Diarrhea in children

Children have diarrhea in order to protect the body and this is a natural systemic reaction. It is the reaction of the intestine to rid itself of the substances or microorganisms that enter and infect it. However, when diarrhea is severe, electrolytes and water, which are the main composites of the body, can escape as well and cause dehydration. Therefore, it is important to ensure that children are not dehydrated when they have diarrhea.

Infants need to continue having breast milk even if they have diarrhea, so they can continuously receive the required supply of nutrients. When infants feeding on milk powder have diarrhea, it is important that they also continue to have what they are normally fed, without stopping or thinning the milk by adding water. A child eating food must also continue to have the food while they have diarrhea. While the child has diarrhea, food that has less of a burden on the intestine should be consumed, such as rice porridge, rice, persimmon, banana, apple and toast; while foods such as potato, beef, chicken and animal fat are not recommended in the initial stages of diarrhea.

To correct the dehydration, electrolyte solutions are used and this solution can be bought at a pharmacy with a pediatrician’s prescription. Currently, electrolyte solutions available on the market come in the form of a powder to add to water, and as a ready-mixed solution.

With the powdered solution, the correct amount of boiled water needs to be mixed according to the instructions. The consumption of electrolyte solution is as follows: Give approximately 30 cc every 20 minutes, three times. If the child is able to take the solution well, increase the amount of the solution to 60 cc with the same interval for three times. This process should be repeated while increasing the solution by 30 cc each hour. The electrolyte solution can be given in a milk bottle or on a spoon if the child is unable to consume the solution well. In the case where dehydration is not severe for the first four to six hours, 50-100 cc of the solution should be given for each kilogram of the child’s weight (e.g. a 10-kg child will take 500-1,000 cc) and every time the child has diarrhea, the solution should be given as a supplement.

If diarrhea is severe, the loss of electrolytes and water through diarrhea or vomit can be supplemented by giving 10 cc for each kilogram of the child’s weight (e.g. a 10-kg child will take 100 cc) every time the child has diarrhea. If the child refuses to take the electrolyte solution by mouth, barely urinates, has a rapid pulse, hollow eyes, reduced skin elasticity, the skin feels cold or the child vomits severely, then the child must be taken to the hospital.

In addition, if the child vomits but barely has diarrhea, has severe stomach pain, large amounts of blood mixed with the feces and has a severe fever, the child must be taken to a children’s hospital and a pediatric gastroenterologist consulted.

By Choi Yeon-ho

The author is a doctor at the Department of Pediatrics at Samsung Medical Center and a professor of Sungkyunkwan University School of Medicine. ― Ed.