Managing diarrhea-
Current nutrition perspectives
The document discusses the management of diarrhea from a nutritional perspective. It emphasizes that breast milk is best for infants in the first 6 months as it provides optimal nutrition and protection from illness. For acute diarrhea cases, the main treatment goal is to replace fluid and electrolyte losses through oral rehydration with oral rehydration solution given in small, frequent amounts. Intravenous fluids are only recommended for severe cases involving persistent vomiting or shock. Proper nutritional management during and after diarrhea is also important to support recovery.
BASIC HEALTH IN COMMUNITY REHABILITATIONSalmaAzeem3
The document discusses community-based rehabilitation and strategies to promote health in communities. It was initiated by the WHO following the Declaration of Alma-Ata in 1978 to enhance quality of life for people with disabilities. Key topics covered include handicaps in the community, nutrition and malnutrition, breastfeeding, immunization, and oral rehydration therapy. Community-based rehabilitation aims to meet basic needs and ensure inclusion of people with disabilities. Nutrition is important for health and growth, and malnutrition can result from inadequate intake of calories, proteins or other nutrients. Breastfeeding provides immunity and nutrition to children while immunization protects against infectious diseases. Oral rehydration therapy treats dehydration from diarrhea by replacing lost fluids and electrolytes
A human milk bank collects, screens, processes, stores, and dispenses donated human milk to infants who need it. Donated milk is preferable to formula or animal milk for preterm and low birth weight babies, as it decreases rates of health issues like necrotizing enterocolitis and improves outcomes. A human milk bank operates by registering and screening donors, collecting and pasteurizing donations, testing the milk, storing it frozen, and distributing it by prescription to reduce risks for recipient infants. Challenges include cost and availability, but human milk banks can improve infant health and reduce long-term costs from issues associated with prematurity.
Diarrhea is common in children under 2 years old and is usually caused by viral or bacterial infections. It can lead to dehydration if fluid losses are not replaced. Dehydration is classified as none, some, or severe based on signs like thirst, skin pinch, and sunken eyes. Treatment involves oral rehydration solution to replace fluids based on the dehydration classification. For severe dehydration, IV fluids are given quickly followed by oral fluids. Preventing diarrhea involves exclusive breastfeeding, hand washing, safe water and food, and immunizations. Managing diarrhea at home includes extra fluids, continued feeding, zinc supplementation, and seeking care for danger signs.
1. The document provides dietary advice and nutritional guidance for a 1 year old child weighing 7 kg, which is below the expected weight of 10 kg. It outlines the calorie and protein requirements and provides a sample weekly menu.
2. It also discusses principles of weaning and complementary feeding for infants after 6 months, including introducing semi-solid foods and finger foods. The importance of continued breastfeeding is emphasized.
3. Under-five clinics aim to provide comprehensive healthcare for children under 5, focusing on prevention, treatment of illness, growth monitoring, immunizations, and health education. They play a major role in reducing child mortality.
2 physiology and benefits of bf, risk of artificial feeding230113Varsha Shah
Here are the answers to the true/false and multiple choice questions:
1. True
2. True
3. False
4. True
5. False
6. e. Tonsillitis
7. e. Infertility
8. c. Higher cost to feed a lactating mother
9. f. No free sponsorship from pharma, samples of formula and less earnings for hospital
10. d. Mother can do house works, can take care of sibling and save money
11. c. Causes high incidence of jaundice
12. e. All of the above
13. a. Exclusive breast feeding till 6 month
Breast milk is the ideal food for infants, providing all necessary nutrients for healthy growth. The WHO recommends exclusive breastfeeding for the first six months to achieve optimal infant health outcomes. Breastfeeding benefits both mother and child, protecting infants from illness and reducing risks for mothers. Supporting breastfeeding practices like early initiation and avoiding supplementation are important to establish and sustain breastfeeding.
This document discusses various feeding methods for infants, including breastfeeding, formula feeding, cup feeding, and finger feeding. It provides advantages and disadvantages of each method. Breastfeeding is described as the best method, providing superior nutrition and protection against diseases. The document also covers composition of breast milk, importance of feeding, indications for formula feeding, benefits of extended breastfeeding beyond 6 months, and guidelines for introducing solid foods during weaning.
BASIC HEALTH IN COMMUNITY REHABILITATIONSalmaAzeem3
The document discusses community-based rehabilitation and strategies to promote health in communities. It was initiated by the WHO following the Declaration of Alma-Ata in 1978 to enhance quality of life for people with disabilities. Key topics covered include handicaps in the community, nutrition and malnutrition, breastfeeding, immunization, and oral rehydration therapy. Community-based rehabilitation aims to meet basic needs and ensure inclusion of people with disabilities. Nutrition is important for health and growth, and malnutrition can result from inadequate intake of calories, proteins or other nutrients. Breastfeeding provides immunity and nutrition to children while immunization protects against infectious diseases. Oral rehydration therapy treats dehydration from diarrhea by replacing lost fluids and electrolytes
A human milk bank collects, screens, processes, stores, and dispenses donated human milk to infants who need it. Donated milk is preferable to formula or animal milk for preterm and low birth weight babies, as it decreases rates of health issues like necrotizing enterocolitis and improves outcomes. A human milk bank operates by registering and screening donors, collecting and pasteurizing donations, testing the milk, storing it frozen, and distributing it by prescription to reduce risks for recipient infants. Challenges include cost and availability, but human milk banks can improve infant health and reduce long-term costs from issues associated with prematurity.
