CARE AND FOLLOW-UP OF A CHILD WITH DIARRHEA AND VOMITING
It is known that 4-5 million children lose their lives annually due to diarrhea, and the majority of cases are from developing countries. Diarrhea is a disease that is encountered most commonly in the 0-5 age group.
Approximately 1 billion cases of diarrhoea are observed in the world in children younger than 5 years of age, and almost 2.5 million of these children died. The most significant reason for these deaths is loss of fluid. Loss of fluid leads to death especially in children under two years of age.
What is Diarrhea?
The World Health organization defines diarrhea as
defecation of watery stool at a frequency of over 3 times a day.
However, diarrhea in breast feeding babies is accepted as diarrhea
when there is stool which is more frequent and more watery than at
other times. Frequent defecation is not accounted for as diarrhea,
if consistency is noral. In diarrhea, as a result of an increase in
the bowel movements, and consequent decrease in absorption of water
and minerals, the daily number of defecations increases, or a
disorder of the stool consistency occurs, taking up a soft and watery
appearance. In childhood, diarrhea is seen more frequently in the
summer, and usually occurs due to infectious agents (microbes)
affecting the stomach and the intestines. Infectious agents generally
spread from human to human through the hand-mouth path, in addition
to oral intake of unclean water and food.
What are the Symptoms of Diarrhea?
The main symptoms of diarrhea include:
- Watery defecation,
- Urgency to defecate and fecal incontinence,
- Frequent defecation,
- Nausea and vomiting,
- Increase in body temperature,
- Pain and gas discomfort in the abdominal region.
What can we do to protect our children from Diarrhea?
the first 6 months, only breastfeed the baby (Nutrition
with a pacifier and intake of nutrients other than mother’s milk in
the first 6 months of life increase the probability of diarrheal
- Try to keep away foods outside. Store foods in a tightly closed container in the refrigerator.
- Do not ever give drinks and foods if you are not sure about the cleanliness
- Pay attention to hand hygiene, and ensure hygienic washing of your
- Be much more cautious when consuming milk and milk products. Look at the date of production and the expiry date, in addition to the storing instructions.
- Have the vaccinations recommended by your physician for your children performed on time.
When should you visit the physician?
Take your baby to the physician without losing time,
-if your baby is less than 6 months of age.
-if the diarrhea has persisted for longer than 3 days.
-if your baby is vomiting continuously, and is not taking anything by mouth.
-should there be blood and a mucous appearance
-should there be fever and vomiting concomitant with the diarrhea.
-should there be findings of fluid loss; if the baby is unable to urinate, if there are no tears when the baby cries, if the fontanelle and the eye balls are depressed, and if the abdominal skin slowly returns to normal after pulling on it and leaving it.
Planning of Treatment
The physician will adjust the treatment according to your child’s needs. However, there are 3 important principles in the planning of treatment:
First, to replace the lost fluid and electrolytes, if possible through the mouth,
Second, if the fluid intake by mouth is insufficient, provision of supportive therapy intravenously according to the physician’s recommendations,
Third, treatment depending on etiological factor: when the physician would feel the necessity for initiating antibiotic therapy according to the result of the stool analysis.
Diarrhea and vomiting may be the cause of concern for the parents. Some wrong actions may be taken by the parents due to this concern and with panic. For example, fearing that the baby would become dehydrated and attempting to make the child drink something rapidly is not right. Yes, the child must intake fluid, but this needs to be provided slowly and in small portions.
Water and watery drinks must be given to children with diarrhea in order to compensate for the fluid loss. Babies who are yet not receiving nutrients other than breast milk, should be breast-fed more often; babies over 6 months of age, who have begun to take extra nutrients can be given nutrients such as yoghurt, fat-free meat, rice, boiled potatoes, bread, peaches, and bananas. When possible, oral nutrition must be continued. The amounts of each meal can be decreased and the number of meals can be increased. Nevertheless, fatty nutrients, tea, fruit juice, and drinks containing high amounts of sugar such as cola, must be abstained from in the presence of diarrhea.
The child’s temperature must definitely be measured, and if there were fever, the fever must be brought under control with cold compresses.
The majority of diarrhea cases seen in childhood are related to viruses and usually resolve by themselves in 3-6 days. Due to the fact that antibiotics cannot kill viruses, there is no need to use antibiotics in the majority of diarrhea cases. Antibiotics may be required in diarrhea cases accompanied by blood and mucus in the stool, high fever and severe abdominal pain. Antibiotics must not be used unless prescribed by the physician.
In general, there is no need to give any anti-diarrhea drug to children with diarrhea. In addition to these drugs’ not contributing to cessation of diarrhea, they may sometimes lead to serious harm to children.
Do you know these?
- that your child can be protected against diarrhea caused by Rotavirus througha vaccine,
- that Cola increases the diarrhea?
Emergency Unit Supervising Nurse