Nutrition for Kids with Diarrhea: What you need to know

Diarrhea is when bowel movements are more frequent, loose, and watery than usual. In children, sometimes this can be completely normal, sometimes it might mean your kiddo is unwell, and other times there could be more going on to cause these changes in stool frequency and consistency. At Ignite Nutrition we hear it all, as experts in gut health we have the knowledge and tools to help!

Keep reading to learn more about diarrhea in kids and the role nutrition can play!

Let’s review what normal bowel habits are:

• Kids 3 years of age and older typically have 1-3 bowel movements per day, ideally, they are having at least 1 bowel movement every day – as they grow into teens bowel movements might be once every 2-3 days
• Formed, soft, smooth, and easy to pass is the ideal consistency of stool
• The colour and thickness of a child’s poops will change depending on what they eat. You will see a noticeable change in colour, smell, thickness, or texture when babies go from breastmilk or formula to cow’s milk and then eventually to solids.

It is important to note that occasionally, changes in stool are normal. A bout of passing stool every other day or having more loose, watery consistency can be normal. It is when this becomes a more chronic, ongoing issue that further investigation might be worth pursuing.

Indications for diarrhea in kids

• Loose, watery, unformed bowel movements or liquid bowel movements
• Urgency of getting to the nearest toilet or accidents
• Looser stool accompanied by fever, vomiting, nausea

 Causes of diarrhea in kids

Changes in diet – When kids eat something different, something that they haven’t tried before, or large quantities of certain foods, this may cause a fluctuation to looser, more watery stools. As already mentioned, these short-term changes in bowel movements are not usually cause for concern, and usually resolve within a few days. Dietary changes can also be related to consuming more or less fibre, which can in turn affect the volume or consistency of stool as well.

Stomach bug – Diarrhea is often caused by viral or bacterial infections like the stomach flu or food poisoning.

Constipation – Yes, that’s right – constipation can be the actual cause of loose stools as well. Overflow diarrhea occurs when stool becomes too hard to pass and fecal fluids flow around the stool blockage. In this case, the stool will usually be liquid only, like fecal coloured water. This is often accompanied by urgency, where kids have difficulty getting to the bathroom fast enough, this may also result in accidents.

Intolerance to food – Food intolerance can cause diarrhea after digestion of the triggering food – these are usually associated with other symptoms, including abdominal discomfort or pain, bloating and distension, and other symptoms, but not always!

Excess sugary drinks or sports drinks – Drinks with excess sugar, like juice or sports drinks can cause looser, more watery stools and diarrhea. Sugar can make diarrhea worse and specific fruits in 100% fruit juices can also worsen diarrhea like prune, apple, and pear juices. If your kiddo is drinking a lot of sugary drinks and having diarrhea, stop offering these sugary drinks to see if this helps.

Dietary Strategies for Diarrhea in Kids

Stomach bug

We have all been there, the dreaded “stomach flu”… running to the washroom with either vomiting or diarrhea, nausea, feeling awful, often a fever… The stomach bug is super common for kids and often teens. Sadly, the stomach bug often hits multiple times through childhood and teenage years, no matter how much hand washing and trying to avoid it we do. I wish I could say there is a magic food or foods that would “cure” this virus, but at the end of the day we need to simply rely on time, rest, and fluids to get through the stomach bug.

When your little one has the stomach bug there are a couple things that are key to focus on:

1) Fluids!!

Fluids are easily more important than anything else when it comes to intake for your kiddo when they aren’t feeling well with the stomach bug. When they are having multiple loose, watery stools daily, especially if they are also vomiting – they are losing a large amount of fluid and it is important you try to help them replace this fluid through drinking more.

Ways to get more fluids in:

• Water
• Diluting juice with water
• Ginger ale
• Popsicles
• Soups
• Regulated electrolyte drinks like Pedialyte

Watch for signs of dehydration including increased thirst, no tears, dark urine, less urine, dry skin, mouth and tongue, faster heartbeat, headaches, nausea. 

