Pay attention to pediatric diarrhea and help your baby grow up healthily.

Pediatric diarrhea, or diarrheal disease, is a group of digestive tract syndromes caused by multiple pathogens and factors, characterized by increased frequency of bowel movements and changes in stool characteristics. The incidence rate is high among infants and young children aged six months to two years, and the incidence and mortality rate of childhood diarrhea are high, which has a great impact on families and society.

Classification of childhood diarrhea Physiological diarrhea vs. pathological diarrhea. Physiological diarrhea is common in infants under six months old who have diarrhea soon after birth. Except for an increase in the frequency of bowel movements, there are no other symptoms. The appetite is good and growth and development are not affected. The bowel movements are normal after adding complementary foods. Pathological diarrhea is divided into acute (within two weeks), protracted (two weeks to two months), and chronic (>two months) according to the course of the disease. It is divided into infectious (viral, bacterial) and non-infectious (diet, allergy) according to the cause. It is divided into mild and severe according to the condition.

The causes of diarrhea in children are complex and vary according to different age groups and living environments.

If pediatric diarrhea is not controlled, it will further develop into chronic diarrhea. The results of intestinal mucosal biopsy of children with chronic diarrhea show that the occurrence of chronic diarrhea depends more on the degree and range of intestinal mucosal damage. Damage to the repair hormone of the small intestinal mucosa makes diarrhea protracted and chronic, which in turn leads to chronic diarrhea through multiple mechanisms, and the sick children will suffer from malnutrition. Chronic diarrhea/protracted diarrhea in children and malnutrition form a vicious cycle. The prolonged and chronic course of diarrhea in children causes malnutrition: ① Reduced protein absorption, hypoproteinemia, and increased risk of infection. ② Insufficient absorption of trace elements and vitamins, iron deficiency anemia, and impaired growth and development. ③ Insufficient carbohydrates and fats, insufficient energy, and restricted growth and development. After malnutrition occurs, the following will occur: ① Affect the body's immunity. ② Anemia. ③ Affect growth and development. ④ Increase the risk of poor prognosis of diarrhea.

Pediatric diarrhea and nutrition are inseparable and interact with each other. Therefore, nutritional support can help improve the prognosis of children with chronic diarrhea. In the treatment of chronic diarrhea, enteral and parenteral nutrition therapy can effectively improve nutritional status and relieve diarrhea symptoms. In view of the problem of malnutrition after diarrhea, the correct nutritional support strategy should be adopted. Goal one, to help children with diarrhea achieve an ideal nutritional state and meet their needs for normal growth and catch-up growth. Goal two, to focus on the development of nutritional metabolic homeostasis in children's diarrhea stage and nutritional supplementation in the recovery stage. Avoid affecting the growth and development of children.

Nutritional support strategies for different diarrhea mechanisms

① Sugar-induced diarrhea. Lactose intolerance is the most common, and treatment should be a disaccharide-free diet. Lactose-free (low) formula milk can be used.

② Chronic/migratory diarrhea. This type of patients often have intestinal mucosal damage and malabsorption syndrome, and enteral nutrition support therapy with elemental diet is recommended.

③ Allergic diarrhea. Milk allergy is the most common. Avoid eating allergic foods and use oral desensitization feeding without restricting foods that have already been tolerated. Deeply hydrolyzed protein milk powder can effectively promote the growth and development of children with allergic diarrhea.

④ Severe diarrhea. This is a minority of cases. They are often unable to tolerate oral nutrients and are accompanied by severe malnutrition and hypoproteinemia. Total parenteral nutrition can be used.

Enteral nutrition support helps to restore and maintain the physiological function of the digestive system. ① Protect the mucosal mechanical barrier. ② Promote digestive function. ③ Protect the mucosal immune barrier. ④ Maintain the mucosal biological barrier. ⑤ Maintain the mucosal chemical barrier. ⑥ Reduce the risk of complications.

Enteral nutrition support methods:

① Enteral nutrition is administered orally, without technical difficulty and with very few complications.

②If the child has gastrointestinal function and oral supplementation is not possible, tube feeding should be chosen.

③The nasogastric tube may be displaced, compressing the nasal mucosa and causing congestion or erosion of the nasal mucosa.

④Common complications of stoma tube placement, such as tube displacement and obstruction. Intestinal perforation caused by tube displacement is the most serious complication of jejunal feeding.

When treating diarrhea in children, it is necessary to detect it in time and intervene early to avoid malnutrition; when treating diarrhea that has already occurred, it is necessary to actively cooperate with treatment to reduce the impact on children.