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  • Title: [Current treatment of acute diarrhea in infants].
    Author: Girardet JP, Fontaine JL.
    Journal: Ann Pediatr (Paris); 1988 Nov; 35(9):609-12. PubMed ID: 3143301.
    Abstract:
    Infantile diarrhea in France is usually benign and self limiting, but in rare cases dehydration or malnutrition with continuing diarrhea can occur. Dehydration may almost always be prevented and treated with an oral solution containing glucose and electrolytes. Rapid feeding adapted to the age of the child can help prevent nutritional problems. The need for antibiotics and other medications is very limited. Intestinal infection is the cause of most cases of infantile diarrhea. 10-15% of cases are caused by bacteria of various types and the vast majority of the remainder by viruses, with the rotavirus alone accounting for around 1/2 of cases. Oral rehydration can compensate for the exaggerated loss of water and electrolytes. No matter how serious the diarrhea or its cause, some potential for absorption of water and sodium is always retained. Sodium absorption is facilitated by the concomitant presence of glucose in the intestines. Oral rehydration solutions commercially available in France have an electrolyte content adapted to the average fecal loss locally observed in acute diarrhea. Oral rehydration solution is offered to infants at short intervals in a bottle, allowing the child to drink as the need arises. Significant quantities may be absorbed in the 1st 24 hours. Any vomiting usually ceases after administration of a small amount of glucose. Traditional dietary preparations for diarrhea such as carrot soup and products based on rice have essentially an absorbent power and do not diminish intestinal loss of water and electrolytes. In cases of severe dehydration with weight loss of over 10% and unconsciousness, intravenous rehydration is indicated. Whether oral or parietal, rehydration should always be rapid so that feeding can begin. Feeding should start after 24 or at most 48 hours of rehydration to maintain the nutritional state. Rapid feeding is usually well tolerated, but there may be a transitory intolerance to lactose or a secondary sensitivity to proteins in cow's milk. Breast feeding should not be interrupted, but bottle feedings should be stopped for 24-48 hours and reintroduced for infants under 3 months with protein formula not based on cow's milk and for those over 3 months with diluted formula.
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