Diarrhea Prevention Steps in Children
Treatment and Management in Diarrhea :
1. What should not be used in treatment of acute diarrhoea?
|Combination antibiotics- nalidixic acid+ metronidazole|
2. What are the indication for antibiotics?
|Malnourished or premature infants|
|Gross blood in stool|
|Associated non GI infections e.g. pneumonia|
3. What is the choice of antibiotics?
Ampicillin+Gentamicin in malnourished and prematures.
|- nalidixic acid|
4. What is the dietary management in diarrhoea?
Children should continue to be fed during acute diarrhoea because feeding is physiologically sound and prevents or minimises the deterioration of nutritonal status.
Optimally energy dense foods with the least bulk are recommended for routine feeding and those available in the household should be offered during diarrhoea in small quantities but frequently.
Staple foods that do not provide optimal calories per unit weight should be enriched with fats,oil or sugar e.g khichri with oil, rice with milk or curd and sugar,mashed potatoes with oil and lentil.
Foods with high fibre content e.g coarse fruits and vegetables to be avoided.
In non-breast fed infants, cow or buffalo milk can be given undiluted after correction of dehydration together with semisolid foods. Milk should not be diluted with water. Alternatively milk cereal mixtures can be used.
Outine lactose free feeding is not required in acute diarrhoea even when reducing substances are detected in the stools. Lactose malabsorption meriting dietary modification is very uncommon in acute diarrhoea.
During recovery, an intake of at least 125% of normal should be attempted with energy dense foods till nutritional status is normal as measured for age.
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