From constipation to diarrhoea: what to do! Part 2

In Part 2 of our articles From Constipation to Diarrhoea, we go in-depth in our discussion of the smelly but serious topic of diarrhoea. Please read Part 1 for a more detailed look at constipation and what you can do to help treat your baby.

When can we say a baby or child has diarrhoea?

A baby or child is reported to have diarrhoea when there is a decrease in the consistency of the stools (stools are more loose or liquid) as well as an increase in the frequency of stools passed, typically more than 3 episodes in 24 hours. Acute diarrhoea typically lasts less than 7 days and not more than 14 days and most babies and children also vomit during a diarrhoea spurt (Guarino et al., 2014).

What causes diarrhoea?

Diarrhoea can be caused by:

  • infections including bacteria and viruses (infectious diarrhoea)
  • an increased osmolarity in the gut, which is as a result of too sugary or too salty foods which in return draws water to the stools (osmotic diarrhoea)
  • a sensitivity to a food such as a lactose intolerance could also cause diarrhoea.

Whatever the reason, diarrhoea should be treated quickly to avoid more serious health problems, since diarrhoea could rapidly lead to dehydration.

How can I treat diarrhoea?

As already mentioned, the first risk of diarrhoea is dehydration. In case of severe diarrhoea, an oral solution of rehydration should be given to baby for a few hours, especially if the weight loss is more than 5% of the weight of the infant before the diarrhoea started.  Oral rehydration or solutions with fluids (containing glucose, Na+, K+, Cl–) is preferred.  Alternatively, oral electrolyte solutions such as Rehydrate are readily available.  After the baby is rehydrated, refeeding is needed to stimulate the infant’s recovery after which the baby’s normal feeding should be continued, with special care to avoid a relapse.  If baby is being breastfed, it is advised to continue to do so.  However, for babies that are formula fed, the options on the market might cause uncertainty and you might wonder what infant formulas are available on the market that can be used to treat diarrhoea?

Soya milks are known to be lactose-free but are not specifically designed for feeding during diarrhoea, but rather for primary lactose intolerance and long-term feeding.  The same applies to the various Lactose-Free (LF) formulas on the market (NAN LF, S26 LF, S26 Gold LF).  For the treatment of diarrhoea, a single week of lactose-free feeds should be sufficient, after which the usual formula should be used again.  These above-mentioned formulas do not have an adapted mineral, electrolyte and a carbohydrate profile to assist with rehydration and their taste has not been improved or modified to assist with overcoming the loss of appetite.

While analysing all of the formulas on the shelf, I noticed Novalac AD, which is especially for the dietary management of diarrhoea.  This formula is not only lactose-free to prevent any secondary intolerances as needed if baby has diarrhoea, but contains higher concentrations of relevant electrolytes (such as sodium, potassium and chloride) to allow for rapid rehydration as well as an optimal energy intake to help with weight recovery.  After analysing the label, I decided to buy a tin and give it a try as my baby was coincidentally suffering from a bout of diarrhoea.  I was impressed with the formula’s pleasant banana and apple taste, because usually lactose-free formulas and rehydrate solutions have a terrible taste. Yuck!  This is a great feature of this formula and makes total sense to use since it would help stimulate the infant’s appetite, as babies usually do not want to consume anything during a diarrhoea episode.  Please remember that you should always consult your doctor, clinic sister or pharmacist for medical advice when your baby seems to be suffering from diarrhoea.


What else can be done?

The following products could also be considered if you prefer making use of pharmacological options:

Absorbents – such as Smecta,(which acts like a clay) coat the entire mucosal lining and absorb toxins, bacteria, viruses, however, such products cannot be given within one hour before or after any additional medications, as it will absorb that too.

Kaolin/Pectin Combination – a combination of adsorbent and protectant, which mode of action is by absorbing excess fluid and reducing intestinal movement. Examples of such products include Gastropect or Pectrolyte, but these products are not safe to use from birth.


Essential Measures in cases of diarrhoea

Parents must be particularly vigilant in cases of diarrhoea and take these essential measures:

  1. Regularly monitor baby’s weight
  2. Monitor baby’s appearance
  3. Check the temperature of the baby twice a day
  4. Watch out for vomiting occurrences
  5. Give baby as much water as possible
  6. Consult the doctor urgently if diarrhoea continues

To prevent diarrhoea from recurring good personal hygiene is highly important and parents should also ensure that feeding bottles and teats are sterilised and to wash their hands thoroughly before preparing food for their infant. If formula feeding, discard unused formula immediately after a feed to reduce the risk of contamination.

So, don’t let diarrhoea catch you by surprise again, be prepared by having the necessary on hand, especially when travelling to areas you are not familiar with.  After my positive experience with Novalac AD, I will most definitely add this handy tin to my emergency kit.

This article is based on personal opinion and has not been sponsored or paid for.