Diarrhea in a child: what to do, causes, complications, treatment

Diarrhea is defined as loose stool more than 3 times a day for 4 days or more.

Chair in children

However, it must be taken into account that in an infant, stool 2-3 times a day is considered normal. During the first 4-6 weeks it may be more frequent, up to 5-8 times a day. The reason for this is insufficient digestive function from such an early age.

Feces during this period are mushy, yellow or greenish in color, with a sour odor.

If the child is feeling well and gaining normal weight, this can be ignored.

In some cases, when breastfeeding, stool occurs once every 2-3 days. This indicates that the milk is well digested and absorbed by the body, producing very little waste.

When fed with cow's milk, the stool is thicker, darker, and has an unpleasant odor.

This situation is usually temporary and goes away without any treatment.

After six months, stool becomes less frequent - 1-2 times a day.

Symptoms of simple diarrhea

In most cases, the disease begins suddenly. The child develops frequent loose stools. In this case, the feces are green mucus with white and yellow lumps. The stool contains a large amount of liquid, which forms a large wet spot on the diaper.

The smell may vary:

often sour,

but when artificially fed it can be putrefactive.

The mucus is distributed evenly in the stool, which gives it a shiny appearance, but can be interspersed in separate nests.

Sometimes the stool may be watery with greenish odorless flakes.

Diarrhea is considered to be a stool frequency of 5 to 15 times a day.

Often the child defecates continuously, leaving small yellowish-green spots on the diapers. This happens when a lot of gases form in the intestines and they pass out along with the stool.

Diarrhea is often accompanied by regurgitation. It can occur both during feeding, when the child regurgitates unchanged milk, and after feeding, when the child regurgitates curdled milk.

In severe cases, regurgitation appears to be constant—a milky-white stream constantly flows from the corner of the child’s mouth.

A common symptom of diarrhea is intestinal colic - abdominal pain. The fact that a child has a stomach ache can be identified by the following signs:

• the child screams persistently, hysterically,
• moves his legs
• the child's face turns red,
• he frowns tensely.

With prolonged diarrhea, symptoms such as:

• the weight curve stops or goes down,
• evening and morning body temperature shows significant fluctuations (over 1°C),
• If a child’s skin is folded, it will not straighten out for a long time,
• complexion becomes pale or grayish,
• Circles form under the eyes.

Diarrhea due to overfeeding

This type of digestive disorder can also occur during breastfeeding, but much less frequently than during artificial feeding.

Overfeeding occurs

• when a baby is given too much milk at each feeding
• or they feed him too often and incorrectly, even if only a little.

The first case occurs in children whose mothers have a lot of milk that is easily separated - much more than the amount that the child’s gastrointestinal tract can handle.

If you do not follow the feeding regime and feed the child chaotically, this will also burden the child’s gastrointestinal tract.

This type of diarrhea begins violently, but quickly disappears with the elimination of its cause at an early stage.

With artificial feeding, indigestion is observed much more often and is much more severe.

Sometimes the disorder occurs after the child begins to be fed with more concentrated formulas, for example, porridge, jelly. Especially if they do not begin to accustom them to this food in small portions, but give the child a whole portion at once.

Diarrhea due to infection

Any, even mild, infection in infancy can be accompanied by diarrhea. Sometimes the symptoms of a digestive disorder are so striking that they overshadow the picture of the underlying disease.

This occurs especially often with inflammation of the middle ear, as well as with infectious diseases .

Based on the onset and course of diarrhea during infection, two forms are distinguished:

• spicy,
• I'll sharpen it up.

Acute symptoms

With this form of diarrhea, all signs appear immediately.

• The child, who looked strong and healthy the day before, turns pale, spits up, and has frequent loose stools.
• The child refuses to eat, is restless, and loses weight.
• Body temperature rises slightly.

If measures are not taken in this condition, diarrhea can become toxic.

Subacute form

This form develops gradually, a few days before the appearance of typical symptoms.

• The first signs are the child regurgitating food, either before or after feeding. At the same time, the stool remains normal.
• The child’s appetite worsens, weight gain stops, and sometimes weight decreases.
• Pallor gradually increases, and, finally, frequent loose stools appear, accompanied by significant weight loss.

