What should children eat when they have persistent infectious diarrhea?

The article was consulted professionally with MSc Vu Tan Phuc - Department of Medical Examination & Internal Medicine, Vinmec Phu Quoc International General Hospital.

Children with long-lasting infectious diarrhea are the main concern of many parents, because infectious diarrhea not only affects the digestive system but also slows down the child's development.

Infectious diarrhea, also known as infectious diarrhea in children, is the passage of loose stools with a large volume and more frequent bowel movements than usual. Diarrhea occurs when food and liquids pass quickly through the large intestine. Normally, the large intestine will absorb liquid from food and leave solid stools. But if the fluids from foods are not absorbed the result is loose bowel movements.
Persistent infectious diarrhea : An acute episode of diarrhea lasting more than 14 days Distinguish between persistent diarrhea and chronic diarrhea or malabsorption syndromes . Children with diarrhea and absorption disorders, digestive disorders lasting many months due to congenital causes such as congenital enzyme deficiency such as primary disaccharidase enzyme deficiency, pancreatic cystic fibrosis (mucoviscidose), or diseases such as Coeliac disease is also known as Spru disease.

The common bacteria causing infectious diarrhea in children are:
E.coli : There are 5 types but the most common are enteropathogenic E.coli strains (EPEC), semi-adhesive E.coli strains (EAECs) and strains of E.coli. E.Coli intrusion (EIEC). Shigella, Salmonella, Campylobacter jejuni. Types of parasites: Cryptosporidium, L, giardia.

Age: Children under 1 year of age have a higher risk of having an acute episode of diarrhea that becomes infectious diarrhea than in older children.
Regarding nutritional and immune status: The prevalence of persistent infectious diarrhea in malnourished children is higher than in normal children. A study in Brazil showed that the incidence of persistent diarrhea in children with a height of less than 90% and a weight of less than 75% of the standard was twice as high as that of normal children. In severely malnourished patients, acquired immunodeficiency syndrome (AIDS) is prone to infectious diarrhea, high risk of death.
Regarding the diet, children who are not breastfed or are lactose intolerant or allergic to animal milk proteins are at risk for infectious diarrhea.
Repeated infectious diarrhea, children with frequent episodes of diarrhea are at risk for prolonged infectious diarrhea.
Treatment of infectious diarrhea inappropriately: Abuse of antibiotics, prolonged use of antibiotics causing dysbacteriosis or use of antidiarrheal drugs that reduce the ability to eliminate bacteria, prolonged diet when infected with diarrhea bacteria.

The duration of infectious diarrhea episodes lasted for more than 14 days, the number of diarrhea episodes per day decreased and increased. In the stool there is a lot of liquid water, clumps, sour or acrid smell, yellow or green, foamy, mucus when intolerant to sugar. Mucous stools that are pink or bloody, and have to be strained to pass are common in children with persistent diarrhea after dysentery. Children are anorexic, have difficulty digesting strange foods or have diarrhea again.
Children lose weight, slow growth in weight and height. Children are severely malnourished with Kwashiokor, or atrophy if infectious diarrhea persists and fasting for a long time. Vitamin deficiency: group of fat-soluble vitamins can cause dry eyes, rickets, hemorrhage... and lack of B vitamins. Prolonged infectious diarrhea can cause dehydration - electrolytes. Children who are only mildly dehydrated can be rehydrated orally.
Accordingly, parents should take their child to a doctor when the child has the following symptoms:
The child has diarrhea lasting more than 2 days without relief; Your child's stools are bright red or dark brown with blood and mucus like a runny nose; The child's abdomen is painful to the touch; Continuous vomiting, inability to eat and drink for a long time; There are signs of severe dehydration such as dry wrinkled skin, crying without tears, little urine, lethargy, skin rash, etc. The child has diarrhea with a high fever continuously.

Wash your hands with soap and warm water before touching your baby: Washing your hands is the simplest way to prevent you from transmitting harmful bacteria to your child. You should wash your hands after going out, shopping, working, ... before making milk or preparing food for children. Wash your hands immediately after going to the bathroom to change a diaper or when covering your mouth with your hand every time you cough or sneeze.
Clean baby's feeding bottles and utensils: Clean your baby's feeding bottles or utensils and boil them in hot water. This way, you will limit the transmission of disease to your baby. However, you should carefully read the instructions on the heat resistance of those tools.
Wash children's toys: Usually, children will have a habit of putting toys in their mouths, which inadvertently causes them to become infected. Therefore, you should regularly clean plastic toys with mild detergent and water. If the item's instructions for use allow it to withstand high temperatures, boil and dry. Properly cleaning children's toys will help prevent infectious diarrhea.

