DIARRHOEA: CHILDREN DON’T HAVE TO DIE

Before I share my story, I have just a question for you.
Did you know diarrhoea is the 2nd leading cause of death among children less than 5years old?

Without mincing words, in the course of my PAEDIATRICS POSTING, diarrhoea was the commonest cause of death. I can’t say for sure if this is as a result of ignorance on the part of the Mothers, but what I know for certain is, this should never cause death as much as it does if only these mothers did the right thing!

The Story

One cool Sunday evening I visited the Children Emergency Room (CHER) to see if there were new patients to clerk as I typically did.
On arrival, there were lots of patients, but this particular patient whose story I’m about to share was more eye-catching. He was unconscious and grunting, while having an oxygen mask on. The doctors were doing their best to save him
Then sitting beside him was a young woman, in her late 20s’, weeping profusely, with a man standing behind her, whom I presumed is her husband and by extension, patient’s father.

I couldn’t just walk away without at least consoling the crying woman. I really hate to see people cry, at least not around me. Sigh

“Good evening, I’m Ola”. I said
“Can I talk to you?” I asked
I was expecting the “No” response, but surprisingly, she nodded in acceptance.

I made it clear to her I needed to take a history from her, and also gave her the option to return later when she felt it was ‘OK’ for her to talk. She chose to speak at once.

He was a Five Months old boy. Their first child.
He presented to us with 7 days of Diarrhoea, having about five episodes on the first day. Just watery, pale coloured stool. She stopped feeding him soon afterwards as she assumed the foods (both breast milk and other foods) were contributing to this. With no improvement.

On the 3rd day, she was informed by her friends that Baby had ‘Jeddy-jeddy’, some claimed it was as a result og ‘teething’.
So on hearing this, she was relieved.
Hours later, the frequency of the stooling progressively increased. She again got worried and this time, gave him some herbal concoctions. All to no avail.
She visited a patent medicine dealer who then prescribed DIASTOP.
With diastop, the diarrhoea stopped. However, she noticed the baby was not getting any stronger or better, rather weaker and also his urine flow drastically reduced, as the baby had one diaper on all day as against the usual per 5-6per day.
She informed her husband of the need to take him to the hospital, but he refused.

So fast forward to this day at CHER. Baby‘s condition got worse. He was unresponsive, breathless, with multiple fits ( (seizures) and a weak cry. He had been given palm kernel oil, scent leafwater. Instead of getting better, he got worse. So at this point, she decided to bring him to the hospital.

To be frank… a lot of things went through my mind. I still could not comprehend why this keeps recurring. It was the umpteenth time I was experiencing such. Like a ‘norm’. Mothers bring their children to the hospital after all their trials and errors had failed. Just when the condition has deteriorated, and they come expecting the doctors to perform a “Miracle”.
These children are hapless. But repeatedly, their parents fail them. Most of them pay with their lives. Why is this so? I imagine poverty plays a big role too.

“You have to love your children unselfishly. That is hard.  But it is the only way”
-Barbara Bush

Well, that’s by the way.
I counseled her but I also knew baby was a ‘red flag’. However, I tried to be positive,
The following morning, I visited and I was told “ we lost him”

Let’s discuss Diarrhoea in Children

Diarrhoea is defined as the passage of three or more loose or liquid stools per day (or more frequent passage than is normal for the child).

It is the 2nd most common cause of death among children less than 5 and also the leading cause of malnutrition in this age group.

Risk Factors

Lack of exclusive breastfeeding.
Bottle feeding
Poor maternal hygiene
Poor immunization Coverage
Malnutrition
Lack of access to clean water
Maternal ignorance

Causes

These include:

1. Viral.Rotavirus is the commonest cause of diarrhea in children in this environment.
2. Bacterial. E. Coli is the 2 leading cause in our environment.
3. Protozoa
4. Fungi . Echeteria echeteria

Complications of Diarrhoea

• Dehydration which is the commonest cause of death.
• Malnutrition 
• Seizure
• Hypoglycemia (Low blood sugar)
• Electrolytes imbalance

What to do…

• Continue feeding the child. Preferably give only breast milk.
• Give ORS or SSS
• Give vitamin A and Zinc
• If the diarrhea persists , See a Paediatrician.

10 THINGS EVERY PARENT OR PROSPECTIVE PARENT MUST KNOW.

1. NEVER WITHOLD FOOD IN A CHILD WITH DIARRHOEA. Withholding feeding reduces the blood sugar level and this can result in Seizures or even death. Also, the child to becomes ‘DEHYDRATED’ which can lead to kidney failure. It is one of the commonest causes of death in these children.

2. ORS. ORS. ORS. (Oral Rehydration Salt).
The importance of this can never be overemphasized. If you must take home one thing today, LET IT BE THIS. ORS is widely available and affordable (less than #50 a sachet).
This should be the first thing every mother ‘must’ give her child who starts passing watery stools. It is a lifesaver! It works like magic. It is only when this fails that you should bring your child to the hospital.
An effective alternative is SSS or SALT SUGAR SOLUTION.
I will be making a post on this… “HOW TO MAKE SSS / ADMINISTER ORS PROPERLY at a later date. Stay tuned.

3. NEVER USE BOTTLE FEEDS/ FEEDING BOTTLES. Plate and spoon is the WHO recommendation. It is more hygienic.

4. VITAMIN A AND ZINC should never be found wanting in your home. If you must administer any drug, it should be these.

5. VACCINE. Your child must be adequately immunized for age. Some of the vaccines help to prevent this disease. ROTAVIRUS vaccine is also available in some hospitals, however, it is not FREE.

6. HAND WASHING. You or the person that prepares baby’s food must wash your hands frequently with soap,  before :
   • feeding your child
   • after changing babies diapers
   • after using the restroom. You must maintain good personal hygiene.

7. No concoctions or herbal drugs. No. You’re harming your innocent child.
8. No Antibiotics. Never you give a child passing WATERY STOOL ANTIBIOTICS. As earlier stated, the commonest cause of diarrhoea in our environment in children less than 5 years is ROTAvirus. So antibiotics won’t work. Only a Doctor can administer antibiotics when it is necessary.
9. Exclusive breastfeeding for the first 6 month.

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10. Never you take your child’s health for granted. Once you notice any changes in your child’s health, go see a Doctor

Diarrhoea kills faster than you can imagine. And these deaths are highly preventable. Forget the Myths of Jeddy-Jeddy, teething and what have you. It is not caused by any of these.

Prevention is better than Cure

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Disclaimer: name, dates, or any other identifying details of this patient in this story were changed to protect his privacy