Pediatrician mother: baby diarrhea, parents care better quickly

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Pediatrician mother: baby diarrhea, parents care better quickly

2017-01-12 00:48:17 69 ℃

The baby poop, not too tangled, do not excessive treatment. The treatment of diarrhea is to prevent and treat dehydration.

PART1 is not easy to determine the baby diarrhea

Which circumstances do not have to be too tangled

As a result of small babies, especially the small breast feeding babies, stool itself is relatively soft, the number is more, it can not be described by simple stool and stool frequency to determine the number of diarrhea in infants. Infant defecation is not stable, more closely, and the relationship between eating in general, as long as the baby is eating good, good, good mental development, parents need not too tangled stool color (mostly related with food unless neonatal stool in the stool or white color, blood, milk (Times) the baby is generally higher than the baby milk powder to eat more) and stool traits (breast fed babies, add a food supplement from the stool will be slowly forming, unless there is watery stool etc.).

A variety of normal stool in infants and young children

The development of gastrointestinal tract in infants and young children is not yet mature, feeding methods and food types are constantly changing, so the stool during this period is often changed.

A hidden disease signal in stool odor, color and character

We can analyze the baby's health from the smell, color and character.

The above picture from "canon" parenting small shrimp Mummy

PART2 common causes of infantile diarrhea

A lot of the cause of diarrhea in infants, the most common is food intolerance (that is, we often say that on a food sensitive or allergic) and infection (including viruses, bacteria, fungi, parasites, before the two rare, especially virus infection), caused by the use of antibiotics in diarrhea also need attention.

If diarrhea accompanied by vomiting, fever and other symptoms, is likely to be caused by diarrhea infection. Virus infection is the most common, accounting for about 70 to 90% of diarrhea caused by infection, rotavirus, enteric adenovirus can cause diarrhea symptoms, generally through the respiratory tract and gastrointestinal tract.

Correlation examination and preliminary diagnosis

First assess whether there is dehydration, and determine the severity of dehydration.

The doctor may perform the blood electrolytes and blood gas analysis for the children with moderate or severe dehydration. Then according to the observation of the naked eye, stool routine, combined with the onset of the season, age and prevalence of the disease to predict the possible causes of the disease.

Interpretation of routine stool Report

Stool report "-" representatives were normal, with "+" on behalf of the suspect, the "+" represents the positive, and from "+" to "+ + + +" said increasing severity.

If the stool with mucus, pus and blood stool, white blood cells and / or red blood cell > 10 ~ 15 /HP (HPF), combining with the history can be considered as bacterial infection, and shall do stool culture and drug susceptibility detection further.

If the stool was watery stool, or even no red / white blood cells, can be considered as the combination of history and viral infection or lactose intolerance.

If the stool was jam like, the baby was very sick, the doctor will recommend the X-ray, ultrasonography, exclusion of intussusception.

Note that the 1 stool routine examination may not be able to diagnose, if necessary, to do a number of checks to assist in the diagnosis.

PART3 do not over treatment or treatment

The treatment of diarrhea is to prevent and treat dehydration. That early oral rehydration, stressed the need to continue feeding, emphasizes the identification of dehydration syndrome, emphasizing zinc treatment, promotion of breastfeeding, as recommended by the new formula of low permeability ORS.

In the event of diarrhea, adequate oral fluid should be given to prevent dehydration and to ensure nutrient intake. Breastfed babies should continue to breastfeed, and increased feeding frequency and prolong the time of single feeding; artificial feeding the baby can give diluted milk and ORS liquid; 6 months or more of the children can continue to have the habit of eating diet, encourage children with a small number of meals, avoid giving children fed rich crude fiber vegetable fruit and sugar food.

Breastfeeding or artificial feeding of children with secondary lactase deficiency, can be temporarily given to (go) low lactose milk formula, generally 1-2 weeks after diarrhea improved gradually to the original feeding way. Breastfeeding children can also be based on breastfeeding, adding exogenous lactase.

Can give children zinc. Treatment of diarrhea and zinc supplementation can shorten the duration of diarrhea, reduce the incidence of diarrhea. WHO recommended to the world under the age of 5 children with acute or chronic diarrhea daily oral intake of 10 to 20 mg of zinc, lasting for 10 to 14 days. 2009 edition of the "children's diarrhea diagnosis and treatment principles of the expert consensus" recommended for more than 6 months of age, every day to supplement the element zinc 20mg, under the age of 6 months, the daily supplement element zinc 10mg.

