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Toddler’s diarrhea

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 4 minutes read
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Toddler's diarrhea is a common condition that doesn't usually mean anything serious, so long as your child is growing well, keeping up with their developmental milestones, and doesn't have other symptoms.

As the name implies, it affects those aged 1 to 5. Children usually pass loose stool at least twice a day, but sometimes up to 10 times, and it might appear a bit paler and more smelly than usual, possibly with some undigested food. It's thought to be a combination of their developing gut and a less-than-ideal diet. It's more common in boys, although it's not clear why.

Doctor’s advice

How do I know it’s not something serious?

Toddler’s diarrhea falls under the category “diagnosis of exclusion.” This means that there is no specific test or examination for it, but by eliminating other causes, it is most likely toddler’s diarrhea.

Gastroenteritis or stomach bugs can commonly cause diarrhea, but these last for only a few days, and kids will also sometimes have vomiting, stomach pains and cramps, and a mild fever.

Malabsorption is a particular medical condition that may lead them to fail to grow or gain weight, and it may be something that runs in the family. Allergies or intolerances like lactose and gluten can create a similar picture, and they also experience abdominal cramps and bloating.

With toddler’s diarrhea, they should have no other symptoms or pain, no blood or mucus in the stool, and they should be their usual selves, playing, alert, and eating as usual.

What’s the cause?

It's not clear what causes toddler's diarrhea. One working theory is that the digestive system is under-developed, and the final part of the gut, the large bowel (or colon), is where water is absorbed from the digested food, but it may not reabsorb enough, or stool may pass through too quickly, making it less formed and more watery at the other end.

As the diarrhea has cleared in most children by the time they start school, this theory would fit with the bowel maturing in its development.

What’s the treatment?

No treatment is usually needed for mild toddler's diarrhea. It's important to not make too much of it, so they don't become self-conscious – keep checking diapers regularly or, once trained, allow them to feel comfortable to go to the toilet as often as they need, and inform their nursery or school of the same. Potty training can go ahead in the same way.

It can be tempting to take a shortcut and get medications from the pharmacy to bulk up the stool, but this shouldn't be necessary after a few changes in their diet and reassuring yourself it's nothing serious.

Sometimes diet can contribute, and a good rule of thumb is to consider the four F's - fiber, fat, fluid, and fruit juice.

Fiber is essential for all of us to help bulk out stool by absorbing water so it passes easily down and out. It's found in whole-grain bread and high-fiber cereals like oatmeal or muesli with raisins, lentils, beans, fruit like grapes, and vegetables. Too little fiber can cause less absorption of water, and increasing this slightly may help. Too much fiber can be the cause of loose stool, so it's important to maintain a balanced diet with a little of everything.

Exactly the opposite message to what we tell adults, toddlers need relatively a high-fat content in their diet, and changing semi-skimmed milk to whole milk, and giving them full-fat yogurt or cheese, can help toddler's diarrhea.

Again, contrary to what we usually say, but too much fluid can contribute, even if it's just water. Some toddlers seem to drink for comfort. Try to limit drinks to mealtimes and snack times to see if this helps.

Finally, fruit juice – every child's favorite – can contribute to toddler's diarrhea. Try to keep this to just a treat rather than maintaining their fluid balance – their teeth will thank you too.

When should I take them to the doctor?

If your child has diarrhea lasting longer than 2 weeks and not improving, even if the toddler’s diarrhea seems to fit, it’s best to get this checked out by their doctor and formally diagnosed.

If your child has other concerning signs like blood or mucus in their stool, a persistent fever or vomiting, persistent abdominal pain, they are struggling to maintain fluids, or they seem more irritable and drowsier than usual, you should seek your doctor’s help urgently.

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Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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