Diarrhea is common in children under 2 years old and is usually caused by viral or bacterial infections. It can lead to dehydration if fluid losses are not replaced. Dehydration is classified as none, some, or severe based on signs like thirst, skin pinch, and sunken eyes. Treatment involves oral rehydration solution to replace fluids based on the dehydration classification. For severe dehydration, IV fluids are given quickly followed by oral fluids. Preventing diarrhea involves exclusive breastfeeding, hand washing, safe water and food, and immunizations. Managing diarrhea at home includes extra fluids, continued feeding, zinc supplementation, and seeking care for danger signs.
1. The document provides dietary advice and nutritional guidance for a 1 year old child weighing 7 kg, which is below the expected weight of 10 kg. It outlines the calorie and protein requirements and provides a sample weekly menu.
2. It also discusses principles of weaning and complementary feeding for infants after 6 months, including introducing semi-solid foods and finger foods. The importance of continued breastfeeding is emphasized.
3. Under-five clinics aim to provide comprehensive healthcare for children under 5, focusing on prevention, treatment of illness, growth monitoring, immunizations, and health education. They play a major role in reducing child mortality.
2 physiology and benefits of bf, risk of artificial feeding230113Varsha Shah
Here are the answers to the true/false and multiple choice questions:
1. True
2. True
3. False
4. True
5. False
6. e. Tonsillitis
7. e. Infertility
8. c. Higher cost to feed a lactating mother
9. f. No free sponsorship from pharma, samples of formula and less earnings for hospital
10. d. Mother can do house works, can take care of sibling and save money
11. c. Causes high incidence of jaundice
12. e. All of the above
13. a. Exclusive breast feeding till 6 month
Breast milk is the ideal food for infants, providing all necessary nutrients for healthy growth. The WHO recommends exclusive breastfeeding for the first six months to achieve optimal infant health outcomes. Breastfeeding benefits both mother and child, protecting infants from illness and reducing risks for mothers. Supporting breastfeeding practices like early initiation and avoiding supplementation are important to establish and sustain breastfeeding.
This document discusses various feeding methods for infants, including breastfeeding, formula feeding, cup feeding, and finger feeding. It provides advantages and disadvantages of each method. Breastfeeding is described as the best method, providing superior nutrition and protection against diseases. The document also covers composition of breast milk, importance of feeding, indications for formula feeding, benefits of extended breastfeeding beyond 6 months, and guidelines for introducing solid foods during weaning.
Feeding of infants and baby friends hospital initiativeJayaramachandran S
At the end of this session, you will be able to
List the advantages of breastfeeding
Describe artificial feeding of Infants
Enumerate the differences b/n human and cow’s milk
Explain the concept of weaning
Enumerate the 10 steps of Baby-Friendly Hospital Initiative
National Guidelines for Infant and Child Feeding and Infant Mortality RateDr. Ankit Mohapatra
National Guidelines for Infant and Child Feeding
Infant Mortality Rate
Early nutrition
Exclusive Breast feeding
Counseling during pregnancy
Complementary feeding
First food
Traditional food
Modified family food
Instant infant food
Protective foods
Feeding during illness
Feeding in exceptionally difficult circumstances
Integrated child development scheme
Reproductive and child health programme
Institutional promotion
International organaisations
Diarrhoea is a major cause of death in children under 5 years old worldwide. Oral rehydration salts (ORS) are the primary treatment for diarrhoea to prevent dehydration. Zinc supplementation for 14 days is also recommended. Probiotics like Lactobacillus rhamnosus GG and Bifidobacterium lactis BB-12 can help treat diarrhoea. Continued feeding and providing extra fluids is important during and after diarrhoea to prevent malnutrition and further illness.
Breastfeeding provides optimal nutrition for infant growth and development. It protects infants from infection through antibodies and aids in bonding. Common breastfeeding positions include football hold, cradle hold, and cross-cradle hold. Supplementary feeding with expressed breast milk or formula may be needed if the mother is ill or baby is not gaining weight. Cow's milk differs significantly from breast milk in composition and is not recommended as a primary food for infants under 6 months. Weaning involves transitioning from breast or bottle feeding to use of a cup and solid foods.
This document discusses the control of diarrhoeal diseases. It begins by defining diarrhoea and describing the types of diarrhoeal diseases such as acute watery diarrhoea, acute bloody diarrhoea, and persistent diarrhoea. It then discusses the magnitude of diarrhoeal diseases globally and in India, describing that diarrhoea is the second leading cause of death in children under 5 years old worldwide. The document outlines the three essential elements in managing diarrhoea - rehydration therapy, zinc supplementation, and continued feeding. It provides details on assessing and treating dehydration, including treatment plans for severe and some dehydration.
This document discusses probiotics and their role in managing diarrhea. It defines probiotics as live microbes that provide health benefits when consumed in adequate amounts. Common probiotic strains include Lactobacillus, Bifidobacterium, and Saccharomyces boulardii. Probiotics can help treat digestive disorders, allergies, and lower cholesterol. They are found naturally in foods like yogurt. Clinical studies show certain probiotic strains like L. rhamnosus GG and a mix of bacterial strains can significantly shorten the duration of acute diarrhea in children. The document also outlines guidelines for classifying and treating diarrhea based on dehydration signs, recommending oral rehydration, zinc and probiotic supplements,
- Functional constipation, which accounts for 95% of cases in children and adolescents, is diagnosed based on the Rome IV criteria through a history and physical exam without additional testing.
- Common treatments for functional constipation include polyethylene glycol (Miralax), lactulose, and enemas. Increasing fiber/fluid intake and probiotics are not effective treatments.
- Referrals to a psychologist can help with some treatment goals, like improving a child's quality of life negatively impacted by chronic constipation. Managing constipation requires addressing relapses and potentially long-term therapy.
PRACTICE TEACHING. BFHI-1.power point presentationKittyTuttu
The document discusses the Baby Friendly Hospital Initiative (BFHI) and exclusive breastfeeding. It provides:
1) The 10 steps of successful breastfeeding according to the BFHI which hospitals must follow to be certified. This includes rooming-in, not giving supplements, encouraging on demand feeding, etc.
