Diarrhoea in infant is a very discomforting health issue both for the child and the mother. According to Web MD, Diarrhoea is the body’s way of ridding itself of germs and most episodes last a few days to a week. It often occurs with fever, nausea, vomiting, cramps, dehydration and most significantly, frequent defecating of watery stool. Mrs. Joy Agbo, the Chief Nurse in Cottage Hospital Uwani, Enugu, in one of her health lectures to mothers on immunization days said that diarrhoea in children can be avoided by maintaining good hygiene in the home. She maintained that every item used for the child if kept in utmost clean condition can reduce/minimise the risk of Infant Diarrhoea.
She stressed that the major preventive measure for diarrhoea is exclusive breast feeding.
He enjoins mothers to boost their children’s immunity by feeding them exclusively with breast milk till six months. This she maintains enhances the child body defence against diseases.
Most importantly, she stressed that mothers should be cautious of what goes into their children’s mouths. Firstly, mothers should mop the floors with disinfectant so as to be sure the baby’s hand doesn’t pick things that are infected and put them to the mouth.
Secondly, after breast-feeding exclusively, when the child starts eating, the utensils used in preparing and feeding him/her should always be sterilized in order to kill, the germs that might cause Diarrhoea. Again, the water your child drinks should be treated to a clean level.
Furthermore, she maintained that Diarrhoea could also be prevented by Parents being cautious to avoid spreading infections to themselves, their families, and friends. Care with hand washing, Diapering, and keeping sick children out of school or day-care until the Diarrhoea is gone are a few ways to limit the number of people exposed to the infection.
Hand-washing is an essential and very effective way to prevent the spread of infection. Hands should ideally be wet with water and plain or antimicrobial soap, and rubbed together for 15 to 30 seconds. Special attention should be paid to the fingernails, between the fingers, and the wrists. Hands should be rinsed thoroughly and dried with a single-use towel.
Alcohol-based hand rubs are a good alternative for disinfecting hands if a sink is not available. However, alcohol-based hand rubs do not prevent all types of diarrhea (eg, Norovirus, Clostridium difficile). Hand rubs should be spread over the entire surface of hands, fingers, and wrists until dry, and may be used several times. Hand rubs are available as a liquid or wipe in small, portable sizes that are easy to carry in a pocket or handbag. When a sink is available, visibly soiled hands should be washed with soap and water.
Hands should be cleaned after changing a diaper or touching any soiled item. They should also be washed before and after preparing food and eating, after going to the bathroom, after handling garbage or dirty laundry, after touching animals or pets, and after blowing the nose or sneezing.
CAUSES OF DIARRHOEA
Viruses are the most common cause of a child’s Diarrhoea. Along with loose or watery stools, symptoms of a viral gastroenteritis infection often include vomiting, stomach ache, headache, and fever.
When treating viral gastroenteritis — which can last 5-14 days — it’s important to prevent fluid loss. Offer additional breast milk or an Oral Rehydration Solution (ORS) to infants and young children. Water alone doesn’t have enough sodium, potassium, and other nutrients to safely rehydrate very young children. Be sure to talk to your doctor about the amount of fluid your child needs, how to make sure he or she gets it, and when to give.
Older children with Diarrhoea can drink anything they like to stay hydrated, including ORS and brand-name products (their names usually end in “lyte”). Popsicles can also be a good way to get fluid into a child who’s been vomiting and needs to re-hydrate slowly.
Be sure to consult with a doctor if you have travelled outside of the country recently. Your child may need to have his or her stool tested.
Medications like laxatives or antibiotics can also lead to Diarrhoea in children as well as adults.
For mild diarrhea caused by medication, keep your child safely hydrated. If a course of antibiotics is causing your child’s Diarrhoea, be sure to continue the medication and call your doctor. Your doctor may recommend reducing the dose, changing your diet, adding a pro-biotic or switching to a different antibiotic.
Studies show that yogurt with live cultures or pro-biotics can help ease Diarrhoea caused by antibiotics. Cultures and pro-biotics help replenish healthy gut bacteria killed by antibiotics.
Food poisoning can also cause Diarrhoea in kids. Symptoms usually come on quickly, may include vomiting, and tend to go away within 24 hours.
Treatment for food poisoning-related diarrhea is the same as for the diarrhea caused by infection: Keep your child hydrated and call your doctor with any questions.
Other causes of Diarrhoea include irritable bowel disease, Crohn’s disease, food allergies, and celiac disease. If you’re not sure what’s causing your child’s Diarrhoea, give your doctor a call.
Breast feeding a child when the mother is pregnant:
Some lactating mothers who get pregnant and continue breast-feeding their babies put those children at risk of severe diarrhoea. Therefore, when you treat your child of Diarrhoea, check your pregnancy status. If it is positive, stop breast-feeding immediately.
