Is Your Breastfed Baby's Diarrhea Normal? Stool Changes and Care

Is a exclusively breastfed newborn's stool considered normal or diarrhea?

The baby is currently 2 months and 15 days old, weighing 6 kg.
Since birth, the baby has been exclusively breastfed.
Diapers are changed every 2 hours, with approximately 4 to 6 urinations per day, but more than 12 bowel movements, which have consistently been wet, mushy stools with a mucous consistency.
The baby's anus is red and swollen, with red spots indicating a fungal infection and slight skin breakdown.
Since mid-February, a physician has prescribed Miconazole cream to treat the fungal infection around the anus.
At that time, the physician believed that since the baby is exclusively breastfed and is doing well in terms of energy and growth, even if there is diarrhea, it would not be a concern and does not require treatment.
The questions are as follows:
1.
This week, the baby has frequently had diapers without solid remnants but with a large amount of yellow watery stool.
Is this a normal stool consistency?
2.
About 4 times a day, the baby can be heard passing stool accompanied by gas, and upon opening the diaper, the stool is much wetter than before.
Is the baby experiencing diarrhea?
3.
If the baby continues to have diarrhea like this, could it negatively affect the digestive system? Under the condition of continued breastfeeding, is there any way to improve this diarrhea situation?
4.
The fungal infection around the baby's anus has not improved since February, and the Miconazole cream has been used continuously since then.
Could there be any side effects? Are there alternative treatment options?
5.
Could diarrhea potentially lead to a decrease in immunity? Since the baby's facial skin appears to be possibly infected with fungus, is this related to the diarrhea?
There are many questions; thank you, doctor, for your response!

Wenqi, 30~39 year old female. Ask Date: 2020/04/12

Dr. Pei Rensheng reply Pediatrics

Hello!
1.
This week, the baby has frequently had diapers without residue but with a large amount of yellow watery stool.
Is this a normal stool condition? --> After one month, breastfed babies typically have fewer bowel movements.
Based on your description, there is a possibility of diarrhea.
2.
About four times a day, I can hear the baby passing stool accompanied by gas.
Upon checking the diaper, I found that the stool is much wetter than before.
Is the baby experiencing diarrhea? --> Based on your description, there is a possibility of diarrhea.
3.
If the baby continues to have diarrhea like this, could it have adverse effects on the digestive system? While continuing to breastfeed, is there any way to improve this diarrhea condition? --> It is recommended to take the soiled diaper to the hospital for testing.
4.
The baby has had a fungal infection around the anus since February, and it has not improved despite using Meikang ointment continuously.
Could there be any side effects? Are there other treatment options? --> Consider using an antifungal ointment.
5.
Could diarrhea lead to a decrease in immunity? The baby's facial skin appears to have a suspected fungal infection; is this related to the diarrhea? --> Diarrhea may cause a local decrease in skin immunity, and if there is nutritional deficiency, it could also lead to a systemic decrease in immune function.
Generally, the suspected fungal infection on the baby's face is not directly related to diarrhea.
Wishing everyone health and safety! Sincerely, Ren Sheng.

Reply Date: 2020/04/12

More Info

When it comes to understanding your breastfed baby's stool changes and whether diarrhea is normal, it's essential to consider several factors, including the baby's age, diet, and overall health. Here’s a comprehensive response to your questions based on the information provided.

1. Is the Presence of Yellow Watery Stool Normal?
Breastfed babies typically have stools that can vary in consistency and color. It's common for breastfed infants to have soft, yellow, and sometimes watery stools. The presence of a large amount of yellow watery stool without solid remnants can be a normal variation, especially if the baby is exclusively breastfed. However, if the stool is excessively watery and frequent, it may indicate diarrhea.

2. Is My Baby Experiencing Diarrhea?
Diarrhea in infants is generally defined as having more than three watery stools in a day. If your baby is having multiple instances of very wet stools accompanied by gas sounds, it may indeed be classified as diarrhea. While breastfed babies can have looser stools compared to formula-fed babies, the key is the consistency and frequency. If the stools are significantly more watery than usual and the frequency has increased, it’s advisable to consult with your pediatrician.

