Diarrhea in Infants & Children
Diarrhea in infants is usually seen in the 0-5 age group. Diarrhea is defined as an increase in the number of stools per day and a soft, watery appearance of stool consistency deteriorating. Excessive watery defecation is not considered diarrhea unless consistency is impaired. Especially in young infants fed with breastfeeding, the number of defecation changes according to the type of feeding. For example, defecation in the newborn period 5-6 times a day, provided that the consistency is considered normal. This number during the transition poo (days 3-15) may reach 8-10 per day. However, until the end of the first age in the next period, the number of stools is usually 2-3. However, the number of daily stools may increase to 7, especially in normal babies fed with breast milk.
What causes Diarrhea in infants?
In our country, infections are the leading causes of diarrhea. The lack of clean drinking and potable water, unhygienic conditions, failure to observe the cleaning rules in the preparation of meals and foods, lack of hygiene knowledge of the baby carers are the reasons that facilitate the formation of infectious diarrhea.
Another risk factor is unbalanced nutrition. Unbalanced nutrition is the most common carbohydrate excess in the diet. Usually, in the first year of the baby, a diet consisting of flour, over-diluted starch and milk with sugar added leads to insufficient feeding on the one hand and increases the tendency of watery defecation in the intestines. Various bacteria, viruses, parasites and many other causes play a role in diarrhea formation. Rotaviruses are among the most common diarrhea viruses. Acute diarrhea is most common in infants aged 0-2 years in developing countries.
Diarrhea in infants How is it diagnosed?
Infants vary according to the cause of diarrhea. The most common form is diarrhea with infectious agents located in the small intestine. In these diarrheas, the faeces are watery, green or light yellow in color. Excessive water and salt loss caused by it affects the metabolism in a short time. Diarrhea; diarrhea duration, form, vomiting, fever, infant fluid and nutrient intake in the last 24 hours, the last time and amount of urination is important. The general condition is evaluated during the examination. The presence of symptoms such as restlessness, thoughtfulness, remittance, thirst, sucking and vomiting are investigated. Fever, respiratory rate and depth, pulse rate and fullness, as well as blood pressure, skin turgor and tone, collapse of the anterior fontanel and eyeball, dryness of the oral mucosa and tear should be evaluated.
In addition, if there is abdominal distension, bowel sounds, abdominal pain, the location and shape, the amount and color of urine should be carefully examined. Laboratory examinations help in assessing the degree and type of fluid loss due to diarrhea. The presence of blood and leukocytes in microscopic examination of stool is particularly important in the diagnosis of invasive type bowel infections. Demonstration of microorganism antigens and stool culture should also be performed.
Treatment of diarrhea in infants
There have been changes in the treatment of acute diarrhea in recent years. These changes, except in special cases; abandonment of medication, compensating water and salt losses with oral fluid therapy and early discharge of nutrition. Breast milk should be continued in infants. The majority of cases of acute diarrhea show spontaneous recovery within 2-7 days. The main treatment for diarrhea is to replace fluid and electrolyte loss regardless of the cause. Antibiotics are generally ineffective and unnecessary. If blood, mucus and leukocytes are present in the stool or diarrhea does not improve in 7 days, the cause should be determined by stool cultures and antibiotics should be given if necessary.
Large and large amounts of aqueous feces may lead to acute dehydration (loss of fluid) and death if left untreated, especially in young children. The main principle in the treatment of diarrhea is to replace dehydration by replacing water and electrolytes lost from the body; diarrhea continues to cover the loss of water and salt. Dehydration can be prevented if fluid treatment is started early. In all cases of diarrhea with mild to moderate dehydration, except in special cases, oral administration of the liquid is envisaged. One of the main principles in the treatment of diarrhea is early initiation of nutrition. Anorexia is common during diarrhea. Children should not be forced, foods should be given in the form of frequent and small meals.
Breastfeeding is the best and effective way to prevent diarrhea. Breastfed baby has little risk of contact with microbes in the intestine. It also has important protective effects as it contains factors that increase the baby's immunity and maintain proper intestinal flora. Breast-fed infants generally do not have severe diarrhea, and infants with diarrhea who continue to receive breast milk are less likely to develop severe dehydration.
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