Diarrhoea – A WonderBaba Guide for Parents
What it is and what causes it?
Diarrhoea is classed as the passing of frequent unformed watery stools three or more times a day and usually clears up within a few days. It’s also worth pointing out that breastfed babies generally have looser stools than formula-fed babies and this is completely normal and not classed as diarrhoea unless the stools become watery. Diarrhoea is usually nothing to worry about but there are a few things you need to know and I will give you the signs to look out for which may require medical advice. Generally when you suffer from diarrhoea there are a number of other symptoms that you may experience at the same time and your child will be no different, these include stomach cramps, nausea, vomiting, headache, loss of appetite, dehydration and a high temperature of 38°C or above. There are a number of things that cause diarrhoea including viruses (also known as a stomach bug and this is generally more common in bottle fed babies), bacteria (E.coli or salmonella which cause food poisoning), or parasites (more common when travelling to foreign countries and drinking contaminated water)
Tips and treatments
It is important to keep your little one hydrated with liquids containing water, sugar and salt. In Ireland Dioralyte is sold in sachets for use in children one year old and over. If your infant is under one year then you will need to seek medical advice before you can give Dioralyte as children under one can become dehydrated quickly and extra caution is needed. Dioralyte is used to replace the salt, glucose and other minerals that are lost during episodes of diarrhoea and vomiting. It is important to make these up as per the manufactures instructions (dissolve in 200mls of fresh drinking water or freshly boiled and cooled water – this can be kept in the fridge for up to 24 hours or used within one hour if stored at room temperature). For tips of giving your child Dioralyte read my blog here – https://wonderbaba.ie/2015/06/22/how-to-get-your-toddler-to-drink-dioralyte/
- If you are breast or bottle feeding then continue to feed as normal and visit your doctor if your child shows any signs of dehydration (described at the end of this blog). You should give oral rehydration sachets (Dioralyte) in between feeds or after each watery stool but don’t stop giving your baby milk.
- If you child won’t drink Dioralyte then you can use flat 7up (boiled and cooled to remove the fizz). Avoid giving fruit juice or fizzy drinks as these can make diarrhoea worse.
- Keep an eye on how many wet nappies your child is having – if they are persistently dry contact your doctor as this can be a sign of dehydration.
- Monitor the colour of the urine, which should be a pale yellow colour, if your baby’s urine turns a dark yellow or brown colour this indicates that they are getting dehydrated and you will need to contact your doctor for advice.
- Your child may not have much of an appetite and if they are dehydrated then it’s important not to give solid food until they have drank enough fluids and signs of dehydration have gone. If your child isn’t dehydrated and they want to eat then offer small light meals often and don’t worry if they don’t eat much.
- Use foods you know they like but avoid fatty or spicy food as this will only make the diarrhoea worse. I would try starting off with potatoes, rice, bananas, soup or salty foods as these will help the most.
- The advice for children has always been to make sure they are hydrated but now there are two products you can use along with the rehydration sachets to try and stop diarrhoea in children. One is called Tasectan (available at http://www.milltownpharmacy.ie/p/tasectan_sachets ). It comes in a paediatric powder that can be added to water or milk (remember to read manufacturer’s instructions before use). Tasectan is a safe treatment with no side effects for babies and children and is usually effective within 12hours. It restores the physiological functions of the gut wall and will shorten the duration of diarrhoea. It is suitable from 2 years of age but can also be recommended by your pharmacist for children under 2 years but will require a consultation. This is only designed to stop diarrhoea so remember to make sure you are giving plenty of fluids as it won’t prevent dehydration. The second product is Dioclear which contains a natural clay called Diosmectite. This absorbs water and binds diarrhoea causing substances which reduces the fluid in the stools and so stops the episode. It is safe for the whole family to use from one year of age and tastes nicely of orange. (available online from http://www.milltownpharmacy.ie/p/dioclear )
- I mentioned earlier in the post that your child may get a high temperature (see my blog on temperatures here – https://wonderbaba.ie/2015/01/12/temperatures-what-they-are-and-how-to-treat-them/ ) while suffering from diarrhoea and if this is the case then you can use calpol or nurofen (following the manufacturer’s instructions) but this will not help stop diarrhoea or dehydration so is important to keep giving fluids as directed above. Fever can sometimes be a result of a bacterial infection and if the temperature doesn’t improve you will need to seek medical advice.
- Diarrhoea is very infectious so to help prevent the spread of diarrhoea it is recommended staying at home during the infection and for 48hours after the last episode of diarrhoea, you should wash hands with liquid soap in warm running water and dry hands regularly, keep toilets and all surfaces clean and wash hand towels frequently. If you are using formula feed then make sure to sterilise bottles before use. It’s also not recommended to take your child swimming for two weeks after last episode of diarrhoea.
- To help avoid diarrhoea when travelling to a foreign country- avoid tap water, ice cubes, raw or undercooked meat/seafood, uncooked eggs, mayonnaise, unpasteurised milk and dairy products (cheese etc) fruit and veg with damaged skin and salads.
- Probiotics may reduce chances of developing diarrhoea after taking antibiotics and if you are interested in taking these then see my blog on probiotics here : https://wonderbaba.ie/2014/11/24/the-pros-of-probiotics/
My favourite probiotic for babies is http://www.milltownpharmacy.ie/p/biokult_infantis_16pk_sachets
There are a number of signs that will require you to seek medical attention. If your little one experiences any of these then you will need to contact your doctor or out of hours service:
- Persistent vomiting
- Severe or continuous stomach ache
- Six or more episodes of diarrhoea in 24hours
- Dehydration- signs include drowsiness, passing urine less frequently and feeling lightheaded or dizzy, babies may become lethargic or irritable, have dry mouth, their skin may become loose, pale or mottled, their eyes and fontanelle (soft spot on top of their head) may become sunken and they may have cold hands/feet.
- Blood in stools indicated by dark or black stools could be caused by internal bleeding
- Persistent diarrhoea that lasts more than 24-48 hours (24 hours in children under one year)
If you are unable to get fluids into your baby or child and they become dehydrated then your doctor or hospital will give fluids and nutrients intravenously, which will make them feel much better, but hopefully if you follow the advice above it won’t get to this stage.
If at any point you are concerned or would like more information or one to one advice don’t hesitate to contact me through the WonderBaba Facebook page by private message or at Milltown totalhealth Pharmacy on 012600262 – as a parent I completely understand the fear and anxiety that arrives when your little one is unwell and that is why I am always happy to help parents – even if it’s just for a little reassurance!