Toddler Diarrhea - Causes, Symptoms, and Management

Introduction

Toddler diarrhea affects children from 2 to 5 years of age; another name for this condition is chronic nonspecific diarrhea of childhood. Toddler diarrhea is not serious; even healthy children can have diarrhea unrelated to infection or any underlying disease. Children with toddler diarrhea will experience 3 to 10 events of loose or watery stools in a day, which occur mostly during the daytime and sometimes immediately after eating. However, 25 % of children with toddler diarrhea also have diarrhea at night. Toddler diarrhea does not cause pain, but the stools are generally more foul-smelling than normal diarrhea, and often undigested foodstuffs are visible in the stool.

It may take days to recover from the condition. Despite diarrhea, the child's development and growth are not affected as long as the diet contains the required calories. The child will be active and have a normal appetite. Toddler diarrhea is not a disease; it gets better by school age without specific treatment.

What Are the Causes of Toddler Diarrhea?

The food and fluid consumed by the children move more quickly through their digestive tract so that the time of absorbing sugar, bile, and fluids back into the blood vessels from the digestive tract is reduced. Increased water and undigested sugar in the intestines cause loose and frequent stools. The presence of excess bile in the stool gives it a green or yellow color. Foods with indigestible fiber, like fruits and vegetables, may appear undigested in the stools. The excess undigested sugars are fed by the large intestine bacteria, creating more gas and fluid as a by-product causing explosive or loose stools. There are multiple factors contributing to toddler diarrhea, including:

• Excessive Fluid Intake - Increased fluid intake can affect the toddler digestive tract's ability to absorb water and electrolytes, which could lead to diarrhea.

• Low-Fat or High-Fiber Diet - Children often avoid higher-fat foods and prefer fruits and vegetables. Fats are essential for slowing down a child's digestion and providing more time for the absorption of nutrients. Diets low in fat and high in fiber may cause rapid food movement through the intestines resulting in diarrhea.

• Malabsorption of Carbohydrates - Fruits are high in sugars and carbohydrates, such as fructose and sorbitol; these are absorbed poorly by a child's digestive tract.

• Immature Digestive Tract - If the nerve-carrying signals to a toddler digestive tract are not fully matured, it can result in rapid food movement through the digestive tract, not allowing adequate time for food absorption and resulting in diarrhea.

What Are the Symptoms of Toddler Diarrhea?

Toddlers affected by diarrhea may develop three or more watery loose stools per day. In some cases, it can even be ten or more. The stools are often foul-smelling and paler than normal, with undigested food particles (such as apple bits, sweetcorn, etc.). Usually, children do not express abdominal pain, but in unusual cases, they may report mild abdominal pain.

A child affected only with a toddler diarrhea will have normal growth and development and is usually not bothered about diarrhea. It also does not affect their normal activities and playtime. A medical and physical examination by a doctor does not point toward any abnormalities, so no further tests are usually required. The symptoms usually disappear without treatment when the child goes to school.

How Is Toddler Diarrhea Managed?

Usually, no treatment is required, particularly if symptoms are mild and the child is usually not concerned. The good news is that a toddler diarrhea will ease with time, and in many cases, it will go away or become less severe by adjusting the child's diet. Following the '4 Fs': fat, fruit juices, fluid, and fiber, diarrhea can be managed.

Fats - Children who eat a low-fat diet can experience toddler diarrhea. Although a low-fat diet is advisable and good for adults to reduce the risk of heart disease and obesity, it is not good for children. Because they get around 35 % of their energy from the fat content in their food. Fat helps slow digestion in the intestine and accelerate food movement through the system. It is recommended to give whole milk and milk products like yogurt, butter, cheese, olive and rapeseed spreads, and oils; rice pudding, avocado, meat, eggs, fish, nuts, coconut milk, etc. Providing fats at the end of a meal can reduce toddlers' diarrhea.

Fluids - Children generally require 6 to 8 cups of fluid daily, but some children drink too many fluids and sugary drinks, which can cause diarrhea. This is mostly for their comfort rather than because of thirst. This can be managed by providing smaller amounts each time as they ask or keeping set times after meals and snacks time. Also, avoid sugary or fizzy drinks and stick to water or full-fat milk.

Fruit Juice - Giving children too much fruit juice or squash is not recommended. Their immature intestine cannot easily absorb fructose (natural sugar in fruit) and sorbitol (a sweetener in many fruit drinks and foods). So, when taken in excess amounts, these sugars are not absorbed or digested and get to the large bowel quickly. These sugars can reduce the child's appetite for normal meals, thus reducing fat and fiber at normal mealtimes. Refined sugars in many packed foods, such as chocolates, sweets, biscuits, cakes, and desserts, can cause loose stools. So, it is advisable to restrict such food.

Fibers - Fiber in the diet plays an important role in the digestion of food. Fiber is a plant food part that remains undigested. It stays in the digestive tract, absorbs water, and is passed through the stools. Fiber is available in many foods, especially fruit, vegetables, and wholemeal bread.

The fiber in the diet absorbs water in the bowel, making the contents a bit bulkier, hence preventing diarrhea. So it is necessary to provide children with around 12 to 18 grams of fiber daily. However, too high fiber can irritate the intestine and cause the contents to move too fast. Foods to reduce if a child has toddler diarrhea are high-fiber cereals, wholemeal bread, sweetcorn, peas, baked beans, lentils, pulses, grapes, and raisins.

Conclusion:

Toddler diarrhea is a commonly faced problem by children between 2 to 5 years of age, which usually does not interfere with the child's growth, appetite, and normal activities. Usually, it does not require any specific treatment; a change in normal diet will be sufficient. It often gets better when the child starts schooling. So, parents need not worry much about this condition. But when diarrhea is associated with vomiting, nausea, stomach pain, fever, fatigue, and dizziness, it is necessary