Every winter, thegastroenteritis epidemic is a regular occurrence, generally not serious for adults, but it can be dreadful for young children. Your baby shows signs of this inflammation of the digestive system and you wonder how to adapt his diet? Should you change the way you hydrate him? Is it important to consult a doctor and when? This article will shed light on the subject and enable you to react at the right time, with peace of mind.
Symptoms and causes of gastroenteritis
There are two types of diarrhoea, one ofviral origin, which is the most common, and another ofbacterial origin which is mainly recognised by the presence of blood in the stools. The latter is fortunately much rarer. In both cases, the management is equivalent from a nutritional point of view.
Diarrhoea may be accompanied by fever of varying degrees and/or vomiting. It is particularly recognisable by loose or liquid stools, and/or increased frequency (greater than or equal to 3 per 24 hours). The latter may cause acute dehydration or even malnutrition in your child. The contamination is done by water, stools or soiled hands. This is why it is essential to wash your hands as regularly as possible (especially after each change)!
Gastroenteritis can cause your child to lose weight, so you need to be careful. If this weight loss is :
- Less than 5%: it may not be necessary to consult
- Between 5 and 10%: dehydration is said to be moderate: you should consult a doctor. For example: a child losing more than 500 g when he/she initially weighed 10 kg
- More than 10%: dehydration is said to be severe: you should seek emergency medical attention
However, this percentage is sometimes difficult to calculate as we don't always know how much your baby weighs before gastroenteritis. To help you, clinical signs such as the absence of tears, sunken eyes, dryness of the mucous membranes and the observation of a persistent skin fold are the main elements that enable the severity of dehydration to be assessed.
Infants are at risk of rapid dehydration because their bodies are made up of more water (80% at birth, 60% around 1 year) than adults (45-60% on average). The risk of dehydration is therefore all the greater the smaller the child!
How can dehydration be overcome?
Dans un premier temps, il sera important de proposer une hydratation régulière à votre enfant ; si possible, en privilégiant des solutés de réhydratation orale (ou SRO), disponibles en pharmacie, qui permettront souvent d’arrêter les vomissements. Ils n’arrêtent cependant pas la diarrhée mais permettent de corriger la déshydratation. Ils doivent être pris dès les premiers symptômes, à volonté et tant que les selles molles ou liquides persistent. Il sera également préférable de proposer ces solutés en petites quantités et très régulièrement, par exemple, 10 à 20ml par prise (à la seringue) et toutes les 20 minutes. Si les vomissements persistent, il sera alors important de consulter rapidement. L’eau pure n’est cependant pas recommandée car elle entrainera une dilution du sodium sanguin.
If you are breastfeeding your child, it is recommended that you breastfeed regularly, split the feeds so as not to overload the stomach (especially in case of vomiting) and offer rehydration solutions between feeds.
Pour les bébés allaités au biberon, proposer également des solutés entre les biberons (composés du lait infantile habituel). Du lait infantile sans lactose pourra être prescrit, par le pédiatre ou le médecin généraliste de votre enfant, pendant 1 à 2 semaines si la diarrhée est persistante (c’est-à -dire supérieure à 5 jours après la reprise du lait habituel).
In a second phase (4 to 6 hours after the "intensive" rehydration phase), baby can be offered to resume feeding with solid, ground or blended food (depending on his age):
- Avoiding foods rich in fibre, such as: wholemeal starchy foods (bread, rice, wholemeal pasta), vegetables, especially greens, fruit, raw fruit or vegetables, spices, cooked fats and dairy products (dairy products, milk, fresh cheese).
- Favouring easily digestible, low-fat foods such as: white meat without skin or white fish (steamed or boiled), cooked white ham, rice, pasta without sauce, bread, potatoes, tapioca, vermicelli, cooked carrots, cooked beetroot, cooked cheeses, bananas, applesauce or quince, and rusks.
Rice water, rich in starch, can also be offered. You can also add a little salt to your food to compensate for the loss of mineral salts. And finally, split the food (i.e. give small quantities regularly) to avoid vomiting.
It should be noted that this so-called "anti-diarrhoea" diet is neither essential nor of proven effectiveness; it can even compromise a child's renutrition due to its low-calorie and unattractive nature. It is therefore preferable to give baby the foods he likes or tolerates so that he recovers as quickly as possible!
Remember to consult your child's doctor if you have any doubts about the best way to proceed.
Dietician - Nutritionist specialising in paediatrics
Source:
- BENOIST G. Paediatrics, Key medical and surgical knowledge. Les référentiels des COLLEGES. Elsevier Masson. 8th edition. 2020
- GUARINO A. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases Evidence-Based Guidelines for the Management of Acute Gastroenteritis in Children in Europe: Update 2014
- GAN L. MATRAY C. Viral gastroenteritis: diagnosis and treatment. EMC, Elsevier Masson. 2019
- HUBERT P. Acute dehydration of infants due to gastroenteritis. EMC, Elsevier Masson. 2015
