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Watching children's health when diarrhea, dehydration occur
Have you ever wondered what a large pinch of salt, a fistful of sugar and a jug of clean water can do for you? Some of you might guess it right - especially intrepid travelers -but many would not have the slightest idea that this is the simplest recipe for an oral dehydration solution - a recipe that could save the life of a child with diarrhea
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ave you ever wondered what a large pinch of salt, a fistful of sugar and a jug of clean water can do for you?
Some of you might guess it right - especially intrepid travelers -but many would not have the slightest idea that this is the simplest recipe for an oral dehydration solution - a recipe that could save the life of a child with diarrhea.
In a 2006 survey conducted by the Rotavirus Vaccine Program (a charity based in Seattle, Washington) 40 percent of the 29 child-health specialists at major international development agencies named AIDS, tuberculosis and malaria as the three greatest childhood killers. But in fact, the top three are pneumonia, diarrhea and malaria.
Worldwide there are 1.9 million deaths among children under the age of five every year due to diarrheal diseases. According to WHO, about two-thirds of these (1.3 million) occur in 15 countries in Asia and Africa. While diarrhea is no more than just an irritant in the advanced world, it is a major killer in developing countries - killing more than 5,000 young children daily. These deaths are largely preventable and unnecessary.
But why is the situation still not improving in the developing countries?
One of the main reasons is simply that this problem is not getting the attention it deserves. Other reasons include inadequate health facilities in developing countries, lack of clean water, lack of infrastructure to ensure public health and possibly because these children were born to parents who are unfamiliar with the oral dehydration solution above.
Causes of diarrhea can be both infectious and noninfectious etiologies, including bacteria, viruses, parasites and contaminated chemicals/toxins. The major mechanism of transmission for the pathogens is fecal-oral (from thumb sucking and picking up things from the floor), with food and water being the vehicles for most episodes. Washing hands, and drinking and eating cooked food are key points in preventing diarrhea.
Most cases of diarrhea in children are caused by one of the viruses and go away by themselves within a week. Symptoms may include loose stools and vomiting with or without fever. Anti-diarrheal compounds are generally not recommended for use in children with diarrhea because of their minimal benefit and potential for side effects.
Your child needs to be evaluated if he or she is less than 6 months old or has any of the following:
Blood in stool
Frequent vomiting
Abdominal pain
Infrequent urination (wets fewer than six diapers per day)
No tears when crying
Loss of appetite for liquids
High fever
Frequent diarrhea
Dry, sticky mouth
Weight loss
It is not necessary to call your pediatrician if your child continues to look well even though there may be:
Frequent or large stools
Lots of intestinal gas
Green or yellow stools
Most of the time mild diarrhea lasts from three to six days. Occasionally a child will have loose stools for several days longer. As long as the child acts well and is taking adequate fluids and food, loose stools are not a great concern.
Most children should continue to eat a normal diet including formula or milk while they have mild diarrhea. Breastfeeding should continue.
Children with moderate diarrhea can be cared for easily at home with close supervision and special fluids. Your pediatrician will recommend the amount and length of time that special fluids should be used. Later, a normal diet can be resumed. Some children are not able to tolerate cow's milk when they have diarrhea and it may be temporarily removed from the diet. Breastfeeding should continue.
Special fluids have been designed to replace water and salts lost during diarrhea. These are extremely helpful for the home management of mild to moderately severe illness and are widely available in nearly every drug store. Home remedies including decarbonized soda beverages, fruit juice, Jell-O, cool-aid and tea are not suitable for use because they contain inappropriately high amoralities.
If your child develops the warning signs of illness listed at the beginning, he or she may require IV fluids to correct dehydration. Immediately seek your pediatrician's advice for the appropriate care if symptoms of severe illness occur.
Dos and Don'ts for children with diarrhea:
Dos
Watch for signs of dehydration that occur when a child loses too much fluid, which may include a decrease in urination, no tears when crying, dry mouth, weight loss, extreme thirst, listlessness and sunken eyes.
Tell a doctor if your child has blood in the stools
Tell a doctor if your child develops a high fever (more than 102 degrees Fahrenheit of 39 degrees Celsius)
Continue to feed your child if he or she is not vomiting. You may have to give your child smaller amounts of food but more frequently.
Use diarrhea replacement fluids that are specifically made for diarrhea if your child is thirsty
Don'ts
Prevent the child from eating if she is hungry.
Use "anti-diarrhea" medicines unless prescribed by your pediatrician.
This article was contributed by Samitivej Hospital, an internationally recognized hospital in Thailand and a service provider of medical tourism in Southeast Asia.
cFlyFreeForHealth2009
Articles in this column, which appears every two weeks, are provided by a panel of doctors from www.flyfreeforhealth.com, a leading multimedia medical tourism platform dedicated to providing adopters of healthy lifestyle with travel and lifestyle incentives. Email us at info@flyfreeforhealth.com. Join our free online seminar on "Back, Neck and Shoulder Pain" today at 16.00 WIB by SMSing your email address to +65 98473224 to get the link invite.