2) The definition of exclusive breastfeeding as only receiving breastmilk and no other foods or liquids for the first 6 months.
3) The benefits of breastmilk for both baby and mother including nutritional, immunological, developmental benefits as well as convenience and health benefits for the mother.
Unit 4 presentation on diarrhea by Anjali yadav.pptxanchalyadav895389
Diarrhea is defined as having 3 or more loose stools per day. Globally, nearly 1.7 billion cases of childhood diarrhea occur annually, making it a leading cause of death among children under 5. Diarrhea can be acute or chronic based on duration, and causes include infections, drugs, diet, surgery, and other miscellaneous factors. Management involves oral rehydration therapy to replace lost fluids, administering prescribed medications, maintaining nutrition, and educating on prevention.
This document discusses infant feeding practices and breastfeeding. It begins with definitions of different infant feeding categories like exclusive breastfeeding, predominant breastfeeding, complementary feeding, and bottle feeding. It then covers principles of breastfeeding like initiating breastfeeding within 30 minutes of birth and exclusively breastfeeding for the first 6 months. The advantages of breastfeeding for both babies and mothers are provided. National breastfeeding practices and initiatives like the Baby Friendly Hospital Initiative (BFHI) are also summarized.
Breastfeeding provides numerous health benefits for both infants and mothers. For infants, breastfeeding results in reduced risks of diseases like diarrhea and pneumonia as breast milk contains antibodies that protect against infection. Exclusive breastfeeding for the first six months can save over one million infant lives annually. Breastfeeding also lowers risks of chronic diseases later in life such as hypertension, diabetes and obesity. For mothers, breastfeeding lowers risks of uterine bleeding, breast and ovarian cancers, and helps mothers return to their pre-pregnancy weight. Overall, breastfeeding is recognized as the best source of nutrition for infant growth and development.
Breastfeeding provides significant health benefits for both infants and mothers. It provides infants with ideal nutrition tailored to their needs and protects them from disease. Breastfeeding reduces infant mortality from diarrhea and respiratory infections and lowers the risks of chronic diseases later in life. For mothers, breastfeeding lowers the risks of breast and ovarian cancer and helps with weight loss after childbirth. Society benefits from lower healthcare costs when more infants are breastfed. Initiatives like the Baby-Friendly Hospital Initiative aim to protect, promote and support breastfeeding. However, myths and misinformation continue to reduce breastfeeding rates in Pakistan.
The document provides guidance for childcare centers on supporting breastfeeding mothers by educating staff on breastmilk storage guidelines, the benefits of breastfeeding for mothers, babies, and childcare centers, and recommendations for helping working mothers continue breastfeeding including establishing and maintaining milk supply. The goal is to increase support for breastfeeding mothers using childcare so they can continue providing breastmilk for their babies.
1. Diarrhea is caused by infections that imbalance the intestines' fluid and electrolyte processes, commonly from rotavirus in children. It can lead to dehydration, malnutrition, and death.
2. Nursing management of diarrhea involves monitoring for complications, maintaining hydration through oral rehydration and continued feeding, and treating any underlying infections.
3. Treatment plans include oral rehydration with zinc at home, or intravenous rehydration in clinic for severe cases along with continued feeding and antibiotics if needed.
Psm mch - infant feeding & under 5 clinicdrjagannath
Breastfeeding is the ideal method of infant feeding for the first six months. It provides optimal nutrition through components in colostrum and breastmilk that enhance infant development and provide immunity. Proper breastfeeding techniques should be demonstrated to ensure babies feed effectively. The Baby-Friendly Hospital Initiative promotes ten evidence-based steps to support successful breastfeeding. Growth monitoring at under-five clinics helps identify malnutrition so it can be addressed, improving child health outcomes.
This document provides an overview of diarrheal disease including its causes, classification, management, and prevention. It discusses that diarrheal disease is the second leading cause of death in children under 5 globally. The main points are: acute watery diarrhea accounts for over 75% of cases; continued feeding and oral rehydration solutions are the primary treatment; zinc and probiotics can help prevent and treat diarrhea; and diarrhea management should focus on preventing dehydration through oral rehydration.
Preventive healthcare- role of pharmacists- II.pptxishikachoudhary6
The document discusses the role of pharmacists in mother and child care. It outlines that pharmacists (1) provide contraceptive options and emergency contraception for mothers, (2) educate parents on vitamins/supplements and encourage healthy habits, and (3) recommend appropriate medication during pregnancy and delivery. The document also discusses the benefits of breastfeeding for both children and mothers, as well as appropriate substitutes if breastfeeding is not possible. It provides guidelines for successful breastfeeding and safe bottle feeding practices.
Feeding of infants and baby friends hospital initiativeJayaramachandran S
At the end of this session, you will be able to
List the advantages of breastfeeding
Describe artificial feeding of Infants
Enumerate the differences b/n human and cow’s milk
Explain the concept of weaning
Enumerate the 10 steps of Baby-Friendly Hospital Initiative
National Guidelines for Infant and Child Feeding and Infant Mortality RateDr. Ankit Mohapatra
National Guidelines for Infant and Child Feeding
Infant Mortality Rate
Early nutrition
Exclusive Breast feeding
Counseling during pregnancy
Complementary feeding
First food
Traditional food
Modified family food
Instant infant food
Protective foods
Feeding during illness
Feeding in exceptionally difficult circumstances
Integrated child development scheme
Reproductive and child health programme
Institutional promotion
International organaisations
Diarrhoea is a major cause of death in children under 5 years old worldwide. Oral rehydration salts (ORS) are the primary treatment for diarrhoea to prevent dehydration. Zinc supplementation for 14 days is also recommended. Probiotics like Lactobacillus rhamnosus GG and Bifidobacterium lactis BB-12 can help treat diarrhoea. Continued feeding and providing extra fluids is important during and after diarrhoea to prevent malnutrition and further illness.
