Diarrhoea is a common problem in infants and children, but if not managed well, it can quickly turn deadly. It is the second biggest cause of child deaths globally after pneumonia. According to the WHO, more than 2.3 million children below the age of five die in India each year, about 334,000 of which are attributable to diarrhoea. This is a needless tragedy because the illness is easy to prevent and manage.
About 88% of all deaths due to diarrhoea worldwide are attributed to unsafe water, inadequate sanitation and poor hygiene. Diarrhoea is largely a water-borne disease. It is important to keep drinking water clean by boiling, filtering or using chlorine tablets and storing it in hygienic conditions. An awareness and focus on hygiene including washing hands with soap before feeding the child goes a long way in preventing diarrhoea.
Children suffer from diarrhoea when they pass at least three loose or watery stools per day. The condition is mostly due to a gastro-intestinal infection caused by some types of bacteria, viruses or parasites. These are transmitted to humans through contaminated food or water. The most common cause of diarrhoea is the rotavirus. It is responsible for about 40% of all hospital admissions due to diarrhoea among children under five worldwide. Symptoms of diarrhoea include loose or watery stools, vomiting, stomach ache, headache and fever. Acute infections usually last less than a week.
Frequent passing of stools during diarrhoea drains a child’s body of water. This can have serious consequences because 75% of our body weight is made up of water, more so in children. A child suffering from water deficiency (dehydration) shows symptoms like dry and sticky mouth, dark yellow urine or no urine at all, no tears while crying, and cool or dry skin.
It is not diarrhoea which is dangerous for a child but dehydration that alters the body’s natural balance of water and electrolytes. Severe dehydration can cause seizures, organ failure, and brain damage. Children below two years are particularly vulnerable. They can die from dehydration within a couple of days or even earlier. Watery stools flush out several electrolytes and nutrients from the body, including potassium and sodium, without which organs cannot function properly.
The aim of diarrhoea treatment is to prevent dehydration by continuously replenishing the child’s body with water and electrolytes. Water is an important element in rehydrating the body, but it doesn’t have sufficient amounts of electrolytes which the child badly needs. The appropriate treatment for diarrhoea includes oral rehydration therapy, zinc, Vitamin A and Folate supplementation and continued feeding.
Packets of oral rehydration salts (ORS) are widely available. When mixed with safe water and fed to the child, the ORS drink rehydrates the body and supplies salt and electrolytes in sufficient quantities. Doctors say that ORS should be immediately begun with the very first vomiting or loose stool. Zinc supplementation helps decrease the severity and duration of diarrhoea. Zinc and ORS are recommended by the World Health Organization for the treatment of simple diarrhoea in children. These together can prevent most diarrhoea-related deaths.
A very important aspect of managing diarrhoea is diet. The child, if breastfed, needs continued feeding. Many mothers think giving water to a child would worsen diarrhoea or that the stomach needs “rest” from eating to recover. These are dangerous myths that may turn counterproductive in terms of a healthy recovery.
Breast-fed infants suffering from diarrhoea need to be breast-fed more often to replace the lost fluid and essential nutrients. For those children who can eat, the food should be non-spicy and easy digestible. Boiled white rice and preparations made from it like khichri of moong dal, idli, rice kheer and rice kanji are very beneficial. There is evidence to suggest that rice-based cereals help better manage persistent diarrhoea along with fluid and electrolyte replenishments. By complementing ORS with rice-based cereals with reduced lactose content, one not only rehydrates a child, but also shortens the duration of diarrhoea, cuts down the stool volume and reduces the frequency of diarrhoea and vomiting, thereby helping in the management of diarrhoea holistically.
Avoid foods high in fiber, fat or grease that are hard to digest, such as daliya, whole wheat flour, whole dals (dals with husk), dairy products like ice cream and cheese (except curd), peas, beans, citrus fruits and others like apple and guava. Sugar-rich foods like cake and cookies should not be given. Concentrated fruit juices can make diarrhoea worse. The bland diet should be continued for about three to four days after the diarrhoea has stopped to ensure full recovery.
Children with poor health who do not get adequate nutrition are more vulnerable to diarrhoea and suffer many episodes every year. Recurrent diarrhoea in early childhood may have long-term effects like stunting and developmental delays caused by poor nutrients absorption by the body. Exclusive breastfeeding for the first six months of life prevents diarrhoea and deaths related to infections,” says Dr. PP Maiyya, Consultant Pediatrician, Agadi Hospital, Bangalore.
There is nothing worse than watching a child suffer from non-stop diarrhoea. Fortunately, the illness is not life threatening if managed properly. With ORS, zinc supplementation and the right type of diet, the child can make full recovery in a matter of days.
No comments:
Post a Comment