Toddler's Diarrhoea

What are the symptoms of toddler's diarrhoea?

Toddler's diarrhoea is also known as chronic non-specific diarrhoea. Affected children develop three or more watery loose stools (bowel motions) per day. Sometimes it can be 10 or more. The stools are often more smelly and pale than usual. You can often see bits of vegetable food in the stools (such as bits of carrot, sweetcorn, etc). These have come from a recent meal. Mild abdominal (tummy) pain sometimes occurs, but is unusual. Some affected children develop constipation which alternates with diarrhoea.

A child with just toddler's diarrhoea is otherwise well, grows normally, plays normally and is usually not bothered about the diarrhoea. An examination by a doctor is normal. No further tests are usually needed if the child is otherwise well. Symptoms usually go, with or without treatment, by the age of 5-6 years.

What is the cause of toddler's diarrhoea?

What is the treatment for toddler's diarrhoea?

The child usually does not need any treatment, particularly if symptoms are mild. The child is usually not concerned. Reassurance that it will ease in time may be all that is required. However, in many cases the diarrhoea will go if the child changes certain eating and drinking habits. Many toddlers develop eating and drinking habits that are not ideal and these may contribute to causing the diarrhoea. One or more of the following may be relevant. They are the 4 'Fs' - fat, fluid, fruit juices and fibre.

Fat

Toddler's diarrhoea is more common in children who eat a low fat diet. Although a low fat diet is good for adults to help prevent heart disease, it is not good for young children. The diet of pre-school children should have about 35-40% fat. In general, this means drinking whole milk rather than semi-skimmed or skimmed, and to include foods such as yoghurts, milk puddings, cheeses and dairy products.

Fluid and fruit juice

Do not give children too much fruit juice or squash. Some children only drink fruit juice to quench their thirst. It is best to give water to children for most drinks and keep fruit juice as a treat. Too much juice or squash is not good for the following reasons.

• Fruit juices contain various sugars (carbohydrates). Some types of sugar are not digested or absorbed and so get to the large bowel. Here they may act to keep water in the bowel and cause watery stools. Clear apple juice seems to be the worst as it contains a lot of certain sugars. Cloudy juices that contain some fibre are not as bad.
• The sugar in juice and squash contains a lot of calories. This can reduce the appetite for normal meals. Therefore, the child tends to eat less fat and fibre at normal mealtimes. Some children seem to get most of their daily calories from juice and don't eat very much solid food.

Fibre

A diet with plenty of fibre such as fruit, wholemeal bread and vegetables is best. Fibre has an action like 'blotting paper' and absorbs water in the bowel. This causes bulkier stools which are less runny.

In summary

Toddler's diarrhoea is not serious and will go as the child becomes older. The diet of young children is often not ideal and is thought to contribute to the cause. The diarrhoea will often stop if the child:

• Has a good amount of fat in the diet (whole milk etc).
• Does not drink too much fruit juice or squash.
• Has meals that include enough fibre.