Diarrhea is one of the major causes of death among children aged under five and simple hand hygiene measures can prevent this. Infective diarrhea is very common and is usually caused by Rotavirus. Diarrhea due to rotavirus starts with some vomiting, then the baby develops loose motions which can be so profuse that the baby may get dehydrated within no time.
A vaccine against is available and it is widely used across the globe. In India too, many states are offering this as a part of their immunization program. Though not 100% protective, this vaccine reduces the intensity of diarrheal infections due to Rotavirus in children.
Dr. Vijayanand Jamalpuri, MD, MRCPCH, FRCPCH, CCT in Paediatrics (UK) & Fellowship in Neonatology (NZ), Consultant Neonatologist and Pediatrician at Rainbow Hospital, Hyderabad spoke to ETV Bharat Sukhibhava.
Diarrhea is an increase in frequency or change in consistency of the stool or both. It is one of the commonest causes of dehydration in children. In severe cases, it can be life-threatening which is highly preventable.
As per the recommendations of WHO and UNICEF, the child should be exclusively breastfed first six months of life and this will reduce the risk of infections in general, and protects against gut infections in specific.
Variability in bowel habits:
Baby in early infancy poo after each feed but babies who are exclusively breastfed can either empty their bowels 4-5 times a day or once in 4-5 days. It is unlikely for a baby to get a tummy infection in the first 6 months if they are exclusively breastfed.
In later infancy, the bowel frequency increases generally to 3-4 times a day following starting solids due to increased intestinal movement. Mouthing, a developmental process wherein, babies keep putting their hands in the mouth. Many babies develop loose motions as they are teething. People usually think that the loose motions are due to teething but in fact, it is due to the irritation of the gums. Infants keep their hands and objects in the mouth to soothe their gums, which in turn cause infection of the gut which results in diarrhea.
Toddlers may have an increased frequency of bowel movement because of active intestinal movements. Parents note some undigested food particles in the stools and may get worried that the child is not digesting any food. It is a very usual normal phenomenon and called “Toddler Diarrhoea”. No treatment is needed if the child is growing well.
Increased risk of diarrhea if …
- Using bottle and or formula feeds
- Early Weaning food if started before 6 months
- Lack of proper hand hygiene before eating food and after toilet
- Improperly cooked or stored food
Things to do to prevent diarrhea:
- Exclusive breastfeeds in first six months of life
- Caretakers should wash their hands before preparing food and after baby’s nappy care
- Older children should wash their hands before eating their food and the toilet.
- Eating fresh and healthy food
How to recognize signs of dehydration:
1. Decreased activity – lethargy
2.Child lips and tongue- moisture is lost and become dry
3. No or fewer tears when baby cries
4. loss of elasticity of the skin
5. Sunken eyes
6.Decreased urine output.
Warning signs in Diarrhoea:
- A child who is lying listless and inactive.
- No interest in feeding
- Blood in motion
- High-grade fever.
- Poor urine output
Treatment:
Generally, medicines are not needed as it is usually caused by a virus. But we ought to replace the salts and water to prevent dehydration.
Maintaining hydration can be achieved by giving sabudana kanji, coconut water, daal water, and WHO-approved ORS. You can prepare your own ORS at home with a glass of water, pinch of salt, and palmful of sugar.
Avoid fluids that mimic ORS, which are high in sugar to make palatable to the child. But this in fact leads to worsening of diarrhea. Avoid fruit juices during diarrhea. If you see any signs of dehydration please seek professional help.
