The truth about diarrhoea

It is common belief that children develop diarrhoea when they start growing teeth or walking. However, according to Dr Nestor Mbabazi, a paediatrician at St Jordan Clinic Mpererwe, these are misconceptions.
“Parents associate diarrhoea with growing teeth because children feel some itch in the gum when the teeth start growing. They feel like chewing something and as a result, a child may put dirty objects in the mouth to respond to the demand and the unclean stuff is what causes diarrhoea.”
Acute diarrhoea is that which has lasted for less than 14 days while persistent is that diarrhoea which lasts for 14 days or more. Majority (60 per cent) of acute diarrhoea cases are due to viral infection from food and drinks contaminated with faecal material.
Dr Anthony Batte, a paediatrician at Mulago National Referral Hospital, says children develop diarrhoea at six months to two years.
“Acute diarrhoea can also be caused by bacteria like salmonella. It is the most common cause of food-borne illness. Salmonella occurs in half-cooked food and unwashed fruit and vegetables. The symptoms may include fever, diarrhoea, abdominal cramps and headache.”
Apart from salmonella, E.coli is another bacterium that causes diseases in toddlers. It does not only cause diarrhoea, but can also result in kidney failure and even death.
Adults can also suffer from diarrhoea caused by E.coli, especially those with immune deficiencies.
“Persistent diarrhoea is caused by bacteria and parasites,” Dr Batte adds. “It is common in children who are malnourished, living with HIVAids and measles. Such illnesses lower the child’s immunity.”

Effects of diarrhoea
Dr Mbabazi says diarrhoea makes children dehydrated. “The degree of dehydration is mild, moderate or severe. With moderate dehydration, a child drinks or eats with eagerness. For instance, a child may grab the breast or cup when it is going to be fed. Besides being too eager to eat, a child may have sunken eyes.”
In severe dehydration, a child might become so weak and unconscious. It may also fail to drink or eat.
“Their eyes become sunken. There is no skin turgidity, meaning its skin pinch is very slow. With persistent diarrhoea, a child may go into shock and die. Diarrhoea also causes low blood sugar, malnutrition and salt imbalance which may either go high or low,” explains Dr Batte.
“If a child becomes weak, inactive or loses appetite, it could be signs that it is becoming severely dehydrated. You should rush it to the hospital,” Dr Mbabazi aises.
World Health Organisation (WHO) ranks diarrhoea among the top five child killer diseases. The other diseases include pneumonia, malaria, HIVAids and malnutrition.
Three out of 10 children who go to hospital suffer from diarrhoea. Diarrhoea complicates other illnesses, for instance, a child with diarrhoea may also have malaria.
Diarrhoea is common among children below two years. This is because at that age, children have started eating. They usually eat whatever comes their way, including objects or food from dustbins. However, their immunity is still too weak to fight against diseases.
This exposes them to bacteria that cause diarrhoea.
After two years, the child’s immunity becomes stronger and they are able to fight some diseases.

Dr Mbabazi says a child suffering from diarrhoea should be rehydrated with Oral Rehydration Solution (ORS) and zinc. A sachet of ORS is mixed in a litre of boiled water, and a child is then given five to 10 spoons every after a bowel movement. This helps to keep the baby dehydrated.
Dr Batte says zinc helps to heal the intestinal injuries that a child may have obtained as a result of diarrhoea. Besides, zinc helps to boost the child’s immunity.
“Children below six months should be given a half tablet of zinc per day for 10 days, while those above six months should swallow a full tablet per day for 10 days,” he says.
Dr Mbabazi aises parents to rush their children to hospitals if they do not show any sign of improvement after treatment has been administered.

Mbabazi aises mothers to breastfeed children exclusively for at least six months. Thereafter, they can start feeding the child on milk, porridge and other soft food such as mashed Irish potatoes, beans and minced meat.
Parents should maintain a high level of hygiene by washing hands and the breast before breastfeeding. The breasts should be wiped before they are inserted in the child’s mouth. Wash the utensils used to feed the child.
Dr Batte aises parents to vaccinate children against rotavirus diarrhoea. The vaccine is given before the baby turns six months.
Rotavirus vaccine is not recommended for children above six months because it can cause serious complications.

SOURCE: Daily Monitor


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