3. Potential Impact of Prolonged Diarrhea on Digestion
If diarrhea persists, it can lead to dehydration, which is a significant concern in infants. Continuous diarrhea can also affect nutrient absorption, potentially leading to weight loss or growth issues. To manage this, ensure your baby stays hydrated, and continue breastfeeding, as breast milk provides essential nutrients and antibodies that can help combat infections. If the diarrhea continues or worsens, it’s crucial to seek medical advice.

4. Concerns Regarding Persistent Fungal Infection
The ongoing fungal infection around the anus, despite treatment with a topical antifungal like Meconazole, should be monitored closely. Prolonged use of topical medications can sometimes lead to skin irritation or sensitivity. If the infection does not improve, it may be necessary to consult your pediatrician for alternative treatments or further evaluation. They may recommend a different antifungal or investigate other underlying causes.

5. Relationship Between Diarrhea and Immune Function
Diarrhea can potentially impact an infant's immune system, especially if it leads to dehydration or nutrient deficiencies. However, the immune system of a breastfed baby is generally supported by the antibodies present in breast milk. If your baby is experiencing skin issues, such as a suspected fungal infection on the face, it may not be directly related to diarrhea but could indicate a broader issue with skin health or immune response. Maintaining good hygiene and consulting a pediatrician for skin concerns is advisable.

Additional Considerations
- Dietary Adjustments: If you suspect that your diet may be affecting your baby (for instance, if you consume dairy or other allergens), consider discussing dietary changes with a healthcare provider.

- Monitoring Symptoms: Keep a close eye on your baby's overall health, including weight gain, hydration status (look for dry mouth, fewer wet diapers), and any signs of distress.

- Consulting a Pediatrician: Given the complexity of your baby's symptoms, including diarrhea and a fungal infection, regular check-ups with a pediatrician are essential. They can provide tailored advice and treatment options based on your baby's specific needs.

In summary, while some variations in stool consistency are normal for breastfed infants, persistent diarrhea and fungal infections warrant careful monitoring and consultation with a healthcare professional. Your baby's health and comfort are paramount, and proactive management can help ensure their well-being.

Similar Q&A

Concerns About Diarrhea in a Nearly Four-Month-Old Breastfed Baby

My baby is almost four months old, and it seems like he has diarrhea these past few days! He is exclusively breastfed, so his stools are usually quite loose. However, recently, he has been having a bowel movement every time after feeding—three times within two hours today. The la...

Dr. Pei Rensheng reply Pediatrics
Hello: Recently, as temperatures have risen, there has been an increase in cases of gastroenteritis. If there are blood streaks in the stool, it may indicate an infection, and it would be advisable to go to the hospital for a stool test to check for Salmonella infection. Please c...

Understanding Baby Diarrhea: When to Seek Pediatric Care

Hello Dr. Hsiao: My baby is currently 2 months and 14 days old. Recently, we switched back to breastfeeding after about 3 weeks of formula feeding. Before the switch, my baby had a bowel movement approximately every 1.2 days (dark green). After returning to breastfeeding, the fre...

Dr. Xiao Kaiwen reply Pediatrics
The frequency of an infant's bowel movements can range from two to three times a day to once every two to three days, both of which are considered acceptable. In the case of diarrhea, the frequency of bowel movements will increase, and the stools will become increasingly wat...

Understanding Gastrointestinal Issues in Infants: When to Worry?

The baby is currently 7 days old and has been discharged, receiving a combination of breast milk and formula (Abbott infant formula). The stool color has been normal these past few days, but the baby tends to have a bowel movement whenever passing gas. The stool volume is occasio...

Dr. Xiao Kaiwen reply Pediatrics
Newborns who are breastfed typically have more frequent and looser stools within the first month after birth. After one month, their bowel movements will gradually normalize. Therefore, your child's situation is considered normal, and there is no need to stop breastfeeding.

Understanding Baby's Bowel Changes: Is It Diarrhea or Normal?

Hello Doctor, my baby is currently 8 months old. Over the past two days, the bowel movements have changed from once a day to 2-3 times a day, all yellow and soft. However, I've noticed that there is one instance of watery stool each day (only the color is visible on the diap...

Dr. Xiao Kaiwen reply Pediatrics
The frequency of bowel movements has increased compared to before, and the stool has a higher water content, which is defined as diarrhea. An 8-month-old infant has a weaker immune system and may be susceptible to gastroenteritis. Gastroenteritis does not always present with a fe...