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Diarrhoea and vomiting caused by gastroenteritis in children under 5 years




                        Chapter 10  Information and advice for parents and carers

                        10.1  Caring for a child with diarrhoea and vomiting at home
                        Inform parents and carers that:

                        •  most children with gastroenteritis can be safely managed at home, with advice and support
                          from a healthcare professional if necessary
                        •  the following symptoms may indicate dehydration:
                          –  appearing to get more unwell
                          –  changing responsiveness (for example, irritability, lethargy)
                          –  decreased urine output
                          –  pale or mottled skin
                          –  cold extremities
                        •  they should contact a healthcare professional if symptoms of dehydration develop.
                        Advise parents and carers of children:
                        •  who are not clinically dehydrated and are not at increased risk of dehydration:
                          –  to continue usual feeds, including breast or other milk feeds
                          –  to encourage the child to drink plenty of fluids
                          –  to discourage the drinking of fruit juices and carbonated drinks
                        •  who are not clinically dehydrated but who are at increased risk of dehydration:
                          –  to continue usual feeds, including breast or other milk feeds
                          –  to encourage the child to drink plenty of fluids
                          –  to discourage the drinking of fruit juices and carbonated drinks
                          –  to offer ORS solution as supplemental fluid
                        •  with clinical dehydration:
                          –  that rehydration is usually possible with ORS solution
                          –  to make up the ORS solution according to the instructions on the packaging
                          –  to give 50 ml/kg ORS solution for rehydration plus maintenance volume over a 4 hour
                            period
                          –  to give this amount of ORS solution in small amounts, frequently
                          –  to seek advice if the child refuses to drink the ORS solution or vomits persistently
                          –  to continue breastfeeding as well as giving the ORS solution
                          –  not to give other oral fluids unless advised
                          –  not to give solid foods.
                        Advise parents and carers that after rehydration:

                        •  the child should be encouraged to drink plenty of their usual fluids, including milk feeds if
                          these were stopped
                        •  they should avoid giving the child fruit juices and carbonated drinks until the diarrhoea has
                          stopped
                        •  they should reintroduce the child’s usual diet
                        •  they should give 5 ml/kg ORS solution after each large watery stool if you consider that the
                          child is at increased risk of dehydration.

                        Advise parents and carers that:
                        •  the usual duration of diarrhoea is 5–7 days and in most children it stops within 2 weeks
                        •  the usual duration of vomiting is 1 or 2 days and in most children it stops within 3 days
                        •  they should seek advice from a specified healthcare professional if the child’s symptoms do
                          not resolve within these timeframes.















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