Diarrhea (Baby on Breastmilk)

Diarrhea Scale

Diarrhea in Breastfed Babies: How to Know

Diarrhea in a breastfed baby is sometimes hard to tell.
Normal breastfed stools are loose (often runny and seedy). Stools are yellow, but sometimes can be green. The green color is from bile. Runny stools can even be bordered by a water ring. These are all normal stools.
Breastfed babies often pass more than 6 stools per day. Until 2 months of age, they may pass a stool after each feeding. But, if stools suddenly increase in number and looseness, suspect diarrhea. If it lasts for 3 or more stools, the baby has diarrhea.
If the stools contain mucus, blood or smell bad, this points to diarrhea.
Other clues to diarrhea are poor eating, acting sick, or a fever.

Dehydration: How to Know

Dehydration means that the body has lost too much fluid. This can happen with vomiting and/or diarrhea. Mild diarrhea or mild vomiting does not cause this.
These are signs of dehydration:
Decreased urine (no urine in more than 8 hours) happens early in dehydration. So does a dark yellow color. If the urine is light straw colored, your child is not dehydrated.
Dry tongue and inside of the mouth. Dry lips are not helpful.
Dry eyes with decreased or absent tears
In babies, a depressed or sunken soft spot
Slow blood refill test: Longer than 2 seconds. First, press on the thumbnail and make it pale. Then let go. Count the seconds it takes for the nail to turn pink again. Ask your doctor to teach you how to do this test.
Fussy, tired out or acting ill. If your child is alert, happy and playful, he or she is not dehydrated.
A child with severe dehydration becomes too weak to stand. They can also be very dizzy when trying to stand.

Causes

Virus (such as Rotavirus). An infection of the intestines from a virus is the most common cause. It's called viral gastroenteritis.
Bacteria (such as Salmonella). Less common cause. Diarrhea often contains streaks of blood.
Food-poisoning. This causes rapid vomiting and diarrhea within hours after eating the bad food. It is caused by toxins from germs growing in foods left out too long. Most often, symptoms go away in less than 24 hours. It often can be treated at home without the need for medical care.

Prevention of Spread to Others

Overview:

Mild Diarrhea:

Frequent, Watery Diarrhea:

Nurse your baby more often.
Also, give some extra fluid if you think breast milk isn't keeping up with the fluid losses. You can use formula or ORS (Pedialyte).
Solid foods: If on baby foods, continue them. Cereals are best.

Oral Rehydration Solutions (ORS) such as Pedialyte to Prevent Dehydration:

ORS is a special fluid that can help your baby stay hydrated. You can use Pedialyte or the store brand. It can be bought in food stores or drug stores.
When to use: Start ORS for frequent, watery diarrhea if you think your baby is getting dehydrated. That means passing less urine than normal. Increase fluids using ORS. Also continue breastfeeding.
Amount for babies: Give 2-4 ounces (60-120 ml) of ORS after every large watery stool.
Caution: Do not give ORS as the only fluid for more than 6 hours. Reason: Your baby will need calories and cry in hunger.

Solid Foods:

Babies over 6 months old: Keep on baby foods. If diarrhea is bad, start with cereals.
Go back to a normal diet in 24 hours.

Diaper Rash:

Wash buttocks after each stool to prevent a bad diaper rash. It may be necessary to get up once during the night to change the diaper.
To protect the skin, use an ointment (such as petroleum jelly). Put it on the skin around the anus.

What to Expect: