Diarrhea in Baby: Don't Underestimate

Diarrhea is an important cause of morbidity and mortality in developing countries, especially in infants and young children. Diarrhea is the sudden increase in the frequency and looseness of bowel movements. Diarrhea can be mild to severe. Mild diarrhea is the passage of a few loose or mushy stools. The best indicator of the severity of the diarrhea is its frequency. Green stool points to very rapid passage and moderate to severe diarrhea.

Most diarrhea in children is caused by one of several diarrhea-causing viruses and gets better by itself within a week. Although there can be many causes of diarrhea such as caused by bacteria or parasites, and also can be due to excessive fruit juice or to a food allergy. Diarrhea usually lasts from several days to a week. Most of the time mild diarrhea lasts from 3 to 6 days. Occasionally a baby will have loose stools for several days longer. As long as the child acts well and is taking adequate fluids and food, loose stools are not a great concern.

The main problem of diarrhea is dehydration. Therefore, the main goal of ttreatment is to prevent dehydration by giving enough oral fluids to keep up with the fluids lost in the diarrhea. But, don’t expect a quick return to solid stools since one loose stool can mean nothing.

When will my baby be categorized as a diarrhea sufferer with dehydration? You can know it by observe these following signs:

Signs of mild to moderate dehydration:


  1. no urine (or wet diaper) for 8 hours.

  2. dry lips.

  3. the inside of the mouth is dry or sticky.


Signs of severe dehydration:

  1. no tears when crying.

  2. the inside of the mouth is very dry (no saliva) .

  3. eyes seem sunken.

  4. weight loss.

  5. listless (has little energy).

  6. hard to awaken.

  7. confused.

  8. weakness (hard to sit up or walk, floppy) .


As I noted above that the main goal of the treatment of diarrhea is to keep your baby from getting dehydrated since baby had lost liquids in a significant number. Following are the treatment guide of diarrhea (American Academy of Pediatrics, 1996):

Mild illness of diarrhea and diet
Most children should continue to eat a normal diet including formula or milk while they have mild diarrhea. Breastfeeding should continue. If your baby seems bloated or gassy after drinking cow’s milk or formula, call your pediatrician to discuss a temporary change in diet. There are not usually necessary special fluid for children with mild illness.

Moderate illness of diarrhea
Children with moderate diarrhea can be cared for easily at home with close supervision, special fluids, and your pediatrician’s advice. Your pediatrician will recommend the amount and length of time that special fluids should be used. Later, a normal diet can be resumed. Some children are not able to tolerate cow’s milk when they have diarrhea and it may be temporarily removed from the diet by your pediatrician. Breastfeeding should continue.

Special fluids for moderate illness
Special fluids have been designed to replace water and salts lost during diarrhea. These are extremely helpful for the home management of mild to moderately severe illness. Do not try to prepare these special fluids yourself. It is too easy to get confused by some of these complex recipes. You could accidentally make a bad fluid for your baby. Use a fluid that is made by one of the reputable manufacturers. The two most widely available products that you will find in nearly every pharmacy are:

  1. Pedialyte (Ross Laboratories)

  2. Infalyte (Mead Johnson Nutritionals)

  3. Other brands of special fluids are available and equally effective.

  4. Many drug stores have their own generic brands of special fluids. Ask the pharmacist for assistance.


If a child is not vomiting, these fluids can be used in very generous amounts until the child starts making normal amounts of urine again.

Severe illness
If your child develops the warning signs of illness listed on the first page, he or she may require IV fluids in the emergency department for several hours to correct dehydration. Usually hospitalization is not necessary. Immediately seek your pediatrician’s advice for the appropriate care if symptoms of severe illness occur.


Reminder–do's and don'ts

DO

  1. Watch for signs of dehydration which occur when a child loses too much fluid and becomes dried out. Symptoms of dehydration include a decrease in urination, no tears when baby cries, high fever, dry mouth, weight loss, extreme thirst, listlessness, and sunken eyes.

  2. Keep your pediatrician informed if there is any significant change in how your child is behaving.

  3. Report if your child has blood in his stool.

  4. Report if your child develops a high fever (more than 102°F or 39°C).

  5. Continue to feed your child if she is not vomiting. You may have to give your child smaller amounts of food than normal or give your child foods that do not further upset his or her stomach.

  6. Use diarrhea replacement fluids that are specifically made for diarrhea if your child is thirsty.


DON'T

  1. Try to make special salt and fluid combinations at home unless your pediatrician instructs you and you have the proper instruments.

  2. Prevent the child from eating if she is hungry.

  3. Use boiled milk or other salty broth and soups.

  4. Use "anti-diarrhea" medicines unless prescribed by your pediatrician.



Regards

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