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Nutrition care during episodes of childhood diarrhea

Nutrition care during episodes of childhood diarrhea

Although common, diarrhea can progress to severe dehydration and malnutrition. The disease is responsible for the main reasons for hospital admission and the high infant mortality rates worldwide. For many years in our country, bacterial infection has been at the top of the list of causative factors for acute diarrhea, mainly due to lack of basic hygiene, inadequate food handling and malnutrition. Nowadays, we have rotavirus infections as the most common cause of childhood diarrhea. Parasitic infections, intolerances and food poisoning are also among the most common causes of diarrheal disease.

Diarrheal syndrome, in addition to dehydration, causes significant loss of appetite and malabsorption of nutrients, compromising the child's nutritional status and supporting gravity of the disease. Inadequate practices in conducting treatment, such as discontinuation of food or maintenance of low calorie diets, may impair child development and growth, aggravate malnutrition and lead to a negative outcome in some cases. important in the treatment of childhood diarrhea is proper hydration. Homemade whey should be offered as soon as the first symptoms appear and may be offered gradually after each diarrheal episode.

"Diarrheal syndrome, in addition to dehydration, causes significant loss of appetite and malabsorption of nutrients, compromising the condition The child's nutritional formulation should be carefully prepared so as not to cause adverse effects. Thus, the recommendation is to use a standard measure, distributed at health posts, free of charge, for proper preparation. The recipe? A small measure of salt, two large measures of sugar dissolved in a glass of 200 ml of filtered water or 1 liter of water, 1 tablespoon of cooking salt (3.5g) and 2 tablespoons of sugar (40g) ). Serum can be used for up to 24 hours after preparation.

Soft drinks and isotonic drinks should not be offered to children under 5 years of age in an attempt to prevent or treat dehydration. In severe dehydration situations, oral replacement therapy should be performed in a hospital environment.

Nutrition guidelines of the Integrated Nutrition Therapy Center (Citen) team

1) The fundamental principle of nutritional guidance during episodes of diarrhea is to try to keep the child's food as close to normal as possible in order to maintain weight and avoid aggravation of the disease;

2) Children who are still breastfeeding should continue to breastfeed, even in the oral hydration phase. Breast milk has a low solute load and is of excellent digestion, which makes it well tolerated by the infant organism, even during the diarrhea episode. In addition, breastmilk can also accelerate the recovery of damage to the intestinal mucosa and prevent the malnutrition process.

3) Nutrition care for children receiving artificial feeding is about maintaining adequate age-appropriate dilution. It is not recommended to offer children more diluted solutions, as this practice does not reduce the duration of diarrhea and may contribute to worsening nutritional status. "The bacterial infection has topped the list of the causal factor of acute diarrhea, mainly due to the lack of basic hygiene, improper handling of food and malnutrition "

4) When children already receive solid foods, nutritional care refers only to the supply of food in small amounts and at shorter intervals to combat loss of appetite.

5) Milk represents an excellent source of protein and calcium and is essential in the prevention and treatment of malnutrition. In cases of intolerance, milk should be replaced by lactose-free equivalents, but with adequate sources of calcium. It is very common to introduce soy-based beverages in children with diarrhea, but these beverages in general do not contain calcium and vitamin D in appropriate amounts and therefore should not be consumed as a milk replacer;

6) Meats, in addition to protein sources, represent the main food sources of iron and B-complex vitamins. They can be offered ground, cooked and cut into small or even shredded pieces. Variety in the form of preparation may contribute to better acceptance of the children, since in general, they usually reject this group of food for difficulties in chewing and digestive intolerances. The egg, despite having high nutritional value, should be avoided during diarrhea episodes, as they can cause greater intestinal fermentation and gastric discomfort;

7) Carbohydrates are important energy sources and should be part of every daily meal. At breakfast, this group of foods can be offered in the form of bread or cereal. Roasted breads are usually better accepted by children who have morning sickness. A porridge prepared with oats or rice or cornmeal may be an excellent choice for ingrained children. This preparation may be increased with the addition of olive oil at the time of preparation in order to increase the calorific value of the meal and prevent weight loss; (8) Rice, potatoes and other tubers represent the energy sources of meals lunch and dinner. These foods can be part of preparations such as puree and soup, which can also have their caloric intake increased with the increase of olive oil. Pasta such as pasta are digested very quickly and can cause gastric discomfort, so during the diarrhea episode, the recommendation is to avoid them. However, if the pasta is part of a child's daily diet or if it tolerates this food group better, it should be part of the diet without restriction, preferably prepared in garlic and oil or with fresh tomato sauces; very common to find guidelines that prohibit the consumption of beans during diarrheal disease. This recommendation is not substantiated, except in situations of digestive intolerance caused by the natural fermentation of the grains. This effect can be softened by the appropriate procedure before cooking, which means leaving the grains of sauce in abundant water for up to six hours. The water in the sauce should be discarded before starting cooking, so the fermentative substances in the grains are eliminated and the digestive tolerance improves;

10) Fruits, in addition to energy from carbohydrates, are the main food sources of vitamins and minerals and should be present in all daily meals. Some fruits may aggravate diarrhea like papaya and plum because of their laxative effect. Avocado should be avoided by the high fat content. After the improvement of the picture, all these fruits can be part of the daily diet of children;

11) All vegetables can be part of children's meals, preferably cooked. The use of fibrous foods in the treatment of constipation is widespread, but these substances can also be used to treat diarrhea, especially vegetable fibers. Leafy vegetables should be avoided until episodes of diarrhea cease.


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