Diarrhoea in Infants

Diarrhoea is the rapid movement of faecal matter through the intestine, resulting in poor absorption of water and nutrients, and producing frequent, watery stools. Most babies have frequent, loose bowel motions, which are normal. Diarrhoea becomes a problem if the child is vomiting, feverish, irritable, not gaining weight, not eating or passing blood in the stool.

TODDLER'S DIARRHOEA is also called chronic nonspecific diarrhoea. It involves persistent diarrhoea in an otherwise healthy toddler. The cause is unknown but it is often related to the ingestion of food such as excessive sugar, fat or fruit juice. Dietary modification usually helps relieve the symptoms, which will clear up over time.

INFECTIVE DIARRHOEA is also called gastroenteritis or "gastro". It is caused by bacteria, parasites or a virus and is spread from person to person by faecal/oral contact. The motions are frequent, watery and foul smelling, and may be streaked with blood. The child feels sick, is feverish, dehydrated and vomiting and loses weight rapidly. Hospitalisation for treatment and fluid replacement may be required. See your Doctor immediately to prevent severe dehydration.

DEHYDRATION
This can occur very quickly with infants who are suffering from Diarrhoea. Signs to look for include:
1. Decreased or concentrated (dark coloured) urine.
2. Decreased skin elasticity (when the skin is pinched, it stays up for a while).
3. Drowsiness or floppiness.
4. Fontanelle (soft spot in front of the head) sunken more than usual.
5. Sunken eyes.
6. Dry mouth and tongue or no tears.

CHRONIC DIARRHOEA
This particular type of Diarrhoea is associated with other diseases such as Cystic Fibrosis, Coeliac Disease and Lactose intolerance. Treatment of the underlying disease may help relieve symptoms.

REDUCING THE RISK
Hand washing is the most important rule for stopping the spread of infection. Hands should be washed before and after toileting, food preparation, nappy changes, touching pets and gardening. Keeping a baby away from other children with Gastroenteritis may help to reduce the risk of infection.

Baby bottles of formula should be made up as they are needed and not stored for more than 24 hours. Any milk left over after a feed must be discarded as bacteria from the mouth can enter the bottle and breed. Sterilising bottles, teats, dummies and all implements used for formula preparation is recommended to prevent spread of bacteria.

TREATMENT OPTIONS
As with all conditions, your Doctor should be consulted. Young babies with Diarrhoea become ill very quickly and medical advice should be sought if the following occurs:
1. The baby is less than 3 months old (or less than 6 months old if premature birth).
2. The infant is persistently vomiting and unable to keep fluids down.
3. The child has numerous (more than 10) watery motions a day, especially if they contain blood.
4. The child shows signs of dehydration.
If the child vomits persistently (i.e. every 30-60 minutes), give frequent small amounts of fluid. If this is unsuccessful, see your Doctor.

DIET HINTS
• Avoid fluids such as lemonade, cola, orange juice, sport drinks and full-strength fruit juice, as the high sugar content of these drinks can draw more water into the gut and worsen diarrhoea.
• Continue breast-feeding as normal.
• Encourage infants to drink plain water or water mixed with a rehydrating solution available from your Pharmacy to help replace the electrolytes lost in Diarrhoea.
• The BRAT diet (Banana, Rice, Apple and Toast) is recommended for children who are eating solids.
• A good rule of thumb with Diarrhoea is to eat foods, which are the same consistency as the stools being passed e.g., if stools are watery, drink only water until the stools become firmer.