Dietary advice for toddler diarrhoea - Parent / carer information

This leaflet has been designed to answer some common questions you may have about toddler diarrhoea.

What is toddler diarrhoea?

Toddler diarrhoea is the most common cause of persistent diarrhoea in young children. It mainly occurs between one and five years of age. It is not a serious problem if your child is usually well and their growth is good.

Children with this problem generally have two or more watery loose bowel motions (stools) per day. Sometimes it can be as many as 8 to 10 times per day. The stools tend to be foul smelling and paler than usual. Pieces of undigested vegetables (for example, sweetcorn, carrots) can often be seen in the stool. Mild stomach pain sometimes occurs, but it is unusual.

Parents / carers can find the diarrhoea both a worry and an inconvenience, which can lead to possible problems with potty training.

Toddler diarrhoea will usually resolve itself by the age of four to five.

What causes toddler diarrhoea?

The cause is not fully understood. The food we eat is broken down in the stomach and then absorbed in the small bowel (the first part of your bowel). The large bowel is responsible for absorbing excessive water and producing formed stools. In toddler diarrhoea there may be an imbalance of fluid, fibre and undigested sugars that reach the large bowel. The excessive fluid is then passed out in loose stools.

Toddler diarrhoea is not due to poor absorption of food and is not a serious bowel problem. Your child will usually still get all the nutrients they need from the food they eat and continue to grow well.

What is the treatment for toddler diarrhoea?

Changing the types of foods your child eats usually helps. Foods which are high in fibre or sugar, as well as drinking excess fluid, can lead to toddler diarrhoea. A low fat diet can also contribute to it as fatty foods can slow gut transit time.

Sugars

Refined sugars and sweeteners in a child’s diet (fizzy drinks, squashes, sweets, chocolate and table sugar added to foods such as breakfast cereals) often contribute to toddler diarrhoea. Even fruit juices and smoothies, which are often seen as a healthier option, still contain natural sugar.

It is best to only give your child water or milk to drink. If they will not drink water, gradually dilute their squash / juice more and more until they are just drinking water.

Fluid

Excessive drinking can also cause diarrhoea. Children need plenty of fluid (six to eight drinks a day) but some toddlers like to drink almost constantly. This is often more for comfort than because of thirst. It is a good idea to plan set times for drinks, for example with snacks and at mealtimes. Do not offer drinks in-between. Use distraction methods if necessary. Children will drink enough to quench their thirst so do not worry about dehydration.

Fibre

A normal fibre intake is recommended, however some young children often cannot tolerate high fibre foods very well. In these children, excessive fibre consumption should be discouraged. High fibre foods that can cause loose stools are: high fibre breakfast cereals, such as Weetabix, porridge, flapjacks, and whole-wheat products, such as brown rice and whole-wheat pasta. Certain fruit and vegetables such as grapes, raisins, peas, sweetcorn, and baked beans are also high in fibre. A portion of fruit or vegetables is approximately the size of a child’s fist, and they should be aiming for five age appropriate portions of fruit and vegetables per day.

Fat

Fat in the diet slows down the speed food moves through the gut. Therefore giving your child a reasonably high fat diet may help. It has been found that giving a small amount of a high fat food at the end of a meal can help to reduce loose stools.* These include yogurt, ice-cream, full fat mousse, other dairy desserts, full fat milk or even a cube of cheese.

The table below gives more details on the types of foods to include in your child’s diet and the types of foods to avoid.

* If chocolate is given, it is best to give a small piece at the end of a meal rather than on its own or in-between meals.

Foods to limit / include

Drinks

Limit: Fruit juices, fruit smoothies, fizzy drinks and squashes including sugar-free versions.

Include: Full fat cow’s milk, water.

Fruit

Limit: Grapes, raisins and other dried fruits.

Include: All other fruit.

Vegetables

Limit: Peas, baked beans, other pulses, sweetcorn.

Include: All other vegetables.

Cereals

Limit: High fibre breakfast cereals such as Weetabix, Bran Flakes, Ready Brek, cereals with raisin / fruit, muesli, wholemeal and granary breads, whole-wheat pasta, brown rice, whole-wheat couscous.

Include: Lower fibre cereal, such as Cornflakes, puffed rice cereals, white bread, white pasta, white rice, standard couscous.

Meat / fish / eggs

Limit: None.

Include: All meats / fish / eggs.

Dairy

Limit: Low fat versions of milk, yogurt, mousse, ice-cream.

Include: Full fat versions of milk, yogurt, mousse, ice-cream, cheese, cheese spread.

Sugary foods

Limit: Sweets and chocolate*, added table sugar to food / drinks.

Does my child always need to eat like this?

No - a lower fibre, higher fat diet is usually only needed while your child is experiencing loose stools.

The recommended healthy diet for children of five years and over is to have plenty of fibre and not to eat too much fat.

This dietary advice sheet gives some general information to help you make the recommended changes to your child’s diet. If you are concerned regarding the nutritional value of your child’s diet or if your child is following a special diet that makes it difficult for you to make these changes, please contact your GP who can refer your child to a dietitian.

What should I do if these changes do not help my child?

We expect these dietary changes to improve symptoms within one month. If after one month your child continues to experience two or more watery stools a day or they are losing weight, becoming lethargic or pale, contact your GP who can review your child. If necessary, your GP will re-refer them to the paediatric gastroenterology team.

If you have any other questions that the leaflet does not answer or would like further explanation please contact your GP for further advice.