Dehydration in Children : Part 2

by Food and Drug Administration (FDA)

(Page 2 of 2)

Food can help the intestine absorb more water, which helps slow down the diarrhea. A child should eat as soon as possible after a bout of diarrhea, and at least within six hours. A balanced diet rich in calories is recommended. Foods such as rice, wheat, potatoes, sorghum, corn, and chicken have all been proven helpful in slowing diarrhea. Just about anything the child tolerates is OK, except for foods high in sugar or salt.

Milk products, because they can be difficult to digest, can be withheld for 24 to 48 hours during significant bouts of diarrhea. Infants who are bottle-fed, however, should continue drinking formula diluted to half strength. Breast-fed infants should continue nursing.

The once favored "BRAT" diet — an acronym for bananas, rice, applesauce, and toast — is no longer recommended for children. Instead, parents should offer a more balanced diet that is higher in calories.

Giving anti-diarrhea medicine to children is not the best treatment, according to John Udall, M.D., Ph.D., chairman of pediatric nutrition and gastroenterology at the Children's Hospital in New Orleans.

"Diarrhea is really a purging of the intestine," he says. "Giving medicines to slow down the intestine actually gives the bacteria more time to grow, which prolongs the illness."

Allowing the illness to run its course, while preventing dehydration with fluids, is usually the quickest way toward health.

Dosage information for ORT depends on weight and is listed on the label. Side effects with ORT are rare, but parents should watch for signs of too much sodium in the body: dizziness, a fast heartbeat, irritability, muscle twitching, restlessness, swelling of the feet or lower legs, weakness, and convulsions.

Rehydration fluids have a brief shelf life. Once a bottle has been opened or a mix prepared, it must be used or thrown out within 24 hours because bacteria rapidly grow in the solution. A child could easily drink three or four bottles of the fluid during an illness.

ORT is effective to a lesser degree when the child is vomiting. If the child can keep the liquid down, it will be absorbed. But if the child vomits it back up, intravenous rehydration may be necessary.

ORT is effective for all ages, although the brands available at most grocery stores and drugstores are usually formulated just for children. Adults are usually able to tolerate a bout with diarrhea better than small children because they have more fluid reserves in their bodies. But older adults and those weakened by diseases like cancer and AIDS are at a greater risk for complications from diarrhea. These patients should call their doctors if diarrhea and vomiting persist.

Parents should also remember that ORT will not stop the diarrheal illness. In fact, the child may have even more episodes of vomiting and diarrhea until the illness runs its course. As long as the child is keeping some rehydration fluid down, however, the chances of dehydration are greatly reduced.

If a child under 5 has diarrhea and vomiting for longer than an hour or so, it's always a good idea to call a physician.

According to Snyder, "Parents should have a low threshold of concern to [prompt them to] phone the pediatrician."

Parents don't have to wait for a prescription to use oral rehydration fluids, however. The products are available at grocery stores and drugstores in premixed bottles. National brands can cost as much as $6 per liter, but less expensive generic brands are available as well for as little as $2.

According to a 1991 study in the Journal of the American Medical Association, cost is one reason why more parents do not use ORT for their children suffering from diarrhea. Deaths from diarrhea are most common in the South and in low-income, African-American families headed by young single mothers.

To help with that expense, the federally funded and state-administered WIC (Women, Infants and Children) Program pays for ORT along with certain foods for pregnant women, new mothers, and children under 5. In most states, Medicaid also covers ORT if a doctor prescribes it.

As the use of ORT increases, the number of deaths from diarrhea is slowly declining in the United States. This simple solution of water, minerals and carbohydrates will not eliminate the problem of stomach viruses and flu, but perhaps it will make diarrhea less of a life-threatening risk to America's children.

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FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.