What you need to know about your child's diarrhoea

''Doctor, my child has been passing frequent watery, foul smelling stools for the last 3 days'' - is a very common complaint in the out patient children's clinic. Sometimes the children look well, but many times they look very ill and severly dehydrated. Children are at a greater risk of life threatening dehydration than adults when they have diarrhoea, because a larger proportion of their body weight is made up of water, and they use up water more because of their higher metabolic rate. When diarrhoea starts, children are also at risk of malnutrition, as nutrients are lost with water in stools.

According to the World Health Organisation, Diarrhoea (which is when a person passes 3 or more watery stools in a day), is the 2nd commonest cause of death among children under the age of 5years globally. It causes more deaths than malaria, AIDS and Tuberculosis combined. These deaths are caused by severe dehydration and malnutrition

Children can develop dehydration very quickly and its important to act fast to keep them hydrated and well nourished. The following is a list of home care to be given before a child gets to the hospital.

Do !

1. Give a lot of fluids

• Oral Rehydration Solution(ORS) is a prepackaged powder which contains all the electrolytes that your childs body needs to replace what is lost. It can be purchased in any local pharmacy. Mix with clean water(usually 1 litre) according to the instructions on the pack and give your child to drink. It should also be given to children who are exclusively breastfed.
• If you do not have ORS at home and cannot get it immediately, you can prepare Salt Sugar Solution. This is prepared by mixing is 6 level teaspoons of sugar, 1/2 level teaspoon of salt and 1 litre of clean water.
• Other home fluids that can be used to prevent diarrhoea are Salted yoghurt, salted chicken or vegetable soup, salted rice water or clean water.

2. Continue feeding; A lot of people stop feeding their children when they have diarrhoea, fearing that it will make it worse. Diarrhoea leads to loss of nutrients from the body and malnutrition, its outcome is also worse in children who are already malnourished. A strong and well nourished child recovers faster and better from a diarrhoeal episode.

• If your child is less than 6months of age and is being exclusively breast fed, increase frequency of breastfeeding and length of time spent breast feeding your child.
• If your child has started other meals with breast milk, continue breastfeeding as above and encourage your child to eat as often as he/she wants. Small frequent feeds can be given.

Don't !

1. Do not give anti motility drugs. A common example in this environment is Diastop. These drugs may reduce pain and reduce the volume of diarrhoea, but they delay elimination of the organism from the child's body, thus prolonging their illness and this can be harmful especially in children under the age of 1year.
2. Do not stop feeding
3. Do not give antibiotics; Do not give your child over the counter antibiotics for their diarrhoea. Its common for parents to buy flagyl and septrin for their children with diarrhoea, this is a dangerous habit. The commonest cause of acute watery diarrhoea in children is rotavirus. Indiscriminate use of antibiotics may lead to resistance and some are harmful to children. Antibiotics should be given under a doctor's guidance.
4. Do not give sweet drinks like soft drinks, sweet fruit drinks, sweet tea. Foods or drinks with a lot of sugar can worsen diarrhoea.

Other intervention methods like Zinc supplementation and Rota virus vaccination will be given in a health centre. Its important to institute these intervention methods at home as soon as diarrhoea starts and take your child to a hospital for assessment.

Reference: UNICEF/WHO, Diarrhoea: Why children are still dying and what can be done, 2009