Gastroenteritis in children | Diarrhea and vomiting, perhaps accompanied by fever: these are the symptoms of gastroenteritis. The main cause is infectious.
Diarrhea and vomiting (alone or together), perhaps accompanied by fever: these are the symptoms of gastroenteritis in children, one of the most common diseases.
The main cause is infectious: the responsible agents
As reported by the Guidelines for the management of acute gastroenteritis in children from the European Society of Gastroenterology, pediatric hepatology and nutrition (Espghan)practically all children under three experience one or two episodes a year. Often with great concern for moms and dads.
Here are the most frequent doubts of parents, to which we respond based on the indications of the Guidelines and with the advice of Alfredo Guarino, professor of pediatrics at the University of Naples Federico II and coordinator of the document.
1. My baby has diarrhea: what to do?
It depends on the age and general conditions. If she is more than two months old and the episodes are not too frequent (less than 7-8 during the day) that’s enough administer oral rehydration solution to replenish the body’s salt and sugar reserves, reducing the risk of dehydration.
If vomiting is added to diarrhea, oral rehydration can become more problematic: in this case, the solution should be given a little at a time, with a teaspoon, preferably cold. Instead, it is necessary to go to the doctor or directly to the emergency room if the child is less than two months old or if the diarrhea is very intense (more than 8 episodes a day) or associated with persistent vomiting (for more than 6-8 hours): the risk of dehydration it is high and rehydration with drip or nasogastric tube may be necessary.
2. How can I tell if my baby is dehydrated?
Given that in case of doubt it is necessary consult your doctorcries without tears, dryness of the skin and mucous membranes, reduced urine output, a state of general dejection are signs of dehydration.
3. Are there any medications to relieve the symptoms of gastroenteritis?
In addition to the rehydrating solution, probiotics (in particular products with Lactobacillus rhamnosus and Saccharomyces boulardii) can be administered, which have been shown to be effective in reducing the duration and symptoms of the disease. Yes also a adsorbent drugs such as smectite, while there is no unanimity on antivomites, which work but can cause side effects.
4. In addition to diarrhea, my baby has a high fever: should I give him an antibiotic?
In most cases of gastroenteritis, antibiotics are not needed or are counterproductive, so they should be given only in specific cases and after having done thorough investigations: for example if there are symptoms that suggest a spread of the infection (in addition to fever, strong abdominal pain or blood or mucus in the stool) or if the infection is caused by particular germs such as Shigella, which is however very rare. Finally, yes to the antibiotic if it is a question of children already at risk for other conditions (immunodeficiencies, chronic inflammatory diseases, tumors).
5. My child has had diarrhea for 4 days. It’s normal?
Gastroenteritis lasts an average of 3-5 days: Persistent diarrhea begins to be talked about only after 7-8 days. In these cases, you can rest easy if the child shows any signs of improvement, even minimal. If, on the other hand, the situation does not change, it is necessary to proceed with investigations because diarrhea could be a symptom of non-infectious conditions, such as celiac disease, food intolerance, a chronic inflammatory disease.
6. Can gastroenteritis be prevented?
The basic hygiene measures, such as washing your hands often and always before meals, can help. In the case of infections with rotavirus (the most frequent), the most effective prevention strategy is vaccination. In fact, in the countries where it was introduced, the incidence of the disease has been greatly reduced. The vaccination schedule provides for full vaccination starting from the sixth week of life to be completed by the 24th (two-dose vaccine) or 32nd (three-dose vaccine).
Today in Italy the anti-rotavirus vaccine is provided by the National Health Service as free but not mandatory.
7. My baby has gastroenteritis: should I keep him fasting?
Certainly in the early stages of the disease it is the child himself who does not desire food and it is therefore good to indulge him don’t force him to eat (while it is important that he drink, perhaps often and in small doses if he vomits). But when his appetite returns, fasting is useless: the little one can return to normal nutrition.