5.1 For infants under 6 months of age who are breastfed. For breastfed children: The mother continues to breastfeed normally, even increasing the number of feedings. Thanks to the optimal combination of ingredients, suitable for the baby's digestive system, breast milk will still be well tolerated when the baby has diarrhea. Breastfeeding helps reduce infectious diarrhea, babies with diarrhea will heal faster, and helps to compensate for water loss due to diarrhea. When the child has infectious diarrhea, the mother should apply a more nutritious diet to produce enough milk and provide enough nutrients for the baby only through breast milk.
For children using formula milk (cow's milk, powdered milk,...): If the child with infectious diarrhea is not breastfed, the child can use cow's milk or formula that the child has used before, But it should be noted that children must eat little by little and must divide many meals during the day. If your baby is bottle-fed, then more dilution than usual and at least every 3 hours between meals.

5.2 For children from 6 months of age and older Using foods that are easy to digest: In addition to breast milk, children should eat more easily digested foods such as: Rice flour, chicken, potatoes, pork lean, yogurt, soy milk, banana, pepper, carrots, sapodilla,... During the period of diarrhea, the mother should only give the baby foods that are processed in the form of soft liquid, easy to digest such as: porridge, soup, crushed rice. Food for children with persistent infectious diarrhea should be cooked thoroughly. Feed your baby immediately after cooking to ensure hygiene and reduce the risk of superinfection. In case it is mandatory for the child to be outside to eat pre-cooked food, the mother needs to warm it up before giving it to the baby. When preparing food for children with infectious diarrhea, mothers should wash their hands with soap and ensure the hygiene of kitchen utensils.
Children's meals still need to add fat to increase energy for the diet. Because the child is having diarrhea, the mother should use vegetable oils such as peanut oil, sesame oil, sunflower oil, ... instead of fat.
In addition, mothers should give children with diarrhea to eat more ripe fruits, or ripe fruit juices such as bananas, oranges, mangoes, sapodilla to help increase potassium absorption.

For children with persistent infectious diarrhea, the number one priority is rehydration. After each time the child has a bowel movement, the mother needs to give the child rehydration immediately. The appropriate type of water for children with diarrhea is coconut water or diluted porridge.
Mothers should give children probiotics to help reduce diarrhea symptoms because probiotics contain a large amount of beneficial bacteria for the digestive tract. These beneficial bacteria strains in probiotics help inhibit the growth and cause disease of harmful microorganisms in the digestive tract, enhance the activity of the immune system, thereby helping children digest food. better and enhance the absorption of nutrients.
Along with adding to the child's diet beneficial foods to help the digestive system, the mother should also note the foods that should not be given to the child when the child has infectious diarrhea, for example:
Sugar or foods containing a lot of sugar such as cakes, candies and soft drinks make the diarrhea of ​​children worse because they will cause more osmotic pressure into the intestinal lumen. Limit the use of foods that are high in fiber or low in nutrients such as: Raw vegetables (bamboo shoots, celery) or whole grains (maize, beans) that are difficult to digest. Absolutely do not let children with diarrhea eat uncooked foods and do not drink water. Amount of food and meals for children with diarrhea: For young children, mothers should feed 6 times a day or more. To help children recover from diarrhea and infections quickly and avoid malnutrition. In case the child eats little or vomits when eating, it is recommended to feed less and increase the number of meals compared to the menu. Change and diversify dishes constantly because this is when children will quickly get bored. Let your child choose foods according to their preferences, but you must ensure that they are safe and nutritious, so they can eat more, even exceeding their mother's wishes.

Diarrhea is a serious illness and has a huge impact on a child's health. Hopefully, through the above article, it will help parents get more useful information about prolonged infectious diarrhea in children so that they can help their children stay healthy and have fun with friends.
To protect your baby's health, you should take your child to a medical facility for examination and treatment right away. Pediatrics Department - Vinmec International General Hospital is highly appreciated by customers for the quality of examination and treatment. Vinmec is one of the few hospitals with a full range of doctors specializing in gastroenterology, neurology, psychological disorders, endocrinology, nutrition.. right at the Pediatric Department. Therefore, in case the baby has prolonged diarrhea with complications, it will be handled quickly, bringing good treatment effect. In addition, the baby will be advised to build his own nutrition regimen, which will help provide enough nutrients for the baby, better resistance, and faster body recovery.
If there is a need to examine and treat prolonged diarrhea for your baby, please book an appointment directly at the website or contact the hotline system for service.