Diarrhoea in children (ages one to five)

How can I tell if my child has diarrhoea?

Every child is different when it comes to pooing; how often they go, what it looks like and how much there is (RCHM 2018). You'll know what’s normal for your child, so use your experience to judge when things aren’t quite right.

Diarrhoea is runny, loose poo (Tidy 2018a). If your little one has it, she’ll probably poo at least three times a day (Tidy 2018a). Many children also experience stomach pains, which may feel a bit better after each episode of diarrhoea (Tidy 2018a).

Other symptoms that can sometimes accompany diarrhoea include:

• vomiting
• fever
• aching limbs
• headache
  (Tidy 2018a)

It’s common for young children to get diarrhoea, and most will have it at least once before the age of five (Tidy 2018a). It usually gets better within a week, and most of the time you’ll be able to manage and treat it yourself at home (NHS 2016a). The most important thing is to keep offering plenty of fluids to make sure your child doesn't become dehydrated (NHS 2016a).

This article is about short-term diarrhoea in children. Longer-term diarrhoea in under-fives is known as toddler diarrhoea (Tidy 2018b). If your little one regularly has diarrhoea a few times per day, see your doctor for advice.

What’s causing my child's diarrhoea?

Short-term diarrhoea in children is usually caused by a tummy bug or food poisoning, though it can sometimes be caused by something else (Tidy 2018a).

Tummy bug
Tummy bugs are caused by viral infections such as rotavirus and norovirus (Knott 2014b).

Rotavirus is the most common cause of diarrhoea in children, as it’s easily spread by contact with someone who already has it (Tidy 2018a). But since the rotavirus vaccine was introduced in Australia cases of rotavirus have dropped dramatically (ATAGI 2018).

Symptoms of rotavirus include:

• fever
• vomiting
• diarrhoea
• stomach pain or cramping
  (Starr 2017)

Rotavirus usually gets better by itself within a few days (Starr 2017). But if you're concerned about any of your child's symptoms, she starts getting worse, or you think she could be starting to get dehydrated, see your GP (Starr 2017).

Food poisoning
Food poisoning is usually caused by a bacterial infection, such as salmonella, E. coli or campylobacter, though it can also be caused by a parasite (Tidy 2018a). Symptoms include:

• feeling or being sick
• diarrhoea
• stomach cramps
• fever
• tiredness, aches and chills
  (NHS 2018)

Food poisoning usually gets better on its own within a week (NHS 2018). But if your child seems to be getting worse rather than better, or you're concerned about any of her symptoms, it's always worth seeing your GP (NHS 2016a)

Food allergy or intolerance
If your child's diarrhoea happens after she's eaten a particular food, it could be a sign of an allergy or intolerance. Reactions can happen within a few minutes of eating the food, or up to 12 hours later (Knott 2014a).

Other symptoms of allergies include:

• itching around the mouth, throat or ears
• a raised, red rash (hives)
• swelling of the face, particularly around the eyes and mouth
• vomiting
  (NHS 2016b)

Common allergens in children include milk, eggs, peanuts, tree nuts, fish and shellfish (NHS 2016b).

Your child's diarrhoea may be more likely to be a result of allergies if she has eczema (NHS 2016b). If you suspect your little one could be having an allergic reaction, make an appointment with your GP (NHS 2016b).

Read more about allergies in children aged one to five.

When your child's stomach is upset by a viral infection, she may have problems digesting milk for a little while (Knott 2014b, Starr 2017), causing more tummy pains, wind and diarrhoea (Starr 2017). This doesn't mean she's become allergic; she's just developed a temporary intolerance, which should go away on its own once the infection has cleared (Starr 2017).

Antibiotics
Diarrhoea is a common side-effect of antibiotic treatment. But if you suspect that antibiotics could be causing your child's diarrhoea, don't stop giving her the medicine.

There's some evidence to suggest that giving your little one probiotics (specifically Lactobacillus rhamnosus or Saccharomyces boulardii) while she's on antibiotics may help prevent diarrhoea (NHS 2016c). You can find them in many pharmacies and health food stores.

Contaminated water
Your child's diarrhoea could be caused by a parasite, bacteria or other germs if she's drunk contaminated water (Tidy 2018a). This is unusual in Australia, but may happen if you’ve recently travelled overseas or somewhere remote with your child to a place where the water may not be as clean, or she's been swimming in an infected pool.

Sometimes the diarrhoea can carry on for several weeks, though it can usually be treated effectively with antibiotics (Henderson 2016).

Find out what to do if you think your child may have coronavirus.

Is my child’s diarrhoea caused by teething?

Some parents worry that diarrhoea may be caused by teething. Although many families report some change in their child's poos during teething, there's no evidence that teething causes true diarrhoea (Harding 2016a).

Teething can be uncomfortable, and often makes your little one irritable or miserable, but it doesn’t usually cause a child to become unwell (Harding 2016a).

