Breast-fed babies are less likely to suffer stomach upsets than formula-fed babies. However, because exclusively breast-fed infants’ stools are normally loose, diarrhoea can be difficult to diagnose. Diarrhoea symptoms are: 12–16 stools per day, watery stools with no substance, stools with an offensive odour.
The breast-fed baby may experience diarrhoea because of something that the mother has consumed (e.g. acidic fruit, spicy food), therefore such episodes can be remedied if the mother avoids these foods in future. Breast-fed babies may also develop diarrhoea because of maternal medication (e.g. antibiotics), lactose intolerance or gastro-intestinal infection.1Diarrhoea causes the loss of water, sodium and potassium, which can pose a risk of dehydration. Consequently, fluid replacement is urgently needed. Remove any milk products from the baby’s diet, apart from breast milk, which is rapidly digested and will be absorbed even if there are post-regurgitation episodes. Feeding frequency should be increased, and it is rarely necessary for breast-feeding to be discontinued unless an underlying disorder is diagnosed. Consult the GP if diarrhoea persists and the baby becomes dehydrated. 

DIARRHOEA (in the mother)There is no need to stop breast-feeding: antibodies passed through breast milk should protect the baby from infection. Obviously, good hygiene practices are essential. However, if breast milk becomes discoloured or other unusual characteristics are noted, advice should be sought from a specialist lactation consultant or other health care professional immediately. Loperamide (Imodium®) can be taken safely while breast-feeding.

Reference 1. Vonlanthen M. Lactose intolerance, diarrhea, and allergy. Breastfeeding Abstracts 2000; 18: 11.

From: Journal of Family Health Care Bulletin. Directory of Breast-Feeding Advice. December 2009. Published with JFHC 2009; 19(6).