Beware of gastroenteritis!

A year ago, my husband, myself and my 9-month old daughter all had gastroenteritis. I was the first one to be hit by the vomiting and diarrhoea. It was sheer agony. A day later my husband, Patrick succumbed to same virus. About a week later we were feeling better and hoped that our daughter, Leila, would be spared. No such luck.

It was agonising to see our tiny bundle of joy at the mercy of gastro and so a visit to the doctor was in order.

Chances are we were part of the 18,195 cases of gastroenteritis reported by the Ministry of Health in 2001. That figure leapt to 22, 230 cases last year and as a result the ministry will be stepping up its public education programme on gastroenteritis in 2003.

According to health officials, the rota virus germ which is more active in the cooler climate conditions at this time of year, tends to cause an increase in the incidence of gastro during the period – November to March.

“Gastroenteritis can lead to severe illness and death in younger children (especially under five years),” the Ministry said. “Caregivers and the general public therefore should take special precaution in washing hands after using the toilet, before handling foods and before meals.”

“The public should also ensure that water used for washing fruits and vegetables and for food preparation is safe,” the Ministry warned.

The main symptoms of gastro are diarrhoea, vomiting, fever and dehydration. Keeping your child well-hydrated is the best way of getting him or her over gastroenteritis. The important part of treatment is to give fluids that your child will keep down and absorb such as coconut water, fruit juice and so on.

Pedialyte TM and similar “rehydration formulas” has water with sugar and certain minerals. The sugar provides energy and with the minerals helps the body absorb water better.

Breast milk in particular seems to help children with gastroenteritis, although that may be because of its many other “ingredients” – including mother’s antibodies to many viruses, possibly including the virus that’s making the baby sick

Be careful with plain water in large amounts if it is a case of severe gastro. Plain water is not absorbed as well as water with sugar and minerals. More important, since you lose minerals as well as water in diarrhoea and plain water doesn’t make up for the minerals lost, your mineral balances can be thrown way off.

If your child is vomiting persistently, it’s best not to push fluids very hard – the results can be frustrating (and a mess) for all concerned. Try waiting about 10-15 minutes after the last feeding attempt, then giving a very small amount of clear liquid (maybe about a teaspoon). If this stays down, then try another tablespoon 2-3 minutes later. If that stays down also, increase the next feeding by 1 teaspoon, and keep increasing the amount until you are giving 2-4 ounces/feeding (depending on your child’s size). If your child throws up a feeding, wait 15-30 minutes, then resume at one teaspoon per feeding and work up again. Again, watch the urine output – that’s the best indicator of whether you’re getting enough fluid in.

While you can try monitoring the situation at home for a bit, take the child to the hospital if you notice any to the following:

If your child hasn’t peed for 6 hours or more and you can’t get him/her to take or keep even clear liquids down.

*If your child is becoming lethargic or listless. ‘Lethargic’ means that your child is so out of it that s/he can’t recognise people s/he usually knows. A child that can’t recognise his/her parents is very lethargic and needs to be seen by a doctor. A “listless” child is one who isn’t as active and playful as usual: the less active, the more listless.)

*If your child’s mouth looks dry or his/her eyes are sunken (these are late signs of dehydration, although usually not as late as true lethargy.)

. If your child’s mole is sunken and his skin stands up when pinched.

After examination the doctor can then decide whether to give fluids IV. In some bad cases of gastroenteritis the best way to help get a child over the worst part is to give him or her constant IV fluids until the vomiting and diarrhea go away – which can sometimes take a couple of days if the infection is bad.

Additional treatment information taken from Dr Reddy’s Pediatric Office on the Web TM.