RECOMMENDED FOOD FOR THE CHILD DURING ATTACK
Dietary recommendations — There has been much confusion and folklore about optimal foods for children with Diarrhoea. Fortunately, a number of studies have examined recommendations that are proven to be effective and these recommendations have been consistent since the 1990s.
Children who are not dehydrated should continue to eat a regular diet and infants who are breast feeding should continue to do so unless the parent(s) is told otherwise by their clinician. Dehydrated children require re-hydration (replacement of lost fluid) and suitable oral re-hydration solutions are the most physiologic. After being re-hydrated, severely affected children will be able to resume a normal diet.
Specific suggestions for children who are tolerating a regular diet include the following:
Most children with Diarrhoea tolerate full-strength cow’s milk products. It is not necessary to dilute or avoid milk products, except in children with known allergies to cow’s milk.
Recommended foods include a combination of complex carbohydrates (rice, wheat, potatoes, bread), lean meats, yogurt, fruits, and vegetables. High-fat foods are more difficult to digest and should be avoided.
The unnecessary restriction of a child’s diet to clear liquids or the BRAT diet (bananas, rice, applesauce, toast) results in inadequate intake of nutrients (calories and/or protein). Giving only clear liquids for several days can actually prolong Diarrhoea (called “starvation stools”).
Apple, pear, cherry juice, and other beverages with high sugar contents, should be avoided. Sports drinks (sample brand name Gatorade) should also be avoided because they have too much sugar and have inappropriate electrolyte levels for the patient with diarrhea. When clear liquids are recommended, the best choices are the commercially prepared oral re-hydration solutions for rehydration (sample brand name Pedialyte).
Monitoring for dehydration — Mild dehydration is common in children with Diarrhoea. Signs and symptoms of mild dehydration include a slightly dry mouth, increased thirst, and slightly decreased urine output (one wet diaper or void in six hours). Common features of moderate or severe dehydration include decreased urination (less than one wet diaper or void in six hours), lack of tears when crying, dry mouth, and sunken eyes.
Oral Re-hydration Therapy — Oral Re-hydration Therapy (ORT) was developed as a safer, less expensive, and easier alternative to intravenous fluids. Oral re-hydration solution (ORS) contains glucose (a sugar) and electrolytes (sodium, potassium, chloride) that are lost in children with vomiting and diarrhea. Various re-hydration solutions are available. Parents should check with a healthcare provider to determine which solution is preferred. A child who is moderately or severely dehydrated needs to be evaluated by a healthcare provider. If a child refuses to accept ORS because of vomiting and/or becomes moderately to severely dehydrated, as indicated by decreased urination (6 hours since passing most recent urine), lethargy, or other features, the child requires professional evaluation and treatment.
ORT does not cure Diarrhoea, but it does help to treat the dehydration that often accompanies it. ORS can be purchased at most grocery stores and pharmacies.
Gelatin, tea, rice water, fruit juice, and other beverages are not recommended for use as ORT in children with Diarrhoea.
ORT may be given at home to a child who is mildly dehydrated, refusing to eat a normal diet, or has vomiting and/or Diarrhoea. If needed, ORT can be given in frequent, small amounts by spoon, bottle, or cup over three to four hours. A pediatrician may provide specific instructions for oral re-hydration to their patients. One method is described below:
Parents should first measure out the total amount to be given with a standardized medicine syringe or measuring cup or spoon, rather than a regular cup or spoon.
A total volume of 5 teaspoons per pound, or 50 milliliters per kilogram, should be given over four hours. For a 20 pound child, this would equal 100 teaspoons; for a 9 kg child, this would equal 450 milliliters.
The fluid can be given by teaspoonfuls (approximately equal to 5 milliliters each) every one to two minutes, or as tolerated.
After the total amount has been given, a normal diet can be resumed.
A child who refuses to drink or vomits immediately after drinking ORT should be monitored closely for worsening dehydration. Children who are not dehydrated may drink ORT after every episode of vomiting to prevent dehydration.
Medications — Medications such as antibiotics and anti-diarrhoeal agents are generally not necessary and could be harmful for infants or children with Diarrhoea. Rarely, antibiotics may be used in cases of bacterial infection when a specific cause of the Diarrhoea has been found or is strongly suspected, particularly after recent travel. Inappropriate use of antibiotics will not improve Diarrhoea. Furthermore, antibiotics can cause side effects and lead to development of antibiotic resistance.
Anti-diarrhoeal agents (including Imodium, Pepto-Bismol, and Kaopectate) are not recommended for infants or children, since the benefits do not outweigh the risks. One risk of using an antidiarrheal agent is that it could mask worsening symptoms and delay treatment.