Need advice from seasoned providers! Toddler diarrhea issue

Hi there Ladies,

I am new to this forum and the childcare business so I am hoping for some advice from anyone who may have had a situation like this:

I have had a 20month old in care for just over a month now and he has had b.m somewhere between diarrhea and very loose stools everyday except for 2 days out of the 25 days or so that he has been here.

My handbook clearly says that diarrhea will result in the child being sent home and they will have to stay out until 24 hrs without d or a solid b.m. However when I first spoke to the mom about it (after the first day of it happening) she thought it was the change in diet. I have 2 daughters of my own and I know that can definitely be a factor so I accepted it and said we would keep an eye on it.

Then after a week, the mom was thinking it was a dairy intolerance so we cut out all dairy. My menu is all whole grains, no refined sugar at all, lots of veggies, fruits, no juice, lots of water, varied proteins (not all meat).

Still no change in stools, so by now both of my daughters have had 1 or two cases of diarrhea and I am starting to worry that it is a bacteria. So for about a week and a half I was asking the mom to take him to a clinic and just rule out the possibility of anything infectious/contagious....it just seemed to be a hassle to her.

Last thursday I told her that if I don't have a doctor's note by Wednesday (today) that he could not be admitted. She showed up saying all the clinics closed last night due to high volume but she had the containers, if I could please collect the stools, and oh by the way, it may be a while before we get the results. I somehow lost my backbone and took him in.

Really? I am trying to be really accommodating, but I'm sure the clinics have not been closed since last thursday! And is it really something I should be doing? I don't mean to sound prissy about it, I have no problem with the gross-factor or logistics, but is that something that you ladies would do, or is that the parents job and he needs to be out until it is figured out? Am I being unreasonable? I am changing messy diarrhea diapers at least once a day 5 days a week with this kid.

I have had my oldest in a centre and I know they would have kicked her out until it was resolved! No accommodations.

Please HELP!!!!!!

What should I do? Any advice?

My suspician is that there is a good chance that it is the new diet you are serving. The whole grains and lots of fresh fruit and veggies can certainly cause loose stools in a child not used to them. And it will take him awhile to get used to them and especially if he is not getting them on the weekends it will be like his system starting over.

The fact it is only once a day that you are changing him then it is his normal poop as compared to true diarrhea which is normally several in a day. Some kids just do not have firm stools for the first couple of years and I have had to refuse to potty train certain children due to that fact because the poops were not firm enough to dump in the toilet should they have an "accident".

Now having said that could it be in infection certainly. The fact it has gone on this long without other systems such as an increase in number per day, increase in smell, frothiness, consistency getting even looser or child seeming sick, not wanting to eat etc would make me think it is more diet than bacteria but at least you should know what you are dealing with by having it checked out.

If you go online and do a google search for how a change to a whole foods high fibre diet can effect a child you might be able to find some info that will give you peace of mind.

For my program if it is only once per day - maximum twice, is contained in the diaper and child is eating, sleeping and playing normally, I would not be excluding the child from care. You might try giving more cooked fruit and veggie rather than raw or fresh as that sometimes helps since the cooking starts the breakdown process.

I've had one or two children like this. Her stool was never solid. But she was healthy and happy (just really disgusting to change). Diarrhea is when you CAN'T STOP pooping, so this is not diarrhea, only yucky poops.

It could be caused by a number of things but if the child seems happy and healthy, I wouldn't worry about it

Hi! Aside from the "closed clinics" nonsense and lack of effort from the Mom, the poop may not really be a problem! I have a 22 month old here that has never had a solid bowel movement!!! I'm talking totally disgusting, sticky mess several times a day, haha! I have two others the same age who have "adult" like poops so it just seems like this little ones body processes everything differently.

My own child when she was still in diapers has soft stools .... I can remember from when she was about a year old till she was trained I would change at least 3 disgusting diapers a day and not all were contained in the diaper. I really had to watch her fruit intake cause that made it 3times worse. Now that she is trained I notice she still goes a lot but at least now it's in the toilet and she is finally wiping herself now too. So it could be just normal for that child

All of the little ones in my care poop like this...even the 2 1/2 year old! And some of them do it 2-3 times a day...but it is not diahrea, it is just their normal poop. I do serve a lot of fruit and whole grains etc as well, so it may be because of that, although all of these kids have the same messy poops at home as well. I have had to change blow-out poops many a time on a 2 year old...yuck! Once it was so bad that it went into his shoes (we were outside) and I had to put him in the shower and spray him down...gross! However, none of this warrants excluding the children from care as they are not sick. As the others above have said, diahrea would be several runny poops per day and the child would probably be acting ill. Perhaps that is why the mother is resistant to going to a clinic...she also doesn't believe the child is sick. However, I would NEVER collect a stool sample for a dck! That is totally not our job!

Oh, and I am also now careful about certain foods...I no longer serve bran or corn to my dck's because the 2 1/2 year old just can't handle it...that is what led to the blow-out poop in his shoes...bran muffins two days in a row and corn to top it off...what was I thinking?! Too much fruit is also an issue...I am a bit careful there too.

Quote:

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Originally Posted by kangaroomama

... However, I would NEVER collect a stool sample for a dck! That is totally not our job!

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Ya I agree - while I had to do that in centre care at the request of the Health Unit - it is the parents job in THIS setting now ours ;)

I am with the others though that at this age and stage 'loose' stools can still be normal for various reasons .... stress adjusting to a new setting, new foods, teething and so forth.

I have one who is two next month who has yet to have a solid poop here - he poops two-three times a day shortly after meal time and 'mush' ... now my guess he had a dairy intolerance too but the Dr says he is 'fine' so what can you do ... loose stools and exema sound fine to me :rolleyes:.

Now if they were exploding out of the diaper and even MORE frequent than that than I would categorize it as diarrhea and excluding for sure.

This is also prime Rotavirus season so your own family could have contracted that in addition to this little boys 'normal but loose' poops.

Most of the time you can tell the difference between a diarreah poop (REALLY rank odor, different colors, etc) and just a nasty poop. And yes, some kids just always have nasty poops. In fact, my experience says that most of the time it's kind of mushy and gross, as opposed to a nice, formed (easily cleaned!) stool.
If he is showing no symptoms otherwise, I would just learn to deal with it. It's not often that a child who is truly ill will have diarreah and absolutely NO other symptoms like fever, lethargy, etc.

this seems to be a variation of normal poop. especially with a switch to no refined sugars and an increase in fiber via fruit and veg. That may just be his normal.

I agree with the others as far as the poop goes, my ds always had nasty poops but it got better with time.
The mother's lack of co-operation and request to collect a stool sample would have really ticked me off though.
Be careful with this lady.. if she is like this within the first month she WILL give you a hard time in the future, just be careful : )

Thank you everyone for such great info, I really appreciate it!!

Yes I agree that it is not always diarrhea (a few times a week it is, right out of the diaper, watery and multiple times a day, but the rest of the week it is just really loose stools). I'm glad to hear that it is somewhat normal - both my daughters had formed poops by about 8 or 9 months - even though they were still breast fed, so it just didn't seem right. But he is definitely happy otherwise. I'd still like the mom to go through with the testing just in case because both of my daughters have had a few bouts of really loose stools in the month that the little boy has been here - and that is very rare for both of them (ages 6 and 14 months).

I think a lot of my frustration was regarding the assumption that it was MY job to collect the stool sample and the lack of consideration on the part of the mom for letting it go on this long - but maybe that is my own fault for not being tough about it. I am ok with changing the diapers as long as everything is ruled out, for my family's sake.

Again, thank you everyone for such quick and detailed responses :)