In addition, fever and other symptoms of symptomatic treatment and care. Pay attention to hip care, pay attention to oral hygiene. Isolation and disinfection of infectious children if necessary.

Proper use of oral rehydration salts

ORS liquid should be configured according to the requirements of the specification. At present, WHO recommend a new low permeability ORS liquid, the preferred ORS III, no ORS III can be diluted by 1.5 times to replace ORS I.

ORS liquid should be separated from the right amount of drinking. The key of the liquid is uniformly slow, too much time drinking may cause or increase the vomiting, the ideal approach is to apply a small amount each time, every few minutes to let the children to drink, don't need to drink a lot, to continue to provide their children during the white boiling water, urine volume until the child returned to normal.

ORS liquid is not easy to deteriorate, after the configuration, room temperature preservation 24 hours no problem, but we should pay attention to avoid saliva pollution.

Antibiotics need to avoid misunderstanding

Do not use a small amount of white / red blood cells in the stool with antibiotics, antibiotic associated diarrhea. Overall, the diarrhea caused by viral infection, diet therapy and support, without the use of antibiotics; non invasive bacterial diarrhea, generally only diet and supportive therapy can be selected according to the condition of appropriate antibiotics. Antibiotics should be used only for invasive and mixed bacterial diarrhea. In determining a serious bacterial infection situation, because the stool culture at least 3 days to get results, so usually the first empirical use of antibiotics to be cultured, the results came out, and then consider whether you need to replace antibiotics. If the use of antibiotics should be used continuously for at least 5 to 7 days, in order to avoid drug resistance or persistent disease.

Key points of nursing for mild diarrhea

At this time, most of the children can maintain normal diet (including breastfeeding or formula feeding), need to provide children with white boiling water and drinking is not restricted, can not be considered temporary supplementary oral rehydration salts (ORS solution).

Tips: need to consider the situation

In time the condition has not improved or any of the following symptoms of children sent to medical institutions for treatment:

1 severe diarrhea, stool frequency or quantity

2 frequent vomiting, not by oral administration

3 can not eat liquid or semi liquid

4 abdominal pain

5 high fever

6 stool with blood

7 extreme thirst, found off the water syndrome such as: orbital depression, anterior fontanelle depression, less crying tears, lips and oral mucosa dry, urine volume decreased (wet diaper every day less than 6 pieces), irritability, apathy and lethargy.

8 age < 6 months, premature infants, with a history of chronic disease or complications

Remind the mother from the pediatricianIf that child has moderate or severe dehydration or that child spirit is very poor, please emergency medical treatment; if the child diarrhea for more than two weeks, please visit again.

Focus on the nursing of moderate diarrhea

At this point, the majority of children can maintain a normal diet, the need to add oral rehydration salts, and to provide children with boiled water and not limited to drinking, until the child's urine returned to normal.

In the case of moderate dehydration, the dosage of ORS solution (ML) = body weight (kg) * (50 ~ 75), and in the end of the oral cavity within about 4 hours (about 5ml per minute). If close to 4 hours, children still have dehydration performance, need to adjust the fluid replacement program. 4 hours after the re evaluation of the status of dehydration, and then select the appropriate program. The following findings suggest that oral rehydration may fail and should be considered as an intravenous infusion:

1 persistent, frequent, massive diarrhea (> 10-20ml/Kg.h)

2 ORS liquid dosage is insufficient

3 frequent and severe vomiting.

Key points of nursing for severe diarrhea

In case of severe dehydration, children need medical treatment, can consider intravenous rehydration (note is just one of the means of rapid rehydration), during rehydration, every 1-2 hours an assessment of dehydration, if no improvement is required to accelerate the speed of proper rehydration. Usually after intravenous infusion of 3-4 hours in infants, children in the intravenous infusion of 1-2 hours, you can give ORS fluid. If there is no intravenous infusion, immediately transported to other medical institutions for intravenous rehydration, transit can be used ORS liquid nasal drip infusion, every 1-2 hours an assessment of dehydration.

Network science, only for the maintenance knowledge we added in some hospitals, instead of the hospital, to remind parents, if you can not handle their own or on the baby's condition are not allowed to draw the line, please timely medical treatment!

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[] small shrimp mummy pediatrician, well-known public science author. Graduated from Shanghai Jiaotong University School of Medicine, master of child health. He has been studying in Shanghai Key Laboratory of environment and children's health, Shanghai Children's Hospital, Shanghai children's health care center. Sina micro-blog most parents trusted pediatrician mom (Sina micro-blog: WeChat @ small shrimp mummy; public number: askmommy).