Diarrhoea is frequent bowel opening with loose or watery stool. Frequent passage of normal formed stool especially in breastfed infant is not diarrhea.

What causes diarrhea in children ?

The most common cause of diarrhea is due to infection of the gastrointestinal tract (called gastroenteritis), and the most common cause is a virus. About 40% of childhood diarrhea is due to a virus called Rotavirus. Other causes include food allergies such as cow's milk intolerance and conditions that cause defect in nutrients absorption. Recurrent and chronic diarrhea will necessitate the doctor to look for other rare causes such as defective immune system and diseases like ulcerative colitis.

How would the child become sick due to diarrhoea ?

During diarrhoeal episodes, the body will loose water and salts (termed as electrolytes) such as sodium and potassium. The state in which the amount of body water is reduced is called dehydration. The severity of illness correlates well with the severity of dehydration and imbalance in the electrolytes. Severe dehydration may lead to kidney failure and death.

What can done at home if my child develops diarrhea ?

Since diarrhea causes dehydration and electrolyte imbalance, we need to replace what is lost from the body. The child needs to be fed with his usual milk and drinks, and the amount should be more than usual so as to replace the loss. The caregiver can also prepare oral rehydration solution (ORS) from oral rehydration salt, usually available from the pharmacy. The child should be encouraged to take ORS as much as possible, or at least after every bowel opening.

Can oral rehydration solution (ORS) be made at home ?

Oral rehydration solution (ORS) can be made at home using clean water, salt and sugar or glucose powder. For every glass of clean water (about 250mls), add a pinch of salt and 2 teaspoons of glucose sugar. Then it is ready for consumption. Instead of plain water, fruit juice or coconut water can be used to improve the flavor and add more potassium to the oral rehydration solution (ORS). Rice water from boiled rice porridge can also be used as ORS.

What can be done if the child vomits ?

A vomiting child can still be treated with oral rehydration fluid. Frequent small amount of ORS will help to prevent dehydration.

When should the child be seen by a doctor ?

A child with diarrhoea should be brought to seek medical attention if:

1. the child cannot tolerate oral feeding e.g. severe vomiting
2. there are signs of moderate to severe dehydration such as lethargy, cold extremities, fast breathing and pour urine output
3. the amount of watery stool is excessive
4. there is blood mixed with the stool
5. the diarrhoea persists for more than a week
6. the child is still very young i.e. less than four months old

Will medication be helpful in diarrhea ?

Generally, medication is not only ineffective in the treatment of diarrhoea, but it may also be harmful to the child. Medication should not be taken unless prescribed by doctors. The most important therapy is rehydration. If oral rehydration fails to restore body water, the doctor will rehydrate using intravenous fluid.

Can diarrhoeal disease be prevented ?

Breastfeeding and good hygienic practices are two most important preventive measures for diarrhoea. Ensure that proper hand washing is practiced before preparing food and feeding. Currently, Rotavirus vaccine is available to reduce the risk of getting Rotavirus infection.