How to Tell if a Newborn has Diarrhea

What to Do and When to Call the Doctor When You Think Your Newborn Baby Has Diarrhea

In a scene familiar to all parents who have been there and done that, a new mom and dad stare aghast at the contents of their newborn’s dirty diaper. They ask each other, with concern: Is it supposed to look like that? Is our baby OK? That can’t be normal; can it? Should we call the pediatrician? Whether they’re breastfed or formula-fed, newborn babies’ stools often resemble diarrhea, and even the most unpleasant dirty diapers are not necessarily a cause for concern. However if you suspect that your newborn really is suffering from diarrhea, it’s important that you seek medical attention. Know what diarrhea in an infant really looks like, and if you can’t rule it out, call your pediatrician as soon as possible. With a newborn, erring on the side of caution is always the best approach.

Identifying Diarrhea in a Newborn

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Normal stools for a breastfed newborn are yellow, quite wet and seedy in texture. Formula-fed newborns tend to have thicker, lumpier stools, also yellow but with a texture similar to cottage cheese or peanut butter. Frequency varies considerably, with any number from one to 10 dirty diapers a day considered normal.

Indications of diarrhea in a newborn are a sudden increase in the looseness and volume of their stools and a sudden increase in their frequency. A single diaper with wetter-than-usual poop isn’t cause for concern, but two or more are signs of diarrhea. Having two to five watery stools in a day is considered mild diarrhea; six to nine are signs of moderate diarrhea; and 10 or more indicate severe diarrhea.

Other signs of abnormal stools associated with illnesses that cause diarrhea include a strong, unpleasant odor, blood or mucus in the stool and stools that are red, black or white. If you suspect that your baby has diarrhea, also look for signs of dehydration, such as a decrease in urination, a dry tongue, a sunken soft spot on the skull and increased fussiness.

As soon as you begin to suspect diarrhea in a newborn, note any symptoms that concern you along with a “diary” of diaper changes. If you share diaper-changing duties with a spouse, nanny or day care staff, be sure to discuss your concerns with them and compare notes.

When to Call the Doctor

Any time you believe your newborn baby has diarrhea, you should call the pediatrician, describe the baby’s symptoms, and ask what you should do. Even if you might take a wait-and-see approach when faced with similar symptoms in an older infant or child, a newborn has not yet developed a strong immune system and is especially vulnerable to illness. Diarrhea in newborns means they are subject to dehydration, which can occur quickly and pose a serious danger.

Experts at Seattle Children’s Hospital recommend that parents call a doctor within 24 hours if their baby has mild or moderate diarrhea. However, if your newborn seems very unwell, trust your instincts and call immediately. You also should call the doctor without delay, and, in extreme cases, go to the ER, if your newborn has any of the following symptoms:

• Dehydration
• Blood in the stool
• Vomiting three or more times
• Constant stomach pain for longer than two hours
• 10 or more diarrhea-like stools in 24 hours
• Three or more diarrhea-like stools if under 4 weeks old
• A fever over 104 degrees F

How to Help a Baby With Diarrhea

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Your doctor will advise you, over the phone or at an appointment, about the best ways to help your newborn recover from a bout of diarrhea. First and foremost, you should feed your newborn more frequently. Offer the breast or bottle often, day and night, and let the baby eat as much as she or he can. In some cases, parents are advised to feed their baby an ORS (Oral Rehydration Solution). However, do not feed your baby ORS or give her any over-the-counter medications without first consulting a doctor.

If your doctor suspects a milk protein allergy is the cause of diarrhea, she might instruct you to switch to a soy-based formula. If you’re nursing, she may ask you to eliminate dairy from your diet.

Diarrhea can give your baby a diaper rash. Avoid this, or soothe an already-present rash, by using cotton balls or a soft washcloth with water in place of baby wipes. Let your baby’s bottom air-dry, and apply diaper cream liberally.

If the doctor believes your baby is suffering from an infection (which will generally be treated with prescription medication), be sure to wash your hands thoroughly after every diaper change. Also, frequently disinfect your changing pad and changing area. If applicable, keep the baby home from day care.