Breastfeeding provides optimal nutrition for infant growth and development. It protects infants from infection through antibodies and aids in bonding. Common breastfeeding positions include football hold, cradle hold, and cross-cradle hold. Supplementary feeding with expressed breast milk or formula may be needed if the mother is ill or baby is not gaining weight. Cow's milk differs significantly from breast milk in composition and is not recommended as a primary food for infants under 6 months. Weaning involves transitioning from breast or bottle feeding to use of a cup and solid foods.
This document discusses the control of diarrhoeal diseases. It begins by defining diarrhoea and describing the types of diarrhoeal diseases such as acute watery diarrhoea, acute bloody diarrhoea, and persistent diarrhoea. It then discusses the magnitude of diarrhoeal diseases globally and in India, describing that diarrhoea is the second leading cause of death in children under 5 years old worldwide. The document outlines the three essential elements in managing diarrhoea - rehydration therapy, zinc supplementation, and continued feeding. It provides details on assessing and treating dehydration, including treatment plans for severe and some dehydration.
This document discusses probiotics and their role in managing diarrhea. It defines probiotics as live microbes that provide health benefits when consumed in adequate amounts. Common probiotic strains include Lactobacillus, Bifidobacterium, and Saccharomyces boulardii. Probiotics can help treat digestive disorders, allergies, and lower cholesterol. They are found naturally in foods like yogurt. Clinical studies show certain probiotic strains like L. rhamnosus GG and a mix of bacterial strains can significantly shorten the duration of acute diarrhea in children. The document also outlines guidelines for classifying and treating diarrhea based on dehydration signs, recommending oral rehydration, zinc and probiotic supplements,
- Functional constipation, which accounts for 95% of cases in children and adolescents, is diagnosed based on the Rome IV criteria through a history and physical exam without additional testing.
- Common treatments for functional constipation include polyethylene glycol (Miralax), lactulose, and enemas. Increasing fiber/fluid intake and probiotics are not effective treatments.
- Referrals to a psychologist can help with some treatment goals, like improving a child's quality of life negatively impacted by chronic constipation. Managing constipation requires addressing relapses and potentially long-term therapy.
PRACTICE TEACHING. BFHI-1.power point presentationKittyTuttu
The document discusses the Baby Friendly Hospital Initiative (BFHI) and exclusive breastfeeding. It provides:
1) The 10 steps of successful breastfeeding according to the BFHI which hospitals must follow to be certified. This includes rooming-in, not giving supplements, encouraging on demand feeding, etc.
2) The definition of exclusive breastfeeding as only receiving breastmilk and no other foods or liquids for the first 6 months.
3) The benefits of breastmilk for both baby and mother including nutritional, immunological, developmental benefits as well as convenience and health benefits for the mother.
Unit 4 presentation on diarrhea by Anjali yadav.pptxanchalyadav895389
Diarrhea is defined as having 3 or more loose stools per day. Globally, nearly 1.7 billion cases of childhood diarrhea occur annually, making it a leading cause of death among children under 5. Diarrhea can be acute or chronic based on duration, and causes include infections, drugs, diet, surgery, and other miscellaneous factors. Management involves oral rehydration therapy to replace lost fluids, administering prescribed medications, maintaining nutrition, and educating on prevention.
This document discusses infant feeding practices and breastfeeding. It begins with definitions of different infant feeding categories like exclusive breastfeeding, predominant breastfeeding, complementary feeding, and bottle feeding. It then covers principles of breastfeeding like initiating breastfeeding within 30 minutes of birth and exclusively breastfeeding for the first 6 months. The advantages of breastfeeding for both babies and mothers are provided. National breastfeeding practices and initiatives like the Baby Friendly Hospital Initiative (BFHI) are also summarized.
Breastfeeding provides numerous health benefits for both infants and mothers. For infants, breastfeeding results in reduced risks of diseases like diarrhea and pneumonia as breast milk contains antibodies that protect against infection. Exclusive breastfeeding for the first six months can save over one million infant lives annually. Breastfeeding also lowers risks of chronic diseases later in life such as hypertension, diabetes and obesity. For mothers, breastfeeding lowers risks of uterine bleeding, breast and ovarian cancers, and helps mothers return to their pre-pregnancy weight. Overall, breastfeeding is recognized as the best source of nutrition for infant growth and development.
Breastfeeding provides significant health benefits for both infants and mothers. It provides infants with ideal nutrition tailored to their needs and protects them from disease. Breastfeeding reduces infant mortality from diarrhea and respiratory infections and lowers the risks of chronic diseases later in life. For mothers, breastfeeding lowers the risks of breast and ovarian cancer and helps with weight loss after childbirth. Society benefits from lower healthcare costs when more infants are breastfed. Initiatives like the Baby-Friendly Hospital Initiative aim to protect, promote and support breastfeeding. However, myths and misinformation continue to reduce breastfeeding rates in Pakistan.
The document provides guidance for childcare centers on supporting breastfeeding mothers by educating staff on breastmilk storage guidelines, the benefits of breastfeeding for mothers, babies, and childcare centers, and recommendations for helping working mothers continue breastfeeding including establishing and maintaining milk supply. The goal is to increase support for breastfeeding mothers using childcare so they can continue providing breastmilk for their babies.
1. Diarrhea is caused by infections that imbalance the intestines' fluid and electrolyte processes, commonly from rotavirus in children. It can lead to dehydration, malnutrition, and death.
2. Nursing management of diarrhea involves monitoring for complications, maintaining hydration through oral rehydration and continued feeding, and treating any underlying infections.
