An Expert's Tips on Tackling Diarrhoea in Kids - November 2024

Not many of us want to talk about diarrhoea, especially with our kids. But sometimes when those toilet troubles bubble up, it’s time to have the tough talk. We sat down with Nazatul Amira Hamzah from Primabumi Sdn Bhd to learn more about diarrhoea in children. Pharmacist Nazatul Amira Hamzah Nazatul is a qualified pharmacist with 10 years of experience in pharmacy practice involving both hospital and community settings. She currently holds the position of Pharmacist and Key Account Manager at a renowned pharmaceutical company in Kuala Lumpur. Here’s some advice about diarrhoea from a pharmacist that will hopefully help your kids. Q1: What is diarrhoea and how might my child get it? Diarrhoea is a condition where a person experiences loose, watery stool. If it happens three times or more within 24 hours, it can be considered diarrhoea. However, the consistency of the stools matters more than the frequency. Frequent passing of solid stools is not considered diarrhoea. True diarrhoea is often caused by infection by viruses, bacteria, or parasites, food allergies, medication, food additives, and chemical ingestion. The condition can also be caused by viruses. Namely, rotavirus and some groups of bacteria, such as Eschecrichia coli, Salmonella and Shigella. These are the most common culprits of a type of diarrhoea known as ‘dehydrating diarrhoea’ which is responsible for putting dozens of Malaysian children in the hospital every year. Q2: Is diarrhoea dangerous? If diarrhoea goes untreated, severe dehydration can happen as a result of rapid fluid and electrolyte loss. This can be dangerous and fatal, particularly in babies and children. Diarrhoea may also indicate a non-gastrointestinal tract illness. This can include meningitis, bacterial pneumonia, otitis media (infection in the middle side of the ear), and urinary tract infection. Q3: What kinds of diarrhoea treatments are available at a pharmacy? Generally, the first line of treatment for diarrhoea is oral rehydration therapy (ORS). Examples of ORS products that you can easily find at pharmacies may come in the form of fine powder in individual sachets and usually contain nutrients. You’ll find glucose and several salts, such as sodium, potassium, chloride, and citrate, in varying amounts displayed in the ingredients list. When ORS is dissolved in water, the solution is absorbed into the small intestine, replacing water and salt that have been lost in the faeces. Q4: How do I give an ORS solution to my child? First, empty the contents of one ORS sachet into 250ml of cool, boiled water and mix thoroughly. After each loose stool, give the ORS solution to your child using a clean spoon or cup. Do not use feeding bottles. Children under 2 years of age should be offered a teaspoonful every 1 to 2 minutes. Older children above 2 years of age and adults may take frequent sips directly from the cup. Age Amount of ORS after each loose stool ORS to drink in the first 4 hours ORS to drink daily after the first 4 hours 6 months to 2 years 50 to 100ml (1/2 cup) 500ml 500ml 2 to 5 years 100 to 200ml (1 cup) 1000ml 1000ml 5 to 14 years 200ml (1 cup) 1000ml to 2000ml 1000ml 15 years and older As much as needed (1 cup min.) 2000ml to 4000ml 2000ml Source *The table above serves as general guidance on the recommended intake of ORS solution for treating diarrhoea. Please follow the instructions for treatment as advised by your healthcare professional. If your child vomits, wait for 5 to10 minutes before giving the ORS solution again, but more slowly (e.g. one spoonful every 2 to 3 minutes). Once the ORS solution has been prepared, it must be consumed within 24 hours. Q5: Do probiotics help with my child's diarrhoea? Yes, certain probiotic strains can greatly help with diarrhoea. Which probiotic products work well in this case? Some good examples clude Lactobacillus rhamnosus GG, Lactobacillus acidophilus, Saccharomyces boulardii, and Lactobacillus reuteri. These strains are great at helping to reduce the frequency and duration of diarrhoea symptoms as shown in clinical studies. Q6: When do I need to refer my child to a doctor? If your child’s diarrhoea doesn’t stop for more than 12 to 24 hours even after treatment, take them to the doctor straight away. Do the same as well when they start showing any of the following symptoms: dry diaper in 3 or more hours high-grade fever (above 37.5C) bloody or black stool dry mouth or crying without tears unusually sleepy, drowsy, unresponsive or irritable a sunken-looking abdomen, eyes or cheeks skin does not flatten if pinched and released Q7: I myself usually take charcoal tablets when I had diarrhoea and they seemed to work well. Can my children take them too? Treatment of acute diarrhea with charcoal tablets is a popular choice for adult patients. But it has not been shown to be effective in children. It can also be challenging to determine the right dose for a child. Please consult your healthcare provider before giving any medicine to your child. Q8: Does my child need antibiotics? No. Antibiotics are for bacterial infections only and the most common causes of diarrhoea in children is actually viruses. Therefore, treatment with antibiotics will not work and may even be harmful to your child. However, if there really is a need for antibiotics for whatever reason, your doctor will prescribe the proper treatment. Q9: My child has had diarrhoea for more than 14 days. What should I do? When diarrhoea lasts more than 14 days, it is called a persistent diarrhoea. The condition may lead to malnutrition and serious infection, even if it doesn’t cause dehydration. Bacterial infections, lactose intolerance, and food protein allergies (cow milk and soy protein) are the three most common causes of persistent diarrhoea in Malaysia. In these cases, a more thorough investigation of your child may be needed. So, take them to the doctor for a proper check-up. Q10: What are other things I should pay attention to when my child is suffering from diarrhoea? Rehydration is important. Continue feeding your child liquids i.e. breastfeeding or formula if they are still too young for water. You should continue feeding your child for the next 4 to 6 hours after the onset of rehydration. Remember, rehydration and good nutrition are key to your child’s speedy recovery from diarrhoea. Only give your child foods that are well-cooked. Avoid raw fruits, vegetables, dairy food or meat. Also, avoid foods and medications that may trigger allergies in your child. Don't allow them to consume any caffeinated foods or drinks as caffeine may make diarrhoea worse. It may even contribute to dehydration. Lastly, remember to maintain good hygiene practices and keep your children at home while they recover. Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. For more insightful stories and fun recipes, stay tuned to Motherhood Story!

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