Diarrhoea is extremely prevalent among babies and toddlers for many reasons, explains Dr Rashinta Moodley, specialist paediatrician and nephrologist, consulting at Life Entabeni Hospital and Gateway Hospital Medical Centre. “Infection of the gut is the most common cause due to viruses, food poisoning or consuming contaminated water. Non-infectious causes are due to inflammation of the gut, food intolerance or the use of certain medications.”
- Loose to watery stools
- Abdominal pain and loss of appetite.
- Vomiting may also occur, but the biggest risk is dehydration.
Watch out for the following red flags, advises Dr Moodley:
- Decrease in passing urine
- Dry tongue and lips
- Fewer tears when crying
- Irritability and lethargy
- Sunken eyes.
- These, together with fever, are all danger signs, so it’s important to see a doctor if they are present.
Treatment, according to Dr Tashmin Bisseru, a paediatrician at Life Hilton Private Hospital, includes:
- A home-made rehydration solution of half a teaspoon of table salt, eight teaspoons of sugar and one litre of cooled, boiled water
- Rehydration solutions available at pharmacies
- Encouraging fluid intake by increasing breastfeeding or formula consumption
- A bland diet for older children (broths, purées, toast)
- Supplementing with zinc
- Taking probiotics to improve gut health.
Remember, says Dr Moodley, that diarrhoea usually resolves itself within two or three days. “However, if symptoms continue or are severe, you should always seek medical assistance as your child may need to be put on a drip for severe dehydration.”
Registered homeopath Dr Jaci Schultz suggests trying homeopathic remedies such as Aloe 6ch and Podophyllum 6ch for explosive, yellow diarrhoea and monitoring your little one’s fruit intake, especially during summer. “Too much fruit often produces a dodgy tummy, so if this is the cause, aside from cutting back on consumption, Ars Album 6ch should do the trick.”
Constipation refers to infrequent bowel movements, painful bowel movements, difficulty in passing stools and hard stools, says Dr Bisseru. “Although it can start without any clear cause, there are certain times when a child is more likely to become constipated.” These include:
- A change in diet, such as the introduction of solids, picky eating, decreased fluid intake and low fibre intake
- Psychological issues during toilet training, the start of school, the birth of a sibling or divorce
- Medical causes such as thyroid disorders, Hirschsprung’s disease and the side effects of medication.
- Abdominal pain
- Poor appetite
- Nausea, vomiting and abdominal bloating or distension
Dr Moodley recommends the following treatments:
- Dietary modification such as increasing the intake of fibre-rich foods like bran, fruit and vegetables
- Increasing water intake
- A regular toilet routine
- Medication such as stool softeners and laxatives.
Dr Schultz says that there are many different homeopathic remedies that can be safely and effectively used to treat constipation in babies and toddlers, but it’s important to find the most specific one that addresses your child’s symptoms. “These medications should be individually prescribed, so take your child to a registered homeopathic practitioner to determine the most appropriate remedy,” she advises.
The many causes of tummy ache, says Dr Bisseru, include:
- Bowel (gut) problems such as constipation or irritable bowel
- An infection
- Too much food, food poisoning or food allergies and intolerances
- Surgical problems such as appendicitis or a bowel obstruction
Sometimes, there is no identifiable cause for abdominal pain.
- Associated diarrhoea
- Upper abdominal pain, which could be due to reflux
- Associated vomiting (if the vomit is green, it may be due to an obstruction)
- Blood in the stool
- Severe pain in the right lower abdominal area, which may be due to appendicitis.
Pain relief medication such as paracetamol, if the tummy ache is mild, says Dr Moodley, and possible modifications to your child’s diet. “If no cause is found and the tummy ache persists, psychological management may be an option in older children.”
She adds, “Remember to seek immediate medical attention if the tummy ache is accompanied by a sudden onset of fever, blood in stools or yellow-green vomit.”
If you suspect a reflux-related stomach pain, Dr Schultz suggests using homeopathic remedies such as Ars Album 6ch, Phosphorous 6ch and Robinia 6ch. “However, if the pain is more likely a result of cramp or spasm, Mag Phos 6ch, Colocynthis 6ch and Chamomilla 6ch should offer relief.”
Gastric reflux and vomiting
There are numerous causes of vomiting in a newborn or young child, which range from mild illnesses to severe life-threatening conditions, according to Dr Natasha Padayachee-Govender, a paediatrician at Life Fourways Hospital.
“There’s a difference between vomiting and spitting up, although the terms are often used interchangeably. Vomiting usually has a lot more force behind it and is larger in quantity. Spitting up often occurs with a burp after feeding. The medical term for this is gastroesophageal reflux.
“Vomiting is a symptom that suggests an underlying problem, so it is important for your little one to have a complete history taken as well as a thorough examination.”
The following are especially important in determining the cause:
- Nature of the vomiting, such as the colour, the presence of blood, and whether it’s projectile or not
- Duration, which is severe if more than 12 hours in an infant, 24 hours in children younger than two and 48 hours in older children
- Associated symptoms, which include diarrhoea, moderate to severe dehydration, severe abdominal pain, rectal bleeding and fever.
If your child has any of the above signs or is lethargic, has lost weight or has a distended or tender tummy, he should be assessed by your doctor and immediately referred to the appropriate specialist paediatrician or paediatric surgeon.
Medical treatment of vomiting depends on the underlying cause, says Dr Padayachee-Govender, while reflux may be minimised by measures such as offering more frequent and smaller feeds, keeping your baby upright after feeds, changing his formula or bottle teats, and elevating his head when he is lying down.
Registered homeopath Dr Sheetal Daya suggests using a probiotic to aid digestion and avoid constipation, by preventing an overgrowth of bad bacteria in the gut.
Homeopathic remedies to ease the discomfort of reflux include camomile and Nat phos, which alleviate high acid levels in the stomach that make gastric reflux worse. “Arsenicum album will help children who do not want to eat or drink, while homeopathic medicines such as Nux vomica, Phosphorus and Sulphur can all be effective, but should be individually prescribed by a registered homeopath according to the nature of the symptoms,” says Dr Daya.
A freelance journalist and content writer with a passion for people and health. She has worked in the magazine industry for many years and is a regular contributor to Living and Loving.