Is Your Baby's Increased Bowel Movement a Sign of Diarrhea?

If a baby has an increased frequency of bowel movements, does it indicate diarrhea?

Hello Dr.
Hsiao, thank you for taking the time to read my question.
My baby is over five months old and has been drinking Nestlé Nan Hydrolyzed formula since birth.
Currently, he consumes 210cc at a time and typically has a bowel movement once every one to two days.
However, two weeks ago, he started having a bowel movement after each feeding, resulting in four bowel movements a day, occasionally two to three times.
The stools are yellow or dark green, sometimes watery and sometimes mushy.
Is this bowel movement pattern normal? My baby has also developed a habit of sucking on his hands; could this be contributing to the increased frequency? Additionally, my baby has a fistula near the anus, which required a week of hospitalization for treatment last month.
Due to the increased frequency of bowel movements, the wound has not been healing, and I am quite worried...

Lele Mami, 30~39 year old female. Ask Date: 2016/04/26

Dr. Xiao Kaiwen reply Pediatrics

The increase in the frequency and water content of stools compared to previous patterns is, by definition, indicative of gastroenteritis-related diarrhea.
If this persists for more than two weeks, it may be classified as chronic gastroenteritis, and it is advisable to consult a pediatrician.
Since infections are often transmitted through the mouth, frequent hand-to-mouth contact can certainly increase the likelihood of illness.
Stools that are rich in bacteria, combined with a high frequency and potential anal injuries such as fistulas, can significantly raise the risk of infection.
In such cases, it is recommended to wash the anal area with warm water and then gently pat dry with a cotton cloth.

Reply Date: 2016/04/26

More Info

When it comes to your baby's increased bowel movements, it's essential to understand the context and the characteristics of the stool. In infants, bowel habits can vary significantly, and what is considered normal can change as they grow and their diets evolve.
From your description, your baby is five months old and has been consuming a hydrolyzed formula. It's common for infants to have varying bowel movement patterns, especially when they are on formula. Typically, breastfed babies may have fewer bowel movements than formula-fed babies, but both can range widely in frequency. For your baby, having bowel movements four times a day after each feeding is more frequent than average, but it can still be within the realm of normal, especially if the stools are not excessively watery or accompanied by other concerning symptoms.

The color of the stool can also provide insight. Yellow or green stools can be normal for formula-fed infants. However, if the stools are watery or have a significant change in consistency, it could indicate diarrhea. Diarrhea in infants is characterized by an increase in the frequency of stools and a change in consistency to a more liquid form. If your baby’s stools are consistently watery and you notice any signs of dehydration (such as decreased urine output, dry mouth, or lethargy), it would be prudent to consult a pediatrician.

Regarding your concern about your baby eating their hands, this behavior is typical for infants as they explore their environment. While hand-to-mouth activity can introduce bacteria, it is unlikely to be the sole cause of increased bowel movements unless there is an underlying infection or gastrointestinal upset.

The presence of a fistula (or "膿瘡" as you mentioned) near the anus is concerning, especially since your baby was hospitalized for treatment. If the increased frequency of bowel movements is causing irritation or if the wound is not healing, it is crucial to follow up with your pediatrician or a pediatric gastroenterologist. They can assess whether the increased bowel movements are contributing to the issue or if there is another underlying cause that needs to be addressed.

In summary, while increased bowel movements can be normal in infants, especially with dietary changes, it is essential to monitor the consistency and frequency of the stools. If you notice any signs of dehydration, persistent diarrhea, or if the wound near the anus does not heal, seek medical attention promptly. Your pediatrician can provide guidance tailored to your baby's specific situation and help ensure their health and well-being.

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