Introduction:During a day at the beach a few summers back, Karen Schneider spent most of her time tending to her
two-and-a-half year old son Jeffrey in the toilet. “He told me his tummy hurt and we went to the washroom and he had an explosion in the toilet,” recalls Schneider. “We cleaned up and went back to the beach and within 10 minutes he had to go again. Back up we went, same drill.” Schneider wasn't sure what caused Jeffrey's diarrhea but after several trips to the toilet, he was feeling better the next day. Here's what you need to know about the symptoms and causes of diarrhea, how you should treat it at home, when to take your child to the doctor and what you can do to prevent it.
Symptoms When a child has diarrhea, bowel movements are loose and watery and occur more frequently than usual, says Dr. Joseph Gigante, a pediatrician at the Monroe Carell Jr. Children's Hospital at Vanderbilt in Nashville, Tenn. There is a wide range of diarrhea—it can be mild (one or two watery stools) or severe (10 watery stools in a day). With diarrhea, the stool may be a different colour than usual and there may or may not be blood in it. It's also not uncommon for a child to have some vomiting alongside the diarrhea.
Causes These are some of the possible causes of diarrhea in children: Viral infections: “In younger kids, rotavirus is the most frequent cause of severe diarrhea and dehydration in the world,” says Dr. Neuspiel. These infections occur when children are together in large groups, such as daycares and schools. “Rotavirus is much more of a killer of younger kids in underdeveloped countries in Africa and elsewhere. It's very common in the US and fortunately doesn't cause many deaths but it does cause dehydration.” As children get older, other viral infections can also cause diarrhea. Bacterial infections: At any age, bacteria, such as salmonella, shigella, campylobacter and E. coli can cause bloody diarrhea. “They're less frequently the cause of diarrhea in kids, but they can be more serious,” says Dr. Neuspiel. “Contaminated food and water in certain tropical countries could lead to some of these infections, but it's also not uncommon to pick them up in the US.” Food intolerance: While infections are the most common cause of diarrhea, occasionally diarrhea is due to a food intolerance or allergy,” says Dr. Joseph Gigante. Chronic diarrhea may be related to lactose intolerance (an inability to digest lactose), which would typically start to show up in early childhood, according to Dr. Neuspiel. And cow milk protein allergy can also cause diarrhea. Antibiotics: “Probably one of the most common side effects we see in children treated with antibiotics is the diarrhea that follows,” says Dr. Gigante. “Antibiotics not only treat whatever the child is infected with but will also sometimes kill some of the normal bacteria in the gut that help digest food, which leads to diarrhea.”
Treatment “
Most of the time, kids with diarrhea can be treated at home,” says Dr. Gigangte. Here's how: Focus on fluids: “ When children have diarrhea, they are losing more liquid than usual and they need to replace it so they need to drink more than the usual amounts of fluid,” says Dr. Neuspiel. “To make up for fluid losses, typically we'd recommend an oral rehydration solution, such as Pedialyte, which contains water and electrolytes to maintain hydration.” While infants tend to be okay to take in these solutions, which taste like salt water, toddlers and preschoolers may not like the taste of them. “Add a little unsweetened Kool-Aid to give it a better taste,” says Dr. Gigante. “Because of its high sugar content, fruit juice makes diarrhea worse so we don't recommend that.” Make diet changes: “If diarrhea is really mild—just one or two loose bowel movements, I usually don't tell parents to change the diet,” says Dr. Gigante. “If the diarrhea is more severe, once I get thr fluids in, I'd slowly return to regular foods which are easy to digest.” Assuming the child is not vomiting, that means clear liquids and the BRAT diet: bananas, rice, applesauce and toast. “These foods might improve the diarrhea and help avoid more significant diarrhea and dehydration,” says Dr. Neuspiel.
Prevention Cut your child's risk of getting diarrhea with these simple strategies:
Lather up: “Hand washing is probably the most important way to prevent all types of infectious diarrhea,” says Dr. Neuspiel. That includes encouraging hand washing in children and ensuring that the people who come in contact with them are also careful about washing their hands. “When parents are investigating day care centres, I suggest that they look at the hand washing practices.”
Practice safe cooking: “Salmonella and campylobacter are commonly present in raw chicken and eggs so it's really important to be careful handling meats and cook eggs well for young children,” says Dr. Neuspiel. “Some people are careful to cook chicken well but then use the same utensil to turn over the raw chicken as they use to put it on a plate, re-contaminating it with something like salmonella.”
Get the vaccine: Talk to your child's paediatrician about Rotateq, the new
rotavirus vaccine, which is very effective, says Dr. Neuspiel. It's given to infants in three intervals, at two, four and six months.