CHILDREN’S HEALTH Fluids and Feeding The danger of diarrhoea in young children is the loss of fl uids from the body, which can quickly lead to dehydration. What is it? Diarrhoea is an increase in the frequency, runniness or volume of the faeces. It is a common symptom in children with viral or bacterial infections and allergies, and can be a side effect of antibiotics being taken to help treat these viruses, infections or allergies. The danger of diarrhoea in young children is the loss of fluids from the body, which can quickly lead to dehydration. This can be life threatening and the child must be watched closely because he/she can get worse very quickly. Causes Acute diarrhoea may be a symptom of infection of the digestive system (gastroenteritis), which is usually caused by a virus, but sometimes is caused by bacteria or parasites. It may also occur in association with other communicable diseases such as measles and malaria. Treatment In many cases the condition is self-limiting and resolves in a few days. A child with diarrhoea who is drinking well and who is alert and responsive can usually be looked after at home. The most important treatment for diarrhoea in young children is to provide fluids, which will not cure the diarrhoea but will prevent dehydration. Duration of the illness depends on what organism is the cause and what treatment is used. The child is infectious for as long as the organism is in their faeces, whether or not they are ill. Viruses, bacteria and parasites in the faeces of an infected child may be passed on directly by germs on the hands. They may also be spread indirectly via objects, surfaces or contaminated foods. Children are more likely than adults to be affected and may suffer one or more episodes per year. You should take your child to see a doctor if: • he/she looks unwell • vomiting is frequent and he/she can’t keep anything down • the vomit is brown or green • there is lots of watery diarrhoea • the diarrhoea is increasing • you can see blood in the diarrhoea • there is severe stomach pain • he/she develops a high fever • he/she is under six months of age • he/she is difficult to wake • he/she has diarrhoea and vomiting and refuses extra fluids The most appropriate fluids contain a mixture of special salts (electrolytes) and sugars. Oral rehydration solution can be purchased from pharmacies and should be mixed only with water and according to manufacturers’ instructions. Children who refuse oral rehydration solution should be encouraged to drink water. They may also be given diluted drinks such as: • diluted cordial 10ml + 150ml water • diluted soft drink 50ml + 150ml water • diluted fruit juices 50ml + 150ml water The aim is to give as much fluid as normal as well as replacing the fluid that is being lost. As a guideline: • children aged less than two years should start with 15mls every 15 minutes while awake • older children can be given 50 – 100ml every 30 minutes The fluids should be given slowly, eg. one teaspoonful every one to two minutes for a child aged less than two years. If the child vomits, wait ten minutes, then give the fluid more slowly, eg. one teaspoonful every two to three minutes. Breastfeeding should be continued whenever possible. Offer the breast more often and give babies boiled water between feeds. If bottle-feeding, offer oral electrolyte solutions or other suitable fluids first (see above). If the child is hungry, offer normal strength formula as well and allow the child to eat food. Weight loss may occur if feeding is not continued. Therefore, food should be re-introduced within 24 hours, even if the diarrhoea has not settled. Suitable foods include bread, plain biscuits, potatoes, rice, noodles, vegetables, plain meats, fish and eggs. Other foods such as dairy foods and sweet foods such as jelly, honey and jam can be gradually re-introduced. It’s best to avoid: • Undiluted fruit juice and cordial, or fizzy drinks, ‘sports drinks’ or ‘energy drinks’, as they may make the diarrhoea or dehydration worse. • Drugs to stop the vomiting or diarrhoea, as they may slow down the recovery of the bowel and cause serious side effects. • Antibiotics, as they may prolong the infection and are rarely needed except for certain bacterial or parasitic infections. Diarrhoea 56 Pindara Magazine
Pindara Private Hospital Magazine - Issue One
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