Toddler's diarrhoea is a common cause of chronic (persistent) diarrhoea in young children. It mainly affects children between the ages of 1 and 5 years and is more common in boys. Toddler's diarrhoea is not serious and the child is well. The diarrhoea 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 a normal amount of fibre (but not a high-fibre diet).
What are the symptoms of toddler's 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. 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?
The cause is not clear. It is thought that the balance of fluid, fibre, undigested sugars and other undigested foods that reach the large bowel (colon) may be upset in affected children. This can increase the amount of fluid (water) that is kept in the large bowel rather than being absorbed into the body. In young children, even a slight increase in fluid left in the large bowel can cause stools to become more frequent and runny than normal. As the child grows, the large bowel becomes more efficient and the condition goes.
Toddler's diarrhoea is not due to malabsorption (poor absorption) of food or to a serious bowel problem. It is also not due to an intolerance of a type of food.
What is the treatment for toddler's diarrhoea?
Often, no treatment is needed, particularly if symptoms are mild. Reassurance may be all that is required. However, in many cases the diarrhoea will go, or become less severe, 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.
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 preschool 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
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.
Fibre is present in many foods, in particular in fruit, wholemeal bread and vegetables. Fibre has an action a bit like blotting paper and absorbs water in the bowel. So, if your child has a low-fibre diet, it may help to increase the fibre in the diet to normal levels. This is simply achieved by eating a healthy balanced diet that includes some fruit and vegetables. However, a high-fibre diet may make things worse, as too much fibre can cause loose stools
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