3. Treatment plans include oral rehydration with zinc at home, or intravenous rehydration in clinic for severe cases along with continued feeding and antibiotics if needed.
Psm mch - infant feeding & under 5 clinicdrjagannath
Breastfeeding is the ideal method of infant feeding for the first six months. It provides optimal nutrition through components in colostrum and breastmilk that enhance infant development and provide immunity. Proper breastfeeding techniques should be demonstrated to ensure babies feed effectively. The Baby-Friendly Hospital Initiative promotes ten evidence-based steps to support successful breastfeeding. Growth monitoring at under-five clinics helps identify malnutrition so it can be addressed, improving child health outcomes.
This document provides an overview of diarrheal disease including its causes, classification, management, and prevention. It discusses that diarrheal disease is the second leading cause of death in children under 5 globally. The main points are: acute watery diarrhea accounts for over 75% of cases; continued feeding and oral rehydration solutions are the primary treatment; zinc and probiotics can help prevent and treat diarrhea; and diarrhea management should focus on preventing dehydration through oral rehydration.
Preventive healthcare- role of pharmacists- II.pptxishikachoudhary6
The document discusses the role of pharmacists in mother and child care. It outlines that pharmacists (1) provide contraceptive options and emergency contraception for mothers, (2) educate parents on vitamins/supplements and encourage healthy habits, and (3) recommend appropriate medication during pregnancy and delivery. The document also discusses the benefits of breastfeeding for both children and mothers, as well as appropriate substitutes if breastfeeding is not possible. It provides guidelines for successful breastfeeding and safe bottle feeding practices.
Similar to Managing diarrhea- Current nutrition perspectives.pptx (20)
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
2. IMPORTANT NOTICE: MOTHER’S MILK IS BEST FOR
THE BABY
Breastfeeding provides the best nutrition and protection from illnesses of infants. For infants, breast milk is all that is needed for the first 6 months. Breastmilk is the best and
most economical food for baby.
Warning / Caution: Infant milk substitute is not the sole source of nourishment of an infant. Careful and hygienic preparation of infant milk substitute is most essential for health.
Lactose- free infant milk substitute should only be used in case of diarrehea due to Lactose intolerance. Lactose- free infant formula should be withdrawn, if there is no
improvement in symptoms of intolerance.
Continued use of infant milk substitute should not be recommended to avoid any difficulties in reverting to breastfeeding of infants after a period of feeding by infant milk
substitute. In the event recommending infant milk substitute in addition to breastmilk or its replacement during the first 6 months, keep the costs in mind before recommending use
of infant milk formula. Un-boiled water, un-boiled bottles or incorrect dilution can make a baby ill. Always advise to follow instructions exactly.
Unnecessary introduction of partial bottle-feeding or other foods and drinks will have negative effect on breastfeeding.
Characteristics of breastmilk : Immediately after delivery, breastmilk is yellowish and sticky. The milk is called Colostrum, which is secreted during the first-week of delivery.
Colostrum is more nutritious than mature milk because it contains more proteins, more anti-infective properties, which are of great importance for the infant’s defense against
dangerous neo-natal infections. It also contains higher levels of Vitamin ‘A’.
Advantages of breastfeeding : (A) Breastfeeding is much cheaper than feeding an infant milk substitute as the cost of extra food needed by the mother is negligible as
compared to cost of feeding infant milk substitute; (B) Breastmilk is always available; (C) Breastmilk needs no utensils or water (which might carry germs) or fuel for is
preparation; (D) Mothers who breastfeed usually have longer periods of infertility after child birth than non-lactators.
Management of breastfeeding, as under:
I. Breastfeeding
A. Immediately after delivery enables the contraction of the womb and helps the mother to regain her figure quickly.
B. Is successful when the infant suckles frequently and the mother wanting to breastfeed is confident in her ability to do so.
II.In order to promote and support breastfeeding the mother's natural desire to breastfeed should always be encouraged by giving, where needed,
practical advice and making sure that she has the support of her relatives.
iii. Adequate care for the breast and nipples should be taken during pregnancy.
iv. It is also necessary to put the infant to the breast as soon as possible after delivery.
v. Let the mother and the infant stay together after the delivery, the mother and her infant should be allowed to stay together (in hospital, this is called "rooming- in").
vi. Give the infant Colostrum as it is rich in many nutrients and its anti-infective factors protect the infants from infections during the few days of its birth.
vii. The practice of discarding Colostrum and giving sugar water, honey water, butter or other concoctions instead of Colostrum should be very strongly discouraged.
viii. Let the infants suckle on demand.
ix. Every effort should be made to breastfeed the infants whenever they cry.
x. mother should keep her body and clothes and that of the infant always neat and clean.
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 2
3. outline
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 3
Diarrhea
Principles of therapy
Goals of nutritional management
Lactose malabsorption in diarrhea
Nutrition management in different situations
Recommendations
Summary
4. Definition
Three clinical types of diarrhoea::
Acute watery
diarrhoea – lasts
several hours or days
Acute bloody
diarrhoea – also called
dysentery
Persistent diarrhoea –
lasts 14 days or longer
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 4
https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease
Koletzko S, Osterrieder S. Acute infectious diarrhea in children. Dtsch Arztebl Int. 2009;106(33):539–548.
Diarrhea is defined as the passage of three or more loose or liquid stools per
day (or more frequent passage than is normal for the individual). Frequent
passing of formed stools is not diarrhea, nor is the passing of loose, "pasty"
stools by breastfed babies.
5. Epidemiology
Childhood diarrhea is a major public
health burden in India.
Diarrhea is third most common cause
of death in children under five years
of age in India.
Infants and toddlers typically suffer
from acute infectious gastroenteritis
once or twice per year.