2) Eating what they feel like eating

Of course, I am a dietitian, and offering your kiddo nutritious foods often is important but everything kind of goes out the window when your child is sick with a stomach bug. We really want to get any intake we can from food so whatever they actually feel like eating is the key.

Some things may be more soothing for them and help them to feel better. Things like ginger, ginger ale, soups, toast, etc. might be remedies that helped you and I feel better when we were younger experiencing the stomach bug. Again, the key is really that you are giving enough fluids and getting some food in at all. This is not the time to be overly health conscious – just allow them to eat what feels good!

Changes in diet

There is really nothing we need to do or change if your child is experiencing a one-off episode of diarrhea from a sudden diet change. Unless the changes in bowel movements become chronic, it is best to simply move on from this experience – offer them fluids to replace any losses and they should be back to normal very soon! Your kiddo’s bowel movements are going to change, and this is normal. Sometimes they are going to eat large amounts of certain foods, and this could cause them to have changes in their bowel movements. Typically, this resolves within a few days.

Constipation

For some advice check out our post on constipation in kids and consider working with a dietitian. Having expert advice is helpful in managing the overflow diarrhea, while also relieving the underlying constipation at the same time.

Strategies with fibre

One thing that may help with more chronic diarrhea is soluble fibre from food. It might seem counterintuitive to add fibre to the diet when diarrhea is the problem. While fibre helps us keep regular, certain fibres work differently in the body and can be used strategically to help with symptoms of these looser, more watery stools. When soluble fibre mixes with water it forms a gel, and therefore when we increase soluble fibre in the body, this can help to create more bulk to the stool. Ultimately, this improves the consistency to reduce some of that free water in the stool and decrease urgency around watery stools.

What foods have soluble fibre?

• Oatmeal, oat bran, bran buds, barley
• Psyllium, flaxseed, chia seed
• Beans, peas, lentils
• Carrots, brussels sprouts, sweet potato, edamame, broccoli
• Passion fruit, oranges, pears with the skin on
• Dried fruits like figs and prunes

There are also different soluble fibre supplements available on the market but ask your doctor or dietitian first about whether these are appropriate or necessary for your child experiencing diarrhea.

Is cutting foods out of my child’s diet the answer for diarrhea?

Not necessarily. While it is possible that a food intolerance or sensitivity to a food could exist and cause diarrhea, this is typically less common in children and teens. Before removing foods from your child’s diet, I strongly recommend working with a dietitian that specializes in digestive health to investigate the possible trigger foods. Then, if necessary, work on a plan to remove possible food triggers but in a way that helps you feel supported and not left wondering what you should feed your kiddo.

When I work with kids and teens struggling with digestive issues, I first spend more time investigating before automatically restricting foods. Changes in the diet, especially in kids who are still growing and developing, can be more detrimental than good. It is important to me when I am working with my young patients to protect their relationship with food. I see too often parents that have the best of intentions in helping their child by removing foods or doing elimination diets that were not in fact necessary. This can have extremely negative results on their kiddo’s relationship with food. As I mentioned before, stress and worry can be big drivers of digestive symptoms, including diarrhea. So, the last thing we want to do is create any fear around food that could exacerbate or even trigger symptoms, therefore making things worse, when they were potentially unnecessary.

Check in with your doctor if your child has any of the following:

• Struggling with constipation
• Bloody or black stool
• Is potty trained but starts to lose control around their bowel movements and is having accidents in their underwear
• Has diarrhea and a fever
• Is not gaining weight

In summary, I want to reiterate that temporary changes in bowel movements are not necessarily a concern. Depending on the reason for diarrhea, food and nutrition might be able to help. Perhaps most importantly, with multiple loose, watery stools per day for any length of time, fluids are very important to prevent dehydration from occurring. If you are unsure and want support in figuring out what is going on, work with our pediatric dietitian to help you create a customized plan with practical tips that fits your family’s needs and get them feeling better.