4th Pediatric Infectious Diseases Conference
 
 
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Acute Diarrhea in Children
ACUTE DIARRHEA
WHO ORS
WHO ORS
How much to give ?
Guidelines For How Much to Give ORS
Less than 24 mths of age:- 50-100 ml per loose stool


Guidelines For How Much to Give ORS
2-10 years of age:- 100-200 ml per loose stool

Guidelines For How Much to Give ORS
More than 10 years of age:- as much as required
How to give
How to Give ORS
One teaspoon every 1-2 mins for child less than 2 years and frequent sips from cup for older children. If the child vomits, wait for 10 mins and give slowly.

What are the DANGER SIGNS ?
Danger Signs For Acute Diarrhea
Danger Signs For Acute Diarrhea
Many water stools

Danger Signs For Acute Diarrhea
Repeated vomiting

Danger Signs For Acute Diarrhea
Marked thirst

Danger Signs For Acute Diarrhea
Eating or drinking poorly

Danger Signs For Acute Diarrhea
Fever- high grade

Danger Signs For Acute Diarrhea
Blood in the stool

Danger Signs For Acute Diarrhea
Drowsy child

Danger Signs For Acute Diarrhea
Marked decreased urine output

What are the indications for antibiotics ?
Indications For Antibiotics
Indications For Antibiotics
Malnourished or premature infants

Indications For Antibiotics
Gross blood in stool

Indications For Antibiotics
Associated non GI infections e.g. pneumonia

What should not be used in treatment of acute diarrhea?
Acute Diarrhea Treatment
Acute Diarrhea Treatment
Adsorbents-kaolin, pectin

Acute Diarrhea Treatment
Motility suppressants-opiates

Acute Diarrhea Treatment
Steroids

What is the dietary management in diarrhea ?
Acute Diarrhea Dietary Management
Acute Diarrhea Dietary Management
Children should continue to be fed during acute diarrhea because feeding is physiologically sound and prevents or minimizes the deterioration of nutritional status.

Acute Diarrhea Dietary Management
In acute diarrhea breast-feeding should be continued with ORS uninterrupted even during dehydration.

Acute Diarrhea Dietary Management
Optimally energy dense foods with the least bulk are recommended for routine feeding and those available in the household should be offered during diarrhea in small quantities but frequently.

Acute Diarrhea Dietary Management
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, mashed oil and lentil.

Acute Diarrhea Dietary Management
Foods with high fibre content e.g. coarse fruits and vegetables to be avoided.

Acute Diarrhea Dietary Management
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.

Acute Diarrhea Dietary Management
Routine lactose free feeding is not required in acute diarrhea even when reducing substances are detected in the stools. Lactose malabsorption meriting dietary modification is very uncommon in acute diarrhea.

Acute Diarrhea Dietary Management
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.


Last created on 13-12-2002
Last updated on 18-11-2006
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