Runny Tummies – When Is Medical Attention Necessary?

DiarrhoeaInfants, toddlers and preschoolers are prone to runny tummies and there will come a time when moms will wonder if the spate of diarrhoea warrants a visit to the doctor.  Toddlers (and definitely infants) can become dehydrated very quickly and moms will need to ensure that a runny tummy is quickly treated in order to prevent dehydration.


What causes diarrhoea?

There are a several causes for an upset tummy and these may include bacterial infections, viruses, or a parasitic infection. In some cases, diarrhoea may be as a result of intolerance to certain foods, such as intolerance to lactose. Diarrhoea is the body’s way of ridding itself of the germ or virus, or where food intolerance is the cause – ridding the body of the intolerable food.

One of the most common causes of diarrhoea in toddlers and infants is a gastroenteritis, or stomach flu. The flu is very contagious and can be passed quickly and easily from kids (especially those who attend crèches or day-mothers).  A runny tummy may also result if the child is taking a course of antibiotics and this can be corrected by administering Interflora (available at all pharmacies), or yoghurts which have live cultures and will correct the balance of good and bad bacteria in the tummy.

Adults are not immune to stomach flu or diarrhoea, but due to the fact that infants and babies can become quickly dehydrated (as the diarrhoea will cause them to lose electrolytes) – diarrhoea (if left untreated) is often deemed as a serious – even fatal – condition in kids under 3, and especially in infants.  Electrolytes are essential for normal functioning of the body’s cells and organs.

Before panic kicks in, parents can try a number of -at home’ treatments for diarrhoea. If, however, these treatments are not able to effectively stop the diarrhoea, parents are urged to consult a medical professional. If diarrhoea is not treated swiftly in infants or toddlers, the loss of fluids will cause their body to dehydrate and this can be fatal.


Treatment for runny tummies

Besides treatments to stop the diarrhoea, it is very important that the fluids that are lost because of diarrhoea are replaced. The best method to do this, is to purchase an over-the-counter rehydration formula (such as Rehydrate) which contains a balance of sodium and potassium and will replenish the depleted electrolytes. An easy rehydrating solution can also be made at home that will replace the lost electrolytes and this is done by boiling a litre of water and adding a half a teaspoon of salt and six teaspoons of sugar. The solution is cooled and offered frequently to the baby or toddler. It is important to bear in mind these rehydrating solutions are not intended as cures for diarrhoea, but only offer symptomatic relief and will ensure that children remain hydrated. The hope is that the tummy will settle and the diarrhoea will end.

Moms who are breastfeeding infants should continue to breastfeed a baby with diarrhoea, but in addition will need to offer them the rehydrating solutions together with breast milk. Bottle-fed infants should be given rehydrating solution and only offered a feed four to six hours after the solution has been administered.

Toddlers who have diarrhoea must only be given foods that are very bland, like mashed potatoes (do not add milk), steamed vegetables, etc. Foods and drinks that that should not be given to a child with a runny tummy include dairy and fried or fatty foods. Yoghurts that contain live bacterial cultures may help to ease and settle the upset stomach. A lot of children who are unwell will generally not want to eat and even though foods are important, fluids are critically important and a child with a runny tummy must always be offered fluids. Besides the rehydrating solutions, kids may be encouraged to drink water or apple juice – avoid fizzy drinks, glucose drinks, etc.

In addition to the systematic treatment of diarrhoea, parents will also need to pay extra attention to a nappy rash which may be caused by the diarrhoea and the frequency of the stools. An infant with a soiled nappy should be changed immediately in order to prevent nappy rash and the use of a good barrier cream is recommended to help protect the baby’s sensitive skin. Baby wipes should not be used to clean baby’s bottom, but rather a solution of warm water used to wash to rinse and clean baby. The chemicals in the wipes may cause discomfort.


When to call the doctor

If the baby or toddler starts to exhibit warning signs, it is necessary to immediately consult a medical professional. These warning signs include:

  • Loose and runny stools for longer than 24 hours or severe diarrhoea (eight movements in eight hours);
  • Very watery diarrhoea coupled with bouts of vomiting (very dangerous as fluids will be quickly lost);
  • Passing stools that contain blood, mucus or pus;
  • Diarrhoea coupled with a high temperature;

A toddler or infant which is showing signs of dehydration, such as:

  • Irritability and continual crying;
  • Sunken fontanel (the soft spot on a baby’s head), as well as sunken cheeks, eyes and tummy;
  • A dry tongue or mouth, and skin that does not return to normal when pinched.
  • The child is lethargic.

Depending on the severity of the dehydration, a doctor may decide to admit the infant or toddler into hospital, where a drip will be set-up. If the diarrhoea is not stopped, the doctor may recommend that certain tests are performed to determine the cause of the diarrhoea and the necessary treatment that will stop the diarrhoea.


How to avoid diarrhoea

If diarrhoea is due to stomach flu, it is virtually impossible to avoid. If the child has intolerance to certain foods, it is wise to eliminate such foods from the toddler’s diet. However, in terms of diarrhoea caused by a bacterial infection, parents can follow a few basic guidelines which will help to prevent the onset of a runny tummy, these include:

  • Washing hands well before preparing meals;
  • Ensuring that all kitchen work surfaces and utensils are properly cleaned before preparing foods or snacks;
  • If an infant is bottle-fed, all bottles and teats must be correctly sterilized (using a sterilising solution or a microwave sterilising unit). Furthermore, mothers must use the correct amount of formula and water when preparing feeds (as per instructions) and the water must be boiled.

– Kathy


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