Diarrhea in Infants: Causes and Solutions

Infant diarrhea

Hello Doctor, my daughter is over four months old and has recently shown signs of diarrhea.
She is primarily breastfed, but due to insufficient milk supply, she is also supplemented with formula (1-2 feedings of formula per day).
My daughter has a history of atopic dermatitis, so last week we switched her formula from regular formula to hydrolyzed formula.
Since the old formula was running low, we completely transitioned to the hydrolyzed formula over four days.
Before the switch, she was having a bowel movement every two days, but now she is having more than once a day, and the stools are very watery! Yesterday, we stopped using the hydrolyzed formula and switched back to exclusive breastfeeding, but she still has diarrhea (she had five bowel movements yesterday).
Her overall condition seems normal, but she is having many bowel movements each day, and they are all watery with moderate volume.
Is this considered normal? Please advise on how to proceed.
Thank you.

Mia, 20~29 year old female. Ask Date: 2016/02/20

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.
If diarrhea persists after discontinuing the newly modified hydrolyzed protein formula, it may not be related to the formula change.
It is possible that a viral gastroenteritis infection has occurred.
Given that the child is only a little over four months old, it is recommended to seek evaluation and treatment from a pediatrician.

Reply Date: 2016/02/20

More Info

Understanding diarrhea in infants can be quite concerning for parents, especially when it comes to the health and well-being of their little ones. In your case, your four-month-old daughter is experiencing increased frequency of watery stools after switching to a hydrolyzed formula due to her atopic dermatitis. It’s important to understand the potential causes and solutions for diarrhea in infants.

Causes of Diarrhea in Infants:
1. Dietary Changes: One of the most common causes of diarrhea in infants is a change in diet. When you switched from regular formula to a hydrolyzed formula, your daughter’s digestive system may have reacted to the new formula. Hydrolyzed formulas are designed for infants with allergies or intolerances, but they can also cause gastrointestinal upset in some cases.

2. Infections: Viral or bacterial infections can lead to diarrhea. Rotavirus is a common viral infection that affects infants and can cause severe diarrhea. If your daughter has been exposed to other children or has had any recent illnesses, this could be a contributing factor.

3. Allergic Reactions: Since your daughter has atopic dermatitis, it’s possible that she may have a sensitivity or allergy to certain proteins in the formula, leading to gastrointestinal symptoms like diarrhea.

4. Overfeeding: Sometimes, if an infant is fed too much, it can overwhelm their digestive system, leading to diarrhea. This is particularly relevant if you are supplementing breastfeeding with formula.

5. Teething: While teething itself does not directly cause diarrhea, it can lead to increased saliva production and changes in feeding habits, which may result in looser stools.

Solutions and Recommendations:
1. Monitor Hydration: The most important thing to watch for in infants with diarrhea is hydration. Ensure your daughter is drinking enough fluids. Breast milk is excellent for hydration, and if she is still breastfeeding, continue to do so. If she shows signs of dehydration (such as dry mouth, fewer wet diapers, or lethargy), consult your pediatrician immediately.

2. Reassess Formula: Since your daughter is experiencing diarrhea after switching to hydrolyzed formula, it may be worth discussing with your pediatrician whether to continue with this formula or consider other options. Sometimes, a gradual transition to a new formula can help minimize gastrointestinal upset.

3. Introduce Probiotics: Probiotics can help restore the natural balance of gut bacteria and may alleviate diarrhea. Consult with your pediatrician about the appropriate type and dosage for infants.

4. Dietary Adjustments: If your daughter is experiencing diarrhea, it may be beneficial to temporarily revert to her previous formula or continue with breast milk exclusively until her stools normalize. Avoid introducing new foods until her digestive system stabilizes.

5. Consult a Pediatrician: Since your daughter has been experiencing frequent watery stools, it’s essential to keep your pediatrician informed. They may recommend stool tests to rule out infections or other underlying issues.

6. Observe for Other Symptoms: Keep an eye on any additional symptoms such as fever, vomiting, or signs of discomfort. If these occur, seek medical attention promptly.

In conclusion, while occasional changes in stool consistency can be normal in infants, persistent diarrhea warrants careful monitoring and possibly medical evaluation. Your pediatrician can provide tailored advice based on your daughter’s specific health needs, ensuring she remains healthy and comfortable.

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