Page 41 - 15Diarrhoeaandvomiting
P. 41
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.
16