Treatment of simple forms of diarrhea

1. If the diet is disrupted, it is necessary to eliminate overfeeding and regulate feeding.
2. If an infection is present, it is necessary first of all to treat the underlying disease. As a rule, when the underlying disease is eliminated, the functioning of the gastrointestinal tract is restored.
3. As a rule, simple diarrhea during breastfeeding has a favorable course and rarely becomes toxic.
4. At the first manifestations of indigestion - loose stools, regurgitation, loss of appetite - you should skip one or two feedings, replacing them with the same amount of boiled warm water or tea. If, despite the missed feeding, the child’s condition does not improve, it is necessary to limit his food for some time.
5. It is impossible to leave a child on a restrictive diet for a long time, as he may be at risk of dystrophy. As a rule, such a diet is prescribed for 12-15 hours. For a child younger than 1 month or suffering from atrophy, the tea diet is prescribed for 6-8 hours. The lack of effect as a result of using the diet indicates more serious causes of indigestion, which are most often associated with some associated disease (otitis media, pneumonia, etc.).
6. The food restriction should be supplemented by drinking plenty of fluids: 150 ml per 1 kg of weight in the first 3 months of a child’s life, 120 ml per 1 kg of weight up to 6 months of age and 100 ml up to one year of age.
7. The appearance and intensification of vomiting, loss of appetite, increased frequency of stools, weight loss and increasing lethargy indicate the transition of a simple form of dyspepsia to a toxic one.

Toxic form

This form of diarrhea can be caused by the same reasons as simple diarrhea - poor nutrition (nutritional), infection (parenteral). As mentioned above, it can develop from a simple digestive disorder.

The reasons for turning into a severe form are:

• improper administration of food for diarrhea;
• attached infection;
• errors in care;
• overheating of the child.

Symptoms

Toxic dyspepsia, unlike simple dyspepsia, is accompanied by severe symptoms.
At first glance at the child, the following phenomena of severe general condition are striking:

• the face is sallow and pale with deeply sunken eyes surrounded by dark blue;
• the gaze is directed somewhere into the distance;
• consciousness is clouded, the child does not pay attention to others and toys;
• the limbs are most often bent, seem numb, and are difficult to straighten;
• sometimes convulsive twitching may be observed;
• body temperature may rise to 39-40°C.

A violation of cardiovascular activity is indicated by such signs as:

• blueness around the mouth;
• cold hands and feet;
• weak pulse;
• muffled heart sounds;
• frequent, uneven breathing;
• shallow breaths are followed by a long pause, sometimes deep breaths follow without pause one after another (“breath of a hunted animal”).

Along with the above symptoms, violent phenomena from the gastrointestinal tract are observed: diarrhea and vomiting.

• Vomiting often becomes uncontrollable; it appears not only during or immediately after, but also in the intervals between feedings. In severe cases, the vomit is dark in color (the color of coffee grounds) due to the admixture of altered blood.
• Frequent bowel movements - up to 10 times a day or more. Greenish-yellow stool mixed with flakes and mucus takes on a watery character and is thrown out under great pressure.
• The abdomen is swollen and tense.
• The tongue is dry, covered with a dirty yellow or gray coating.
• No appetite.
• Every attempt to give the baby milk or water causes him to grimace or cry.

Due to the excessive loss of water due to frequent bowel movements and vomiting, signs of dehydration appear:

• the skin loses elasticity, raised into a fold, it does not straighten out for a long time;
• the fontanel sinks;
• the cornea of ​​the eyes becomes dry, in severe cases ulcerations form on it;
• urination becomes rare and scanty.

The child’s weight drops rapidly, sometimes up to 500 g per day.

Treatment

In less severe cases of toxic diarrhea, after a short-term starvation diet, the appointment of plenty of fluids and appropriate food, a rapid improvement occurs: vomiting stops, stools become less frequent, the child’s eyes become clearer, the child begins to react to others, the weight loss stops and subsequently, with an increase in the amount of food, the weight begins to increase. gradually increase.

In more severe cases, children require urgent hospitalization, since some activities can only be performed in a hospital setting.

The basic principles of treatment are summarized

• to the tea diet,
• careful, limited introduction of food,
• copious fluid administration
• careful care
• antibacterial treatment.

Complications

Toxic diarrhea in its various stages is often accompanied by inflammation of the middle ear, lungs and renal pelvis, worsening the course and delaying recovery.

With severe dehydration and toxicosis, these complications do not always give rise to a clear increase in temperature. Therefore, a thorough examination is necessary:

• listening,
• percussion,
• Analysis of urine,
• special examination of the ears,
• blood analysis.

Inflammation of the middle ear often accompanies toxic diarrhea, so it should be examined by an otolaryngologist. However, when pus accumulates not in the tympanic cavity, but in the adnexa, an external examination may not reveal it. Therefore, if a blood test shows elevated white blood cells, an x-ray should be taken.

Lying on your back for a long time and a stuffy room contribute to the development of pneumonia. The lower posterior lobes of the lungs are most often affected.

To prevent pneumonia you must:

• often change the child’s position in bed, turning him from side to side;
• carrying on hands;
• airing the room,
• child's stay outdoors.

When giving a bath, you need to pay attention every time to how the child reacts to it. If after a bath the skin becomes pale and bluish rather than pink, then the baths should be stopped.

You can read about nutrition for diarrhea here .