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 5
Incidence of Diarrhea in Infants.3
1. Koletzko S, Osterrieder S. Acute infectious diarrhea in children. Dtsch Arztebl Int. 2009;106(33):539–548.
2. Shah, D., Choudhury, P., Gupta, P. et al. Indian Pediatr (2012) 49: 627.
3. International Institute for Population Sciences (IIPS) and Macro International. 2007. National Family Health Survey (NFHS-3), 2005–06: India: Volume I. Chapter 9. Child health page no 223-266
0
2
4
6
8
10
12
14
16
18
20
<6
months
6-11
months
12-23
months
24-35
months
36-47
months
48-59
months
Incidence (%)
6. Causes of diarrhea
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 6
Koletzko S, Osterrieder S. Acute infectious diarrhea in children. Dtsch Arztebl Int. 2009;106(33):539–548.
Viruses
• Rotaviruses, noroviruses, and adenoviruses responsible for
about 70% of the cases.
• Rotavirus responsible for about 40% of cases of acute
diarrheal illness in the first 5 years of life.
• Noroviruses and adenoviruses responsible for a further
30% cases.
Bacteria
• In about 20% of affected children, a bacterial pathogen can
be identified in the stool (Campylobacter jejuni, yersinia,
salmonella, shigella, pathogenic E. coli, or clostridium
difficile)
Parasites
• Parasites are the cause in fewer than 5% (lamblia,
cryptosporidia, Entamoeba histolytica, and others).
7. Clinical features of Dehydration
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 7
Clinical features of dehydration
Mild Moderate Severe
Irritable
• Irritable
• Weak pulse
• Some reduction in urine volume
• Moribund, apathetic
• Peripheral circulatory failure (cold extremities,
warm body, excessive blanching, weak pulse)
• Marked reduction in urine volume
• Fontanelle depressed
• Eyeballs sunken
• Facies dry and pinched
• Buccal mucosa dry
• Lips parched
• Loss of skin turgor (except in in
hypernatremic variety)
• Fontanelle markedly depressed
• Eyeballs markedly sunken
• Facies markedly dry and pinched
• Buccal mucosa dry
• Lips parched
• Loss of skin turgor (except hypernatremic in
which it may not be variety prominent)
Thirsty • Thirsty • Thirsty
Understanding and Managing Acute Diarrhoea in Infants and Young Children. [Internet] 2019. [Accessed: 18 April, 2019]. Available from: https://hetv.org/resources/acute-diarrhoea.htm.
8. Diagnostic evaluation
Most important diagnostic step is clinical assessment
of the degree of dehydration.
The further diagnostic evaluation concerns the
potential complications.
Good history-taking and physical examination is the
foundation of the diagnostic evaluation.
In severe cases, when complications arise, further
studies must be performed
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 8
Koletzko S, Osterrieder S. Acute infectious diarrhea in children. Dtsch Arztebl Int. 2009;106(33):539–548.
9. History
History-taking should follow a
structured procedure, as the
information obtained will largely
determine the further diagnostic and
therapeutic measures to be taken
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 9
Understanding and Managing Acute Diarrhoea in Infants and Young Children. [Internet] 2019. [Accessed: 18 April, 2019]. Available from: https://hetv.org/resources/acute-diarrhoea.htm.
10. ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 10
Every child should be examined and weighed with clothes off. The extent of
dehydration and fluid loss can be estimated
Physical examination
Koletzko S, Osterrieder S. Acute infectious diarrhea in children. Dtsch Arztebl Int. 2009;106(33):539–548.
11. Further diagnostic testing
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 11
Blood tests and a stool test to determine the infectious organism are generally
unnecessary in mild to moderate cases of diarrheal illness.
Blood tests are generally not necessary in cases of mild or moderate dehydration,
because the results do not influence the treatment.
Blood tests are indicated for severely dehydrated patients and/or those who will
undergo IV rehydration.
• These should include a complete blood count, acid-base status, glucose,
electrolytes, creatinine, and blood urea nitrogen.
• The urine output should be monitored in all patients with severe dehydration,
impaired renal function, or suspected infection with enterohemorrhagic E. coli
(EHEC).
Koletzko S, Osterrieder S. Acute infectious diarrhea in children. Dtsch Arztebl Int. 2009;106(33):539–548.
12. Treatment
strategies
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 12
1. Koletzko S, Osterrieder S. Acute infectious diarrhea in children. Dtsch Arztebl Int. 2009;106(33):539–548.
2. Kapikian AZ. Viral gastroenteritis. JAMA. 1993 Feb 3;269(5):627-30.
3. Dekate P, Jayashree M, Singhi SC. Management of acute diarrhea in emergency room. Management of acute diarrhea in emergency room.
The therapeutic goal is to replace the
fluid and electrolyte losses resulting
from diarrhea and vomiting.
Oral rehydration with ORS given in
frequent, small amounts over 3–4 hours
is successful in more than 90% of cases.
Intravenous fluids are not routinely
recommended except in cases of
persistent vomiting and/or shock.
Nutritional management
13. Principles of therapy
Mild to Moderate Cases
• Fluid, electrolyte and acid-base homeostasis should be preserved and maintained.
• Nutritional status to be restored as early as possible.
• Breast feeding should be continued.
• Antimicrobial agents should be sparingly used and only for specific indications.
• There is no scientific basis for the use of anti-motility or binding agents.
• Associated features such as persistent vomiting, abdominal distension and
convulsions should be managed appropriately.
Severe cases
• The status of dehydration should be determined quickly and emergency treatment
instituted if necessary.
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 13
Understanding and Managing Acute Diarrhoea in Infants and Young Children. [Internet] 2019. [Accessed: 18 April, 2019]. Available from: https://hetv.org/resources/acute-diarrhoea.htm.
14. ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 14
What is the nutritional
recommendation in the
management of infantile diarrhea?
WHO-UNICEF recommends that oral rehydration therapy, zinc
supplementation and energy dense food intake, in addition to
breast-feeding are key actions to reduce diarrhea in infants
Available from: https://www.unicef.org/media/files/Final_Diarrhoea_Report_October_2009_final.pdf. Accessed on November 26, 2016.
15. Goals of nutritional management
• To temporarily restrict the amount of animal milk (or lactose) in the
diet
• To provide a sufficient intake of energy, protein, vitamins, and minerals
• To facilitate the repair process in the damaged gut mucosa
• To improve nutritional status
• To avoid giving foods or drinks that may aggravate the diarrhea
• To ensure adequate food intake during convalescence
• To correct any malnutrition
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 15
Diarrhea and Dehydration. [Internet] 2016. [Accessed: April 18, 2019]. Available from: https://www.aap.org/en-us/Documents/Module_6_Eng_FINAL_10182016.pdf
16. Lactose malabsorption in acute diarrhoea
The lactase enzyme that breaks down lactose is present at the tips of the intestinal villi which
makes it extremely vulnerable to intestinal injury and disorders
Acute diarrhea can cause damage to the lactase-containing epithelial cells present on the
tips of the intestinal villi, thus causing lactose malabsorption
The new epithelial often lack sufficient lactase activity, which will further exacerbate the
lactose malabsorption, with subsequent prolongation of the diarrheal episode
Disruption of the intestinal barrier during diarrhea often predisposes the infant to lactose
intolerance temporarily because of the loss of epithelial cells that contain lactase.
The osmotic effects of undigested lactose draw fluid into the intestinal lumen causing loose
stools
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 16
1. Nabulsi M, et al Lactose-free milk for infants with acute gastroenteritis in a developing country: study protocol for a randomized controlled trial. Trials. 2015;16:46.
2. Sethi G, et al. Low lactose in the nutritional management of diarrhea: Case reports from India. Clinical Epidemiology and Global Health. 2018 Dec 1;6(4):160-2.
17. ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 17
Nutrition during diarrhea
Reduction in
food intake
Decrease in
absorption of
nutrients
Increase in
catabolism of
nutrient
reserves
Increased
energy
requirements
during
recovery by
~25% of the
RDA
^During recovery, an intake of at least 125% of recommended dietary allowances (RDA) should be attempted with nutrient dense food, and this should continue until the child reaches preillness weight and ideally until the child achieves a normal nutritional status1 In OP
Ghai’s Essential Pediatrics, 8th Edition; 2015, chapter 11; page 295
https://www.ncbi.nlm.nih.gov/books/NBK219100/
18. Nutrition management in different
situations?
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 18
Exclusive
Breastfed
Continue breastfeeding
Breast feeding+ top
feeding
Continue breastfeeding +
lactose free nutrition
Exclusively top fed
Lactose free nutrition is
beneficial
Ideal but may be
difficult to meet
the additional
25% requirement
Lactose free
nutrition will
help meet the
additional 25%
requirement
Suggested feed
Predominant feed of
child
Rehydration first and then re-feeding with lactose- free nutrition should be started
19. ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 19
COCHRANE ANALYSIS- 2013
In young children with acute diarrhoea who are not predominantly breast-fed, changing to a lactose-free diet may result in
the earlier resolution of acute diarrhoea, and reduce treatment failure
Santosham M, Goepp Julius et al. Pediatrics 1991;87:619-622.
20. ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 20
Global recommendation for lactose free nutrition in
Infantile diarrhea
Recommended:
Avoid lactose-
containing milk in
children with
persistent post-
infectious diarrhoea
(diarrhoea lasting
more than 14 days)
when they fail a
dietary trial of milk
or yogurt
Lactose intolerance
occurs in some infants
as a result of acute
gastroenteritis; and
lactose free formulas
are recommended for
post diarrheal
refeeding in patients
who have signs and
symptoms of clinically
significant lactose
intolerance
Breast-feeding should
not be interrupted and
in non-breast-fed
infants and young
children, lactose-free
feeds can be
considered in the
management of
gastroenteritis. Active
therapy may reduce
the duration and
severity of diarrhea
21. Role of Zinc
• Zinc supplementation is a critical new intervention for treating diarrheal episodes in
children.
• Administration of zinc along with new low osmolarity oral rehydration solutions /
salts (ORS), can reduce the duration and severity of diarrheal episodes for up to
three months
• The World Health Organization (WHO) and UNICEF recommend:
• A dosage of 20 mg of elemental zinc per day in age group six months -to five years,
in the management of diarrhea.
• Oral zinc administration provides substantial benefit in the reduction of stool output,
frequency, and duration, combined with safety, efficacy, and affordability in acute
diarrhea
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 21
1. Bajait C, et al. Role of zinc in pediatric diarrhea. Indian J Pharmacol. 2011 May;43(3):232-5.
22. KEY TAKE
AWAYS….
üDiarrhea can be associated with the development
of secondary lactose intolerance
ü The most important management strategy for
diarrhoea in infants is rehydrate with ORS,
replenish with zinc and refuel with energy-dense
food and continued breastfeeding
ü There is an increase in energy requirement by
25% in infantile diarrhoea
ü Breastfeeding should be continued during
diarrhoea
ü Lactose-free nutrition is clinically shown to be
effective in reducing the duration and severity of
diarrhea
ABBOTT - FOR HEALTHCARE PROFESSIONALS ONLY 22
In the first few months of life, changes of stool consistency compared to the usual situation for the individual child are a more significant indication of an acute diarrheal illness than stool frequency.1
Reference
Koletzko S, Osterrieder S. Acute infectious diarrhea in children. Dtsch Arztebl Int. 2009;106(33):539–548.
