Diarrhea is a group of digestive tract syndromes characterized by multiple pathogens and multiple factors, characterized by increased stool frequency and changes in stool characteristics. The incidence of infants and young children from 6 months to 2 years old is high, and half of them are within 1 year old. It is one of the main causes of malnutrition and growth and development disorders in children.
Therefore, timely and correct treatment is the key when a child develops diarrheal disease. Let’s take a look at a few key questions about treating diarrhoeal diseases.
1. Should take antibiotics?
The course of diarrhea is called acute diarrhea within 2 weeks. There are many causes of acute diarrhea in children. Viral infections, bacterial infections, dietary factors, and climatic factors can cause diarrhea. However, the main cause of acute diarrhea in children is viral infection. Epidemiological investigations show that viral infection accounts for 87% of all diarrhea, of which rotavirus is the most common.
Therefore, in the absence of bacterial infection, children with diarrhea do not need antibiotics. Otherwise, the application of antibiotics will only lead to increased diarrhea.
When the child has diarrhea, a routine examination of the stool is recommended.
2. Oral rehydration salts, II or III?
Diarrhea is easy to cause dehydration. For children with mild to moderate dehydration, the preferred treatment is rehydration, and the preferred method of rehydration is to take oral rehydration salts. There are currently two oral rehydration salts on the market: oral rehydration salts II and oral rehydration salts III. The former is an iso-osmotic pressure and the latter is a low osmotic pressure.
Diarrhea causes an increase in osmotic pressure in the intestine, and an increase in osmotic pressure in the intestine increases the diarrhea, thereby forming a vicious circle. Therefore, in 2005, WHO and UNICEF jointly published the newly revised Guidelines for the Treatment of Diarrhoeal Diseases, recommending the use of a hypotonic oral rehydration salt formula, Oral Rehydration Salt III.
3. Oral rehydration salt III, how much?
(1) Prevention of dehydration:
After each baby’s diarrhea, a certain amount of fluid needs to be added until the diarrhea stops.
Less than 6 months, 50ml;
6 months – 2 years old, 100ml;
2-10 years old, 150ml;
How much can a child over 10 years old drink?
(2) mild to moderate dehydration
Oral rehydration salt dosage: 50ml/kg at the beginning, taken within 4 hours, and then adjust the dose according to the degree of dehydration of the patient until the diarrhea stops. Infants and young children need to give a small number of times when applying this product.
4. Continue breastfeeding?
Many parents ask, can children not breastfeed if they have diarrhea?
For breastfed babies, it is recommended to continue breastfeeding, increase the frequency of feeding and extend the time of single feeding; artificial feeding children less than 6 months can continue to feed formula, children older than 6 months can continue to eat already used Everyday food. Encourage your child to eat, such as eating less, can increase feeding times.
Avoid feeding your baby’s vegetables and fruits with high-fiber and high-sugar foods.
5. Diarrhea milk powder, when to add?
Diarrhea caused by viral infection often has secondary disaccharidase, especially lactase deficiency, leading to lactose intolerance. Symptoms of lactose intolerance include bowel, increased rectal gas, abdominal pain, and increased diarrhea. In children with acute diarrhea, the incidence of secondary lactose intolerance is 32-77%, of which the incidence of infants less than 1 year old is the highest, and the literature reports 59.1%-71.4%.
Therefore, if you consider your child has secondary lactose intolerance, it is recommended to temporarily give your child diarrhea milk powder, that is, no/low lactose formula. Because diarrhea causes an increase in osmotic pressure in the intestinal lumen, it is necessary to select hypotonic, no/low lactose formula. After 1-2 weeks, the diarrhea improved and then changed to the original feeding method.
6. How to supplement zinc when diarrhea?
Acute and chronic diarrhea often leads to zinc deficiency, which can effectively shorten the course of disease and reduce the incidence. Therefore, children with acute diarrhea need immediate zinc supplementation as long as they can eat.
For less than 6 months, add 10mg of elemental zinc per day;
For more than 6 months, add 20mg of elemental zinc per day;
A total of 10-14 days. The elemental zinc is 20 mg, which is equivalent to 100 mg of zinc sulfate and 140 mg of zinc gluconate.
7. When will I go to the hospital?
For children who have not improved their condition as described above, or if any of the following symptoms occur, they should be taken to the hospital in time.
(1) Severe diarrhea, frequent bowel movements or large amount of diarrhea;
(2) Can not eat properly;
(3) Frequent vomiting and inability to orally administer;
(4) Fever (infant body temperature less than 3 months is greater than 38 ° C; 3 – 36 months of infant body temperature is greater than 39 ° C);
(5) Obvious thirst, found dehydration signs, such as eye socket depression, less tears, dry mucous membranes or decreased urine output, such as irritability, apathy, lethargy, etc.;
(6) Feces with blood;
(7) Premature infants with a history of less than 6 months, with a chronic history or comorbidities.
8. Drugs that need to be banned for children
(1) Ban of norfloxacin (quinolone antibiotics)
Because quinolones can cause bone and joint disease, especially damage to the cartilage of weight-bearing bones, children under the age of 18 and adolescents are banned.
(2) Banned gentamicin oral preparation (aminoglycoside antibiotics)
Because aminoglycosides are prone to deafness in children, they can also cause kidney failure.
(3) Prohibition of furazolidone
Because children are prone to induce hemolytic anemia, especially those lacking glucose-6-phosphate dehydrogenase.
(4) Disabled compound diphenoxylate
Because compound diphenoxylate is a combination of diphenoxylate and atropine, children under 2 years old are banned.
(5) Disabling loperamide
Loperamide is contraindicated in children under 5 years of age. The chemical structure of loperamide is similar to that of haloperidol and meperidine (narcotic drugs), which is stronger and faster than diphenoxylate, and is prone to adverse drug reactions in young children.