30kg (77 lbs)
500ml (16.67 oz)
600ml (20 oz)
700ml (23.33 oz)
800ml (26.67 oz)
900ml (30 oz)
1000ml (33.33 oz)
1050ml (35 oz)
1100ml (36.67 oz)
1150ml (38.33 oz)
1200ml (40 oz)
1250ml (41.67 oz)
1300ml (43.33 oz)
1350ml (45 oz)
1450ml (48.33 oz)
1500ml (50 oz)
1600ml (53.33 oz)
1700ml (56.67 oz)
Remember that Toddler Diarrhea is not a diagnosis which is applied to sick children, so if your child is ill in any way their diarrhea will have another cause. If they seem unwell with a fever, abdominal pain, have blood or pus in their stools; if they are losing weight, are dehydrated or do not seem themselves in any way, then seek medical attention.
If your child is suffering from toddler diarrhea DiarrheaNurse.com hopes that these tips help you to cope with the problem. Although this disorder does not have any serious consequences for your child, it is a difficult situation for parents to manage. Having a toddler with diarrhea is not a situation that anybody would wish to have.
Many people do not know about toddler diarrhea and can be alarmed and worried that your child is infectious. It can help to try and find other parents coping with this issue for mutual support. You can find chat about this in online forums such as mumsnet.com.
If your child is younger you may want to look at our advice on baby diarrhea.
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