Diarrhoea is defined as the passage of three or more loose or liquid stools per day, lasting up to 14 days.1 A change to loose or liquid stool consistency rather than stool number is more indicative of diarrhoea in infants.1 Diarrhoea is generally obvious to identify, however, the following cases indicate a healthy infant and should not be confused with diarrhoea:1,2
· Healthy newborn stools are soft and loose
· Newborn babies pass stools frequently, sometimes after every feeding
· Breastfed infants often have pasty stools
What causes diarrhoea in infants?
In infants worldwide, diarrhoea is usually caused by an infection from a virus, e.g. Rotavirus and Norovirus, or bacteria, e.g. Campylobacter or Salmonella.3 Other causes of infant diarrhoea include parasites, a reaction to a medicine, or a rare disease, such as cystic fibrosis2. In either case, diarrhoea may also be accompanied by vomiting,1 which may increase the risk of dehydration.1 Dehydration is the main risk associated with diarrhoea, therefore it is important to ensure that infants remain hydrated.
Diarrhoea as a symptom of Cows' Milk Allergy
Diarrhoea is the most common gastrointestinal symptom related to Cows' Milk Allergy (CMA) and affects more than half of all children with CMA.4-6
The majority of infants affected with CMA have at least two symptoms affecting at least two different organ systems.7,8 If you suspect non-IgE mediated CMA, you can use the CoMiSS® tool11 to score the combination of their symptoms and assess the likelihood of CMA.
Other signs and symptoms related to CMA4-6
· Gastrointestinal/Digestive: Vomiting, reflux, regurgitation, anorexia, diarrhoea, constipation, abdominal pain, blood in stools
· Respiratory: Chronic cough, sneezing, wheezing, shortness of breath, runny nose
· Skin: Rash, atopic dermatitis, urticaria, angioedema
· General: Failure to thrive, anaphylaxis, insomnia, inconsolable crying, pallor and tiredness