How to manage diarrhea: a further explanation

I’ve already briefly given an explanation about the management of diarrhea in child, particularly in baby, according to American Academy of Pediatrics. In this particular posting, I want to make a deeper explanation on how to manage diarrhea in child, specifically in baby. Diarrhea causes a messy and unpleasant condition for both parents and baby, because it can lead to “bowel accidents”. Therefore, it is important to try to manage the diarrhea’s symptoms if at all possible.

Before trying to manage diarrhea, you have to know the several conditions which may lead to the increasing of diarrhea risk. Those are:

having an infection

having an abdominal radiation

taking medications that make the bowel more active, eg: some chemotherapy, antibiotics, antacids

stressing

eating some kinds of food or nutritional supplements or is using some types of tube feedings

constipating and the waste has formed a hard clump (fecal impaction). This creates a block in the bowel and some watery stool leaks around it all the time

having a worsening disease that affects how the bowel works

In order to prevent diarrhea you can check your baby with your doctor or nurse to see if any of your baby’s medications or treatments may cause diarrhea, because sometimes small changes can prevent it from happening. You can also consult with the nurse or dietitian about what foods can be consumed to avoid if diarrhea is a risk because of your child’s condition or treatment.

Here are the following you have to avoid in case of diarrhea:

Try not to eat greasy, fried, spicy, fats, caffeine, nicotine, or very sweet foods.

Some people with diarrhea may begin to have trouble digesting milk. If this is a problem for you, try limiting milk and milk products to no more than 2 cups a day during this time. If limiting milk products does not relieve diarrhea, gas, or bloating, switch to milk and milk products that have the lactose removed. It suggests that you having lactose intolerance. Lactaid and Dairy-Ease are examples of two such products.

Avoid drinks and foods that cause gas, such as carbonated drinks, and gas-forming vegetables. (You may drink carbonated beverages if you leave them open for at least 10 minutes before drinking).

Limit use of sugar-free gums and candies made with sorbitol. Foods that have sorbitol can cause diarrhea, gas, and bloating.

Avoid grape, prune, or full strength apple juice (apple contains sorbitol). These make the diarrhea worse.

Early diarrhea management in the right away.

You can manage the diarrhea by knowing its causal factor then trying to address the treatment to the cause of diarrhea.

Infection: think about whether it will benefit the child to treat the infection

Medication: consider reducing the dose or changing the drug. Check with your doctor or nurse about this.

Foods/nutritional supplements: stop or dilute foods or nutritional supplements that cause diarrhea.

Laxatives: speak with your doctor or nurse about stopping or reducing the dose. (If the diarrhea is caused by constipation, your doctor may want you to continue giving laxatives.)

As noted on my previous posting that the main goal of the diarrhea treatment is to keep your baby from getting dehydrated since baby had lost liquids in a significant number. Therefore, we have to replace lost fluids, salt and minerals without irritating the bowel further.

Don’t give any formula, tube feedings, milk, or solid food for 24 hours unless your doctor advises otherwise.

Offer (or if tube feeding, try giving) small amounts of any of the following clear fluids often.
1. If your child is under 2 years: Pedialyte® or Lytren® or Gastrolyte® (Buy these at the pharmacy).
2. If your child is older than 2 years: same as above or Gatorade®.

After about 24 hours, if the diarrhea is less, offer small amounts of soft foods such as apple sauce, mashed banana, rice cereal, crackers, or Arrowroot® biscuits.

Give a baby his regular formula, but start with it diluted to half the usual strength. Dilute with boiled water.

Encourage as much drink as possible. If you are tube feeding your child, give half strength feeding at a slower rate.

After another 24 hours, if the stools are more solid, start full strength formula or, for older children, slowly go back to a normal diet. Include a little milk and milk products. If you are tube feeding, go back to the regular formula..

Followings are the other things in managing diarrhea in your baby:

In order to manage diarrhea in baby you have to avoid on giving them antidiarrheal medicine, such as Kaopectate®, Kaocon®, Lomotil®, Imodium®, Diban®, Donnagel®, Mitrolan®, or Pomalin®, because it can cause problem in children under 3 years.

Keeping the skin clean. Wash the area gently with mild soap and water after every stool.

Check often for signs of infection - redness, swelling, pain. Ask a health professional for help if you notice sores or rashes around the anus. Use a mild lotion/cream/petroleum jelly to protect the skin (refer to “Personal Hygiene” for more suggestions).

According to the research conducted by Subijanto, et al. the administration of high-lactose Bifidobacterium bifidum-containing formula positively influences the rate of recovery in acute pediatric diarrhea.

You have to get professional help when appropriate. Call your doctor or nurse during the day if: