When a baby experiences diarrhea—a sudden increase in the frequency and looseness of stools—the primary concern is the rapid loss of fluids and salts. This fluid depletion quickly leads to dehydration, the most significant complication of a diarrheal illness in infants and young children. Managing a baby’s diet during this time is essential for preventing serious health issues and supporting recovery. The initial focus must be on replacing lost fluids and electrolytes, with food management following once hydration is stable.
Prioritizing Hydration and Electrolytes
The most important step in managing an infant with diarrhea is preventing or correcting dehydration by replacing water and electrolytes. Oral Rehydration Solutions (ORS), available over-the-counter, are specifically formulated with the correct balance of water, salt, and sugar to facilitate absorption in the small intestine. ORS is superior to plain water, which lacks necessary electrolytes, or sports drinks, which typically have too much sugar and an incorrect electrolyte ratio that can worsen diarrhea.
For breastfed babies, feeding should continue on demand and even more frequently than usual, as breast milk is easily digested and helps to maintain hydration. Formula-fed infants should also continue to receive their regular formula, as stopping it is generally not recommended unless advised by a healthcare provider. If diarrhea is watery and frequent, a healthcare provider may recommend giving ORS—often 2 to 4 ounces—between regular feedings to replace losses, but ORS should not be the sole source of nutrition for more than a few hours.
Strictly avoid giving plain water, fruit juices, sodas, or sugary drinks, especially in large quantities. Their high sugar content can pull more water into the bowel, intensifying the diarrhea. Administer ORS in small, frequent sips, such as 1 teaspoon every five minutes, to prevent vomiting and ensure better absorption. If the baby is actively vomiting and unable to keep down fluids, consult a healthcare provider immediately.
Appropriate Foods During Active Illness
Once a baby’s hydration is stabilized, attention shifts to introducing or continuing appropriate solid foods for older infants. The goal of feeding during active diarrhea is to provide easily digestible foods that contain starches to help bind the stool. Components of the traditional BRAT diet—Bananas, Rice, Applesauce, and Toast—are useful because they are generally bland, low in fiber, and well-tolerated.
Specific foods that are often well-received include rice cereal, plain white rice, mashed bananas, and unsweetened applesauce. Other bland, starchy options like plain pasta, crackers, mashed potatoes without butter or cream, and mild proteins such as plain chicken or turkey are also suitable. These foods supply necessary calories and nutrients without irritating the digestive tract.
Certain foods should be avoided during the acute phase because they can exacerbate symptoms. These include high-fat foods, concentrated sweets, and full-strength fruit juices, all of which increase the osmotic load and worsen watery stools. While formula and breast milk should be continued, excessive dairy products beyond the baby’s usual intake, such as cheese or large amounts of cow’s milk, are often restricted due to potential temporary lactose malabsorption following an intestinal illness.
Reintroducing a Normal Diet
After approximately 24 to 48 hours of improved symptoms, the focus shifts to gradually returning to the baby’s normal diet. Prolonged restriction of foods is discouraged because it can delay the recovery of the intestinal lining and hinder overall nutritional recovery. Reintroducing a varied diet ensures the baby receives a full range of macronutrients and micronutrients needed for healing.
The reintroduction should be done slowly, monitoring the baby for any return of severe diarrhea or vomiting. Begin by adding back mild proteins and complex carbohydrates that were previously restricted, such as strained meats or small amounts of well-cooked vegetables. Once these are tolerated, you can gradually move toward foods with higher fat or sugar content.
Monitoring the baby’s stools and overall disposition is important throughout this process. A full return to the normal, age-appropriate diet should be achieved within a few days of improvement. If the diarrhea returns or worsens significantly during the reintroduction phase, it may be necessary to step back to the bland diet for a short period and consult with a healthcare provider.
Recognizing Signs of Severe Dehydration
While mild diarrhea is manageable at home, severe dehydration is a medical emergency that requires immediate attention. A baby’s small body size makes them highly susceptible to rapid fluid loss, so parents must be aware of the warning signs. These symptoms indicate that the body has lost a dangerously high percentage of its total fluid volume.
Signs of severe dehydration include:
- A lack of tears when crying.
- Fewer than six wet diapers over a 24-hour period.
- A dry, sticky mouth and tongue.
- Sunken eyes or a noticeably sunken fontanelle (soft spot on the head).
- Unusual lethargy, excessive drowsiness, or extreme irritability.
Other serious symptoms accompanying the diarrhea require immediate evaluation by a healthcare professional. These include a high fever, blood or pus in the stool, or vomiting that prevents the baby from keeping down any fluids.