Infectious enteritis is very common in infancy and early childhood.
Children up to age 3 have an average of one to two episodes per year, with peak incidence between the ages of 6 and 18 months.
Reference
Koletzko S, Osterrieder S. Acute infectious diarrhea in children. Dtsch Arztebl Int. 2009;106(33):539–548.
Most cases of acute diarrhea in young children are due to infections with a wide variety of organisms. All of these are riot amenable to the presently available antimicrobial agents. The exact incidence of these microbes may vary from place to place and at different periods of the year. Broadly speaking, 30 to 40 per cent of diarrhoeal episodes are caused by viruses, of which rotavirus is the best example. About 50 per cent are due to bacterial infections of the gut.1
Reference
Understanding and Managing Acute Diarrhoea in Infants and Young Children. [Internet] 2019. [Accessed: 18 April, 2019]. Available from: https://hetv.org/resources/acute-diarrhoea.htm.
In early and mild cases of diarrhoea, the child may be thirsty and slightly irritable. As the diarrhoea continues and dehydration worsens, the child becomes more irritable and develops a pinched look. His/ her fontanelle, if open, is depressed, the eyes appear sunken, the nose is pinched, and the tongue and the inner side of cheeks appear dry. Abdomen becomes distended in hypokalemia. The child passes urine at longer intervals. As acidosis worsens, the breathing becomes deep and rapid. In extreme cases, the child appears moribund, pulse appears to be weak and thready, blood pressure falls and the quantity of urine passed is markedly reduced. Children with severe dehydration succumb rapidly if they are not promptly treated.
ReferenceUnderstanding and Managing Acute Diarrhoea in Infants and Young Children. [Internet] 2019. [Accessed: 18 April, 2019]. Available from: https://hetv.org/resources/acute-diarrhoea.htm
Diagnostic evaluation using stool culture and culture-independent methods if available should be used in situations where the individual patient is at high risk of spreading disease to others, and during known or suspected outbreaks.
Reference
Koletzko S, Osterrieder S. Acute infectious diarrhea in children. Dtsch Arztebl Int. 2009;106(33):539–548
History-taking should follow a structured procedure, as the information obtained will largely determine the further diagnostic and therapeutic measures to be taken.
The most important pieces of information concern the onset and frequency of diarrhea and vomiting, the intake of fluids and food, urine production, and fever. The parents are asked about the child’s intake of medications, any preexisting illnesses (e.g., metabolic or intestinal conditions or disorders of immunity), and any possible exposures resulting from recent travel abroad, hospitalization, or contact with ill persons.
Good history-taking and physical examination is the foundation of the diagnostic evaluation. In severe cases, when complications arise, or when the diagnosis is in doubt, further studies must be performed.
Reference
Koletzko S, Osterrieder S. Acute infectious diarrhea in children. Dtsch Arztebl Int. 2009;106(33):539–548
A search for the causative organism by culture, direct demonstration of an antigen or toxin, or molecular genetic methods is recommended in the following situations:
Nosocomial infection in hospitalized patients, i.e., onset of diarrhea more than three days after admission
Severe course, with an estimated loss of more than 9% of total body weight
Bloody diarrhea
Recent travel to high-risk countries (Africa, Asia, Central and South America)
Congenital or acquired immune deficiency or immunosuppressive therapy
Suspected Clostridium difficile colitis or hemolytic-uremic syndrome
Infants under 4 months of age, particularly prematurely born infants
Other ill persons in the child’s environment, with suspicion of food poisoning
Persistent diarrhea (for more than two weeks), if a positive result might lead to the administration of antibiotics.
Reference
Koletzko S, Osterrieder S. Acute infectious diarrhea in children. Dtsch Arztebl Int. 2009;106(33):539–548.
The foundation of treatment is fluid and electrolyte replacement and the enteric administration of food to prevent or correct a catabolic state and to promote enterocyte regeneration.
Reference
Koletzko S, Osterrieder S. Acute infectious diarrhea in children. Dtsch Arztebl Int. 2009;106(33):539–548.
Refeeding should be started early and extra food supplements should be given during convalescence.
ReferenceUnderstanding and Managing Acute Diarrhoea in Infants and Young Children. [Internet] 2019. [Accessed: 18 April, 2019]. Available from: https://hetv.org/resources/acute-diarrhoea.htm
Recurrent diarrhea in childhood is associated with malnutrition, which contributes to delays or irreversible deficits in physical and cognitive development. Malnutrition is associated with more than 5 million childhood deaths annually. Children presenting with diarrhea in resource-limited countries should be assessed for malnutrition according to WHO standards, which are reviewed separately.
Reference
Approach to the child with acute diarrhea in resource-limited countries. [Internet] 2019. [Accessed: April 18, 2019]. Available from: https://www.uptodate.com/contents/approach-to-the-child-with-acute-diarrhea-in-resource-limited-countries.
Human milk remains the best food for the babies. It is usual practice not to withhold breastmilk even if the symptoms are suggestive of lactose intolerance. In case of breastfed infants, it is important for the mother to understand that her breast milk is the best food for the baby in long-term. However, in infants who are not breastfed and have inadequate weight gain, lowlactose formulas may be beneficial.
Reference
Sethi G, et al. Low lactose in the nutritional management of diarrhea: Case reports from India. Clinical Epidemiology and Global Health. 2018 Dec 1;6(4):160-2.
For maximum impact on diarrheal diseases, zinc and ORS should be made available at the community level. Community-based programs increase the use of zinc and the introduction of zinc increases the use of ORS in the same communities.
References
Bajait C, et al. Role of zinc in pediatric diarrhea. Indian J Pharmacol. 2011 May;43(3):232-5.