If your child has diarrhoea or any other symptoms of illness, it’s important not to put it down to teething (Harding 2016a). Make sure you get the medical advice or help that your child needs, depending on her symptoms.

How should I treat my child’s diarrhoea?

Regardless of what's causing your child's diarrhoea, there are things that you can do at home to help your child feel better and to treat the symptoms.

Keep your child hydrated
The most important thing to do is to replace the fluid she's losing (NHS 2016a). Young children can get dehydrated much quicker than adults, particularly if they have diarrhoea or vomiting (NHS 2016a).

Give your child small amounts of liquid often, such as water and milk (NHS 2016a). Steer clear of fruit juices or fizzy drinks, as these can make things worse (NHS 2016a). If you’re breastfeeding, carry on with regular feeds (NHS 2016a).

If you think that your child could be starting to become dehydrated, ask your pharmacist about oral rehydration solution (ORS) (NHS 2016a). These are special drinks that help replace the water and salts your little one is losing, and keep her well hydrated. Your pharmacist will explain exactly how much to give your child (NHS 2016a).

Don’t give your child anti-diarrhoea medicines, such as loperamide (Imodium) as they’re not recommended for under-12s (NICE 2017).

Help your child feel better
If your little one is feeling generally unwell then you can help her feel better by simply being there when she needs comfort and cuddles, and letting her sleep or doze when she needs to. She may enjoy quiet activities like looking at books and listening to stories (NHS 2015a).

The skin on your little one's bottom is likely to be quite sore from the diarrhoea, so clean it gently using a fragrance-free and alcohol-free baby wipe after each bout of diarrhoea. Use a thin layer of nappy rash cream to protect your child's skin, even if she's toilet trained (NHS 2015b).

If your child has started toilet training and gets diarrhoea, it’s a good idea to put it on hold while she’s unwell and use pull-ups or nappies until she’s back to normal.

Let her eat when she wants
If your child's hungry, encourage her to eat as usual (NHS 2016a, Tidy 2018a). It's normal for children to have less appetite while they're ill, though, so don't worry if she eats a bit less than usual for a few days (Tidy 2018a). It's much more important to make sure she's drinking enough (NHS 2016a, Tidy 2018a).

If you think your child may have diarrhoea because of an allergy or intolerance, get advice from your GP (Harding 2016b). Dairy foods and milk are important for a growing child because they contain calcium, so always get medical advice before excluding them from your little one's diet (Harding 2016b).

Should I keep my child away from childcare, preschool or playgroup?

If your child has diarrhoea because of an infection, she shouldn’t go to her childminder, childcare or preschool for up to 48 hours after the last bout (NHMRC 2012), depending on your childcare provider's policy.

When should I contact my GP?

Most children with diarrhoea will get better on their own within a week or so, and won’t need to visit the doctor or hospital (NHS 2016a). But diarrhoea can sometimes be a sign of a condition that needs treating. And if your child becomes dehydrated because of diarrhoea, this can be dangerous (NHS 2016a).

Contact your GP as soon as possible if your child has diarrhoea and:

• shows signs of dehydration, such as sunken eyes, a dry mouth, no tears when crying, fewer wet nappies and dark yellow wee
• seems to be getting worse instead of better
• throws up and her vomit is green (bile-stained vomit)
• has blood or mucus in her poo
• has very bad tummy pain
• has had diarrhoea for more than a week
  (NHS 2016a)

Whatever your child's symptoms, if you have any concerns about her health, you can always speak to your GP or pharmacist, or call Health Direct (1800 022 222) for advice (NHS 2016a).

How can I stop diarrhoea from spreading?

If someone in your home is suffering from diarrhoea, it’s important to practice good hygiene, to help prevent the infection from spreading:

• Make sure everyone in the household washes their hands well, using warm water and liquid soap (NHS 2016a). It’s especially important to do this before eating or preparing food, and after going to the toilet or changing your child’s nappy (NHS 2016a).
• Use a separate towel and face washer for your child while she’s got diarrhoea (NHS 2016a).
• If your child is using a potty to poo in, wash it with hot soapy water and let it dry. You could also consider wearing gloves while you handle it, or at least wash your hands thoroughly afterwards (Tidy 2018a).
• Use a disinfectant wipe or hot soapy water and a disposable cloth to clean toilet seats, flush handles and sink taps once a day (Tidy 2018a).
• If diarrhoea gets onto your little one's sheets or clothes, get as much of it off as you can and then wash at the highest temperature you can (Tidy 2018a).
• Don't take your child swimming for about two weeks after her last bout of diarrhoea (NHS 2016a).

Following these tips will help keep the rest of the household healthy while your child's under the weather. And with any luck, your little one will soon be back to her usual self.

More advice on looking after your child’s health:

• If your little one's also being sick, get the lowdown on how to treat it.
• Could your child's illness be caused by an allergy? Find out.
• Get more information on when to call the doctor for your child.
• Learn when runny poo is actually a sign of constipation.