Shaken Baby Syndrome

A large number of child deaths are reported in South Africa each year. A lot of deaths relate to neglect, abuse or murder. Despite this, there's a knowledge gap in relation to understanding the issue....

Amniotic fluid problems

The importance of amniotic fluid Amniotic fluid is essential for pregnancy and foetal development. Amniotic fluid is a watery substances residing inside a casing called the amniotic membrane or sac. ...

Choosing a pre-school

Becoming a parent is a momentous; life-changing event filled with hopes, expectations and naturally some fears. Parents often learn and grow alongside their children, as they face the challenges of pa...

Newborn reflexes

Although newborn babies are physically helpless and vulnerable at birth, they have a number of amazing innate abilities or reflexes. Reflexes are involuntary movements or actions, designed to protect ...

Mastitis

Mastitis is an inflammation of the breast that can lead to infection. The word “mastitis” is derived from the Greek word “mastos” meaning “breasts”, while the suffix “-itis” denotes “inflammation”. Ma...

Pelvic floor exercises

Although your new baby will probably bring you immense emotional satisfaction, physically you may feel uncomfortable and strange in your own skin. After 9 months of pregnancy and hormonal changes, you...

Colic

Babies cry because they need to communicate something and most parents, especially new moms, find it distressing to see or hear an unhappy baby. In time, you will learn to recognize the various causes...

Antenatal Classes

Antenatal classes are informative sessions provided to prepare expecting parents for the birth of their child and the early days of being a parent.Most antenatal classes are run by Midwives and occasi...

Strap-in-the-Future

The Decade of Action for Road Safety 2011-2020 was launched on the 11 May 2011. It is a global declaration of war against road crashes and fatalities. According to Mr Sibusiso Ndebele, MP Minister of ...

  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Diarrhoea

Diarrhoea refers to loose, watery stools. A person with diarrhoea generally passes more than 3 stools per day. Acute diarrhoea usually lasts for 1-2 days and does not require special treatment. Chronic diarrhoea poses a more serious problem, especially in children and the elderly who run a higher risk of dehydration. Dehydration means that the body lacks sufficient fluid to function properly. Chronic diarrhoea may also be a sign of a chronic disease (NDDIC, 2008).

 

Causes

Acute diarrhoea is most commonly related to bacterial, viral or parasitic infections. Chronic diarrhoea is often related to a chronic disorder such as irritable bowel disease or inflammatory bowel disease (NDDIC, 2008).

 

Some of the most common causes of diarrhoea

 

Bacterial and viral infections

One of the most frequently occurring and concerning causes of diarrhoea in children is known as gastroenteritis, or an inflammation of the stomach and intestines, that causes diarrhoea and vomiting. Gastro may be viral in origin, where it is transmitted through the air or by contact with infected faeces, or when food or drink is contaminated by bacteria. It is also common for children to develop diarrhoea during or after having a cold (Collins, 2003).

 

Food intolerance and allergy

Intestinal allergies to certain foods, such as cow’s milk, may produce chronic diarrhoea, until the offending allergen is removed from the diet. Other children may develop diarrhoea because their bodies lack the necessary enzymes to digest certain foods, e.g. lactose, the sugar found in milk (Leary, 1990; NDDIC, 2008).

 

Medication

Diarrhoea is one of the possible reactions to certain medications. In children, this most commonly occurs when they are given an antibiotic to treat infections such as URTI (NDDIC, 2008).

 

Functional bowel disease

Diarrhoea can be a symptom of IBS (NDDIC, 2008).

 

Intestinal diseases

Crohn’s disease, ulcerative colitis and inflammatory bowel disease (NDDIC, 2008).

 

Symptoms

·         abdominal pain

·         bloating

·         cramping

·         nausea

·         an urgent need for the bowels to move

·         sometimes a fever (NDDIC, 2008).

 

Why and when is diarrhoea potentially dangerous?

The effective functioning of body organs requires a balance between water and electrolytes (body salts and minerals). Electrolytes have several important functions, such as controlling the amount of water in the body and muscle activity. The watery stools produced by diarrhoea may cause your child to lose too many fluids and mineral salts. When your child loses more water and salts than she takes in, a potentially dangerous condition known as dehydration may arise. Babies and infants are particularly at risk as they dehydrate within 1-2 days. A child can die from dehydration within a few days. Therefore, never hesitate to call your doctor if your child has diarrhoea (Leary, 1990; NDDIC, 2008).

 

Signs of dehydration

·         dry mouth and tongue

·         high fever

·         listlessness or irritability

·         producing no tears when crying or dry eyes

·         a lack of wet nappies for 3 days or more, or little urine output in older children

·         sunken abdomen, eyes or cheeks

·         skin that does not flatten after being pinched, or dry skin

·         drowsiness

·         lethargic behaviour (Leary, 1990; NDDIC, 2008)

 

Treatment

The primary treatment for diarrhoea in children is rehydration:

·                At the first sign of diarrhoea, stop all solid food, formula and cow’s milk, and resume a liquid diet. DO NOT stop breast feeding.

·                Weigh your baby with his clothes off; if he is not losing weight, he is not dehydrating.

·                The best way to give your baby or child extra fluids is by means of an oral rehydrating solution. Rehydrat or Darrowped can be bought over the counter at your pharmacy and should be reconstituted strictly in accordance with the manufacturers’ directions.

·                Alternatively, you can prepare your own rehydrating solution at home, by dissolving ½ tsp salt and 8 tsp sugar in 1 litre of water that has been boiled and cooled.

·                Give your baby or child small amounts (60-120 ml) of clear fluids every 1-2 hours.

·                If her diarrhoea is accompanied by vomiting, give her even smaller amounts every hour.

·                Older children can also be given broth that contains sodium.

·                A clear fluid diet should not be continued for more than 48 hours because it can, in and of itself, cause diarrhoea.

·                In infants, milk feeds can be reintroduced after 24 hours, if your child is not vomiting and the frequency and consistency of her stools has improved. Continue to give smaller, more frequent feeds rather than an hourly bottle. Your paediatrician may change her formula during the recovery period because soya and lactose-free formulas for example are often better tolerated by inflamed intestines.

·                In older children, as their diarrhoea improves, your doctor may recommend a bland diet consisting of foods such as, rice, boiled potato, mashed banana, toast, cooked carrots and plain chicken.

·                Most cases of diarrhoea in children are not treated with medication that stops or lessens frequent, watery stools. Since diarrhoea is often caused by viral infections, the intestines will heal themselves. In the case of bacterial or parasitic infections, if you stop the diarrhoea before these organisms have worked themselves out of your child’s system, they may become trapped in the intestines and prolong the problem.

·                Instead, doctors may prescribe antibiotics as a first line of treatment (Collins, 2003; Leary, 1990; NDDIC, 2008).

 

Contact your doctor immediately if your child has any of the following symptoms

·         high fever

·         any sign of dehydration

·         severe pain in the abdomen or rectum

·         vomiting (12 hrs in children/6 hours in infants)

·         refusing to drink for 6 hours

·         passing no urine for 6 hours in a day

·         diarrhoea for more than 3 days

·         blood in the stools or black, tarry stools (Collins, 2003; NDDIC, 2008)