Pediatric Diarrhoea

WHAT IS ACUTE DIARRHOEA IN CHILDREN?

Defined as a sudden onset of stools which are looser than normal and increased in frequency compared to normal, with or without vomiting.^1a
In South Africa, diarrhoea is commonly caused by a viral infection but may also be caused by bacteria or parasites.^2a
Most cases of diarrhoea in children are caused by bacterial infections in the summer months and rotavirus in the winter months.^2b

Fluid loss from diarrhoea or vomiting may result in dehydration and electrolyte (water and salt) imbalance. This may lead to more serious symptoms and hospitalisation if the fluid loss is not adequately treated.^3a

How to prevent dehydration in children with acute diarrhoea.^3c

Give the child more fluids.
Children younger than one year should get special fluids called oral rehydration solutions (ORS).^3c

An oral rehydration solution (ORS) is a mixture of water, salts and sugar in specific amounts. These solutions can be absorbed even when your child has large amounts of diarrhoea or is vomiting.⁶

Oral rehydration solutions can be used to:

Keep children well hydrated when they have significant amounts of diarrhoea.
Replace lost fluids when children show signs of mild dehydration.⁶
Oral rehydration solutions are available at pharmacies in ready-to-serve preparations, or one can make their own solution at home.⁶

Visit a HCP if the child is not better 24 hours after starting to drink more fluids or if he or she keeps vomiting up the fluids.^3d
A HCP will be able to classify the degree of dehydration on examination and suggest treatment based on physical examination findings.^1b

You can’t always prevent it, but there are things that can help:^3e

Children who breastfeed are less likely to get it.
Children should get the vaccine (shot) to prevent rotavirus, which is a common cause of diarrhoea.
Make sure children wash their hands often to help get rid of germs that can cause infection
Clean surfaces that have been touched by a sick child.

Medical References

The National Department of Health, South Africa: Essential Drugs Programme. Primary Healthcare Standard Treatment Guideline and Essential Medicine List. 7th ed. South African National Department of Health; 2020.
Awotiwon OF, Pillay-van Wyk V, Dhansay A, et al. Diarrhoea in children under five years of age in South Africa (1997-2014). Trop Med Int Health. 2016 Sep;21(9):1060-70.
Gastroenteritis in Children: Treating Dehydration. Am Fam Physician. 2019 Feb 1;99(3):Online.
Farthing M, Salam MA, Lindberg G, et al. Acute diarrhea in adults and children: a global perspective. J Clin Gastroenterol. 2013 Jan;47(1):12-20.
Prisco A, Capalbo D, Guarino S, et al. How to interpret symptoms, signs and investigations of dehydration in children with gastroenteritis. Arch Dis Child Educ Pract Ed. 2021 Apr;106(2):114-119.
Canadian Paediatric Society. https://caringforkids.cps.ca/handouts/health-conditions andtreatments/dehydration_and_diarrhea#:~:text=An%20oral%20rehydration%20solution%20(ORS)%20is 20a%20mixture%20of%20water,have%20significant%20amounts%20of%20diarrhea.

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