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DIETARY MANAGEMENT DURING DIARRHEA AND VOMITING
Rotavirus infections are very common, especially in children under two years old, with watery diarrhea being the most common symptom. Other symptoms include vomiting and fever. Diarrhea may be severe, leading to dehydration.
Diarrhea usually lasts about 3-7 days in most children with rotavirus infection, but some episodes may last as long as two weeks. Although there is no there is no cure or medication for rotavirus infections, treatment with extra fluids is recommended and can prevent dehydration. The main problem from having diarrhea with or without vomiting is that it can lead your child to getting dehydrated. The first sign of dehydration is that your child will urinate less frequently (your child should be urinating every six to eight hours). Other signs include a dry mouth, sunken eyes and decreased activity or increased irritability.
The fluids given need to replace the salts and water lost in the stools and provide a little sugar for energy. Oral rehydration solutions containing these substances as electrolyte or homemade oral rehydration solution can be given.

1.Less than 1 year old:


    Infants with frequent, watery diarrhoea:

    Fluids: Oral glucose-electrolyte solutions for 4-6 hours. Or homemade solution as follows: mix ½ cup of rice powder with 2 cups of water and ¼ level teaspoon of salt.

    Returning to formula : After being given clear fluids for 4-6 hours, your baby will be hungry, so begin her full strength formula or continue with normal breastfeeding but at frequent intervals. If your baby eats solids, give her following starchy foods until the diarrhea is gone: any cereal, strained apple, strained banana, strained carrots, mashed potatoes and other high fibre foods as lot of starch are more easily digested than other foods. Avoid all fruit juices because they make diarrhea worse.

    Infants with mild diarrhoea: -
    Continue regular diet with few simple changes. Give full strength formula as much as your baby wants or continue with normal breast-feeding. If your baby eats solids then offer more rice, mashed potatoes, apple strained, strained bananas and strained carrots.
2.Older children (over 1 year old ):
    With frequent, watery diarrhea: -

    Fluids: give your child water for first 24 hours of watery diarrhoea. (Most toddlers don't need oral glucose-electrolyte solutions unless the child is dehydrated).
    On day 2: offer some milk as well as water. Avoid fruit juices, because they usually make diarrhea worse. If your child refuses solids, give your child milk rather than water.

    Table foods : Keep giving your child table foods while he has diarrhoea. The choice of food is important. Starchy foods are best: examples of such foods are cereal especially rice, bread, crackers, rice, noodles, mashed potatoes, carrots, apple stewed and banana.
    On day 2: if your child some proteins, soft boiled eggs are usually easily digested.

    With mild diarrhoea: -

    Follow a regular diet with simple changes:
    • Eat more foods containing starch.

    • Drink more water. Avoid all fruit juices.

    • Eat or drink less milk and milk products for few days.

    • Avoid beans or any other foods that cause loose bowel movements.
Some homemade oral dehydration solutions:
  • Rice kanji: Boil water and add 30 Gms of rice powder to make solution into a thin liquid. Add one level teaspoon of salt and water to this liquid to make it up to 1 litre.
  • Water, sugar and salt solution: This solution is essential medicine for diarrhoea. It is necessary for adults as well as children. This solution should not taste too salty. Keep this solution in a cool place. Make fresh solution after 24 hrs.
    -  For 1 litre of boiled water, add ¾ teaspoon of salt and 8 level teaspoons of sugar. Mix and taste.
Important reminders:
  • Be Patient: This is a common illness that can last a week or two before resolving on its own.
  • Avoid giving just electrolyte for more than 12-24 hrs.
  • Avoid Medications: Medicines for diarrhoea or vomiting have not been shown to improve symptoms in children and can make them worse. Extra fluids and diet therapy works best.
  • Prevention: diarrhoea is very contagious. Always wash your hands after changing diapers or using the toilet. This is crucial for keeping everyone in the family from getting diarrhoea.
  • Call your paediatrician: If your child is vomiting blood, if diarrhoea is not improved in two weeks or if there is blood or pus in the diarrhoea. Also call if your child is vomiting and has high fever and is unable to retain clear fluids.

 

Last updated on 5-04-2004

 
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