EXPERT ADVICE: Help, my child has diarrhoea!

Frequent loose stools can be extremely troubling, especially in a young child. A paediatrician tells you how to treat diarrhoea.

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If your child keeps visiting the toilet and complains of loose stools, he may be suffering from diarrhoea.

One mother, Pauline Chua, says that her 3-year-old son, Jeremiah, had a mild case of diarrhoea after he started preschool. “It wasn’t very severe, so he was going about four or five times a day, but the stomach pain would come on suddenly and he would cry,” she said.

Since he seemed fine otherwise, she held off taking him to the doctor, and only went to the paediatrician about a week after the loose stool started. “He was still active and had a good appetite, but I started to get worried about him being dehydrated,” Chua adds.

Jeremiah’s bout of diarrhoea came at a most inconvenient time, Chua says. “We had just seen some progression in his toilet training, and he was off diapers during the day at home. But when he fell sick, we had to put him in diapers again.”

“If they do get diarrhoea when they are teething, it is usually due to a mild infection caused by the child putting things into their mouths.”

The diarrhoea lasted about two weeks. After Jeremiah got better, Chua says that because her son was not used to going diaper-free, they pretty much had to start from square one.

Causes of diarrhoea

Dr Ong Eng Keow, a paediatrician at International Child and Adolescent Clinic at Mount Alvernia Hospital, explains that diarrhoea is usually caused by an infection. “This can either be viral or bacterial. Sometimes, children can also get a bit of loose stools when they are on antibiotics,” he says.

For babies who are breastfeeding, it’s normal to have loose and watery stools. Dr Ong adds that there’s diarrhoea if the runniness is beyond the usual looseness, or if there is blood in the child’s stools.

In addition, he debunks the myth that teething causes diarrhoea. “If they do get diarrhoea when they are teething, it is usually due to a mild infection caused by the child putting things into their mouths,” he says.

When a child has diarrhoea, he usually has three or more watery bowel movements a day. For more serious cases, the number of loose bowel movements could be 10 or even more. You might see veggie bits or food from your tot’s recent meals in his stool ― such as tiny pieces of carrot or sweetcorn. The stools may also be smellier or paler than usual.


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Other symptoms

Your child’s appetite may be affected and complain of a tummy ache. “He might find some relief from the pain when he poos, but the pain may come back after a while,” Dr Ong says.

The diarrhoea can also be accompanied by fever, vomiting and bloody stools, adds Dr Ong. “All these are red flags and the child should be reviewed by a doctor. They should be monitored for their fluid intake during the illness.”

Since the severity of diarrhoea varies, do know when you should bring your child to the doctor. Dr Ong says that if your baby is less than 6 months old, a doctor’s visit is required. “For older children, you can observe the child for one or two days if he is feeding well without a fever, vomiting and bloody stools.”

Treatment

Usually, no medication is needed, especially if the diarrhoea is mild. Dr Ong explains, “If the infection is viral, it will eventually resolve. Occasionally, antibiotics may be required if there is a bacterial infection. Even then, not all bacterial infections need antibiotics. Giving of probiotics and other medicine like Racecadotril may be used in the treatment of childhood diarrhoea.”

“Fluids are more important than solids and parents should give the child small amounts of fluid frequently.”

What is more important during this time, is to keep your little one hydrated. “Fluids are more important than solids and parents should give the child small amounts of fluid frequently,” Dr Ong says. So, offer 60 to 100ml every half hour to hour.

The fluids may be in the form of oral rehydrating solutions, or isotonic drinks if the child is older. For infants, boiled rice water is a good alternative. Dr Ong also suggests reducing the intake of veggies and fruits during an acute episode. “Simple foods like porridge and bread is good. Give half a portion, more frequently.”

If your child isn’t passing urine often, losing weight, shows signs of a dry tongue, eyes and lips, or looks particularly lethargic and tired, he may be dehydrated. Increase his fluid intake, or bring him to the doctor for more advice.

Preventions

Proper hygiene is the key to preventing diarrhoea episodes among children. Diarrhoea usually occurs when the virus or bacteria is ingested and causes the infection. As such, parents should start inculcating good hand hygiene habits from young.

“Help the child avoid thumb sucking and pacifier habits. Always clean and wipe their hands before consuming any food. For infants less than 6 months old, proper sterilising of feeding equipment, and preparing of milk is most important,” says Dr Ong.

Photos: iStock

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