Sunday, April 20, 2008

Diarrhoea In Children

What is diarrhoea?

  • Diarrhoea is a condition whereby children will pass motion more frequently than usual and their faeces is usually liquid.

  • Diarrhoea is spread by germs from faeces entering the mouth.

  • The germs can be spread by water, food, hands, eating and drinking utensils, by flies and by dirt under the fingers.

Why is diarrhoea dangerous?

  • Diarrhoea is dangerous. If not treated, it can kill.

  • Most often, diarrhoea kills by dehydration, which means that too much fluid has been drained out of the child’s body.

  • Fluids and nutrients lost during diarrhoea should be replaced.

When a child has diarrhoea, give more fluids than usual

Suitable drinks to prevent a child from getting dehydrated are:

  • Oral Rehydration Salts (ORS) mixed with the recommended amount of cooled boiled water.

  • Breast milk.

  • Porridge (diluted mixture of cooked cereals and water).

To prevent dehydration, one of these drinks should be given to the child every time he/she passes watery stool:

  • Soups

  • Rice water

  • Fresh fruit juices

  • Weak tea

  • Young coconut water

  • If nothing else is available, give cooled water.

The amount to be given is:

  • If your child is less than 2 years old, give ¼ - ½ cup, in small amounts but frequently.

  • If your child is more than 2 years old, give ½ - 1 cup, in small amounts but frequently.

If the child vomits, wait for 10 minutes and then begin again, feeding the drink to the child slowly in small sips at a time.

Extra liquids should be given until the diarrhoea stopped.

ORS - A Special Drink

  • A special drink for diarrhoea can be made by using a packet of Oral Rehydration Salts (ORS)

  • This drink is used by doctors and health workers to treat dehydrated children. But it can also be used at home to prevent dehydration.

  • ORS is available in health centres, clinics and pharmacies.

  • To make the drink:

  • Dissolve the contents of the packet in the amount of cooled boiled water as indicated on the packet.

  • If you use too little water, the drink could make the diarrhoea worse. If you use too much water, the drink will be less effective.

  • Stir well, and feed it to the child in small sips from a cup.

  • After 24 hours, throw away the leftover of ORS solution.

When a breastfed child has diarrhoea, it is important to continue breast feeding

  • When a breastfed child has diarrhoea, breast feeding should be continued, and if possible, more frequent.

  • If the child cannot suck, it is best to squeeze out the breastmilk and feed it to the child from a clean cup and spoon.

Medical help is needed if diarrhoea is more serious than usual

Parents should get help from a health worker as soon as possible if the child becomes dehydrated.

Signs of dehydration are:

  • Sunken eyes

  • Extreme thirst

  • No tears when the child cries

  • Passing less urine which is darker in colour

  • Has high fever

  • Will not eat or drink normally and vomits frequently

  • Pass stool with blood

  • Has persistent diarrhoea

  • Diarrhoea continues for more than 2 weeks

In the meantime, keep giving the child liquids to drink.

A child with diarrhoea needs food

  • Diarrhoea can lead to serious malnutrition unless parents make special effort to keep feeding the child during and after the illness.

  • A child with diarrhoea usually has less appetite. Coax the child to eat frequently by offering small amounts of his or her usual foods.

  • Children who eat solids should be given softrice or congee initially and then add well cooked meat or fish. Add 1 or 2 teaspoonfuls of oil to congee and vegetable mixes.

  • When diarrhoea lessens, fruits like bananas, papayas and pineapples are also good for the child.

  • Food should be freshly prepared and given to the child 5 or 6 times a day.

A child who is recovering from diarrhoea needs an extra meal everyday for at least a week

  • Extra feeding after diarrhoea stops is vital for a full recovery.

  • Give the child an extra meal a day for at least a week. This will help the child to catch up on the food ‘lost’ while the child was ill and the appetite was poor.

  • A child is not fully recovered from diarrhoea until he or she has at least the same weight as before the illness began.

  • Breastfeeding more frequently than usual also helps to speed up recovery.

How to prevent diarrhoea?

  • Give only breastmilk for the first 4 – 6 months of a baby’s life.

  • At the age of 4 – 6 months, introduce clean, nutritious, well-mashed, semi-solid foods and continue to breastfeed.

  • If milk powder solution or fresh cow’s milk has to be used, feed it to the child from a cup with a clean spoon.

  • Water should be boiled and cooled before use.

  • Immunise your child against measles. Measles frequently result in serious diarrhoea. Immunisation protects your child against this cause of diarrhoea.

  • Always use sanitary toilet.

  • Wash hands with soap and clean water before preparing or eating food, and immediately after using the toilet.

  • Cover food and drinking water to protect it from flies.

  • Food should be well-cooked. If possible, prepare it just before eating. It should not be left for long or it will collect germs.

  • Dispose refuse in bins or bags if it is to be collected, or bury it to stop flies from spreading diseases.