The truth about infant diarrhoea
As parents, we are pretty accustomed to handling a kid with an upset stomach and the accompanying symptoms of diarrhoea.
These tummy bugs can go away by themselves but at times some bugs can last for more than a week1.
When this happens, there is a risk that our little one can get dehydrated2. In severe cases, some children need to be hospitalised due to dehydration3, 4.
Every year, around 2 million children around the world are hospitalised with bad cases of diarrhoea5, so it is important that parents understand what causes this and know how it can be prevented.
Rotavirus – a common cause of severe diarrhoea
Here are some facts you should know about rotavirus infections:
- It is the most common trigger for severe diarrhoea in kids’ worldwide6.
- Globally, it is also the leading cause of death among children under 57.
- Yearly, 453,000 children succumb to the illness8.
- These deaths are not limited to developing countries – 9% of the rotavirus-related deaths in kids below 5 years old occur in middle to high income countries5.
Signs and symptoms of rotavirus gastroenteritis
Rotavirus usually starts with vomiting. Some kids may have fever, and watery stools which could last for around 5-8 days1.
How is rotavirus spread?
Rotavirus is highly contagious and can be transmitted by faecal-oral route or through contaminated water, food or other objects3, 9.
The rotavirus infection follows a seasonal pattern in some countries and spreads easily in nurseries where there are many kids3, 9, 10.
Rotavirus: How can you protect your child?
It is important to understand how you can help to prevent your child from contracting the virus and put them into practice. Key preventive measures include:
- Breastfeeding – human milk contains protective agents which may offer some protection11.
- Vaccination – oral Rotavirus vaccine can prevent severe rotavirus infection12, 13.
- Hygiene – It is essential to follow good hygiene practices such as washing hands after using the toilet, after changing a baby’s nappy and before touching or preparing food14.
When to call the doctor?
You should consult your doctor immediately if your child does become ill with severe vomiting and diarrhoea, or if your child shows signs of dehydration such as: 15
- a rapid heartbeat,
- dry mouth, lips and tongue,
- dry eyes and the lack of tears,
- dry nappies for more than 3 hours.
The following are recommended for the management of children and infants with diarrhoea:
- Give your child frequent sips of water to replenish fluids lost through diarrhoea to prevent dehydration16, 17.
- Continue to breastfeed or bottle-feed the child12.
- Avoid fruit juices and fizzy drinks as these can make diarrhoea worse18.
- Your doctor may suggest an oral rehydration solution (ORS) if a child is dehydrated or at risk of dehydration 12.
- Avoid giving your child sugary foods and drinks19 but rather opt for energy- and nutrient-rich food such as grains, meats, fruits and vegetables19.
- If your child doesn’t have an appetite, he or she should continue to be given drinks until the appetite returns 17.
Common myths and facts about rotavirus
Myth – “Infant diarrhoea is not serious.”
Fact – In severe cases of diarrhoea, dehydration can lead to the hospitalisation of infants and young children3, 4, 5. If a child has had six or more episodes of diarrhoea within 24 hours, parents are advised to seek medical advice18.
Myth – “Diarrhoea will generally clear up in a day or so.”
Fact – Sometimes this can be the case, but children suffering from rotavirus gastroenteritis can have diarrhoea which last for up to a week1.
Symptoms or diarrhoea can lead to other health conditions such as dehydration and malnutrition17.
Myth – “Diarrhoea is caused by contaminated food.”
Fact – Viruses which can cause diarrhoea such as rotavirus are easily spread between children, mainly by contaminated toys, objects, hands, water and food9, 10. Diarrhoea outbreaks often occur in nurseries where children are likely to mix together and share toys. 10
Myth – “Diarrhoea is only a problem in developing countries.”
Fact – Although diarrhoea is a significant problem in less developed countries, it also constitutes a large public health burden in the developed countries1.
Almost every child in the world will suffer from diarrhoea caused by rotavirus gastroenteritis before the age of five, with some cases leading to severe illness6.
Myth –“There’s nothing much I can do to prevent a child from getting diarrhoea.”
Fact – The chance of a child experiencing symptoms such as diarrhoea and vomiting can be reduced through various methods such as good hygiene, breastfeeding and proper nutrition20. Additionally oral vaccination has been recommended by the World Health Organisation (WHO) as an effective way of preventing against diarrhoea caused by rotavirus gastroenteritis13.
- Linhares AC, Bresee JS. Rotavirus vaccines and vaccination in Latin America. The Pan American Journal of Public Health. 2000;8(5);305-30
- NHS Choices. Gastroenteritis in children: overview [online] 2012. Available from: www.nhs.uk/conditions/rotavirus-gastroenteritis/pages/introduction.aspx. [Last accessed: March 2014]
- Parashar UD, Bresee JS et al. Rotavirus. Emerging Infectious Diseases. 1998;4:561-568
- Parashar UD, Gibson CJ et al. Rotavirus and severe childhood diarrhea. Emerging Infectious Diseases. 2006;12:304-306
- Parashar UD, Hummelman EG et al. Global illness and deaths caused by rotavirus disease in children. Emerging Infectious Diseases. 2003;9:565-572
- Dennehy PH. Rotavirus vaccines: an overview. Clinical Microbiology Review. 2008;21(1):198-208
- GAVI. Rotavirus Diseases [Online]. Available from: www.gavialliance.org/support/nvs/rotavirus/ [Last accessed: March 2014]
- Tate J, Burton A. 2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infec Dis 2012; 12:136-41
- Fischer TK, Bresee JS et al. Rotavirus vaccines and the prevention of hospital-acquired diarrhea in children. Vaccine. 2004;22 Suppl 1:S49-54
- Kids Health. Causes of diarrhoea [online]. Available from: kidshealth.org/parent/infections/common/diarrhea.html [Last accessed: March 2014]
- Plenge-Bönig A, Soto-Ramírez N et al. Breastfeeding protects against acute gastroenteritis due to rotavirus in infants. European Journal of Pediatrics. 2010;169:1471-6
- WHO. Rotavirus vaccines WHO position paper – January 2013 [online]. Available from: www.who.int/wer/2013/wer8805.pdf [Last accessed: March 2014]
- WHO. Rotavirus [online] 2012. Available from: www.who.int/immunization/topics/rotavirus/en/ [Last accessed: March 2014]
- NHS Choices. Preventing diarrhoea [online] 2012. Available from: www.nhs.uk/Conditions/Diarrhoea/Pages/Prevention.aspx [Last accessed: March 2014]
- FDA, The straight poop on kids and diarrhea [online] 2011. Available from: www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM277678.pdf [Last accessed: March 2014]
- WHO. Diarrhoea: Why children are still dying and what can be done [online] 2009. Available from: whqlibdoc.who.int/publications/2009/9789241598415_eng.pdf [Last accessed: March 2014]
- WHO. The Treatment of Diarrhoea [online] 2005. Available from: whqlibdoc.who.int/publications/2005/9241593180.pdf [Last accessed: March2014]
- NHS Choices. Diarrhoea Treatment [online] 2011. Available from: www.nhs.uk/Conditions/Diarrhoea/Pages/Treatment.aspx [Last accessed: March 2014]
- WGO. Acute diarrhea [online] 2008. Available from: www.worldgastroenterology.org/assets/downloads/en/pdf/guidelines/01_acute_diarrhea.pdf [Last accessed: March 2014]
- GAVI. Rotavirus vaccine support [online] 2012. Available from: www.gavialliance.org/support/nvs/rotavirus/ [Last accessed: March 2014]
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