How can loose motions be managed in a 1-year-old?

Question

Hello doctor,

My 1-year-old daughter has had loose motion for the past five days. Before that, she was vomiting. However, the vomiting issue is resolved, but still, she is passing loose stool.

She is on Ondem thrice daily half a teaspoon, half an hour before meal (today the course will end), Zinconia one teaspoon once daily for five days, Decolic INF drops three times daily for three days (today Decolic course will end), Enterogermina twice daily for seven days, Arbivit Forte one teaspoon daily (this is her regular medicine and not a part of the prescribed medications by the doctor for loose motion) and Peditrol ORS throughout the day (one liter). We are diluting five sachets of Peditrol ORS in one liter of water, consumed by her each day.

She is accepting all forms of liquid as well. The doctor has advised stool RE/CS/OBT and a reduction of the substance. She also has lactose intolerance so we do not give her any milk products, only lactose-free substitutes, and right now the doctor has said not to give breastmilk as well. The doctor gave SOS medicine as Bacigyl-N but looking at her report she is dead against starting the antibiotic. The issue is she is not improving in her stool and already four days have passed. She is average active (normally very hyper) and accepting food as well (in smaller proportion). I just weighed her, and she has lost 0.7 pounds of weight. She is our first baby hence we are very tense. Please advise the best possible ways to make her fit.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

Going through the history suggests that the child is in the treatment for acute gastroenteritis (AGE). Medicines are rightly prescribed. I would suggest no need for vomiting medicine now, as vomiting has stopped. Withhold Arbivit Forte (Cholecalciferol) till loose motions subside. The stool report does not warrant to start of antibiotics as it is near the normal report except for a reduction in the substance (attachment removed to protect patient identity). As most of the AGE is viral, there is no role for antibiotics. Secondly, antibiotics can aggravate loose motion (antibiotic-associated diarrhea). The best thing is that the child is accepting food/meals, which is a good sign. Though in small quantities, which shall improve over a period.

Do not be in a hurry to look for quick results, as the body takes its own time to recover. Make sure the child is passing adequate urine, and the tongue is moist. Keep giving fluids and ORS (oral rehydration solution) as advised by the doctors. AGE usually takes 7 to 10 days to recover. So, do not get tense. You can continue Zinconia (Zinc acetate) total of 14 days, Enterogermina, and ORS medicine. You can add an Enuff sachet (Racecadotril 10 mg) half sachet twice a day for five days. I believe she will improve as she is on the right medications and taking the meals. So relax. Meanwhile, no cold drinks or cold water, give lots of lukewarm water or homemade soups.

I hope that you get your answer.

Please let me know if you want some help.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I am happy to know stool consistency and frequency have reduced (from seven to three times a day), which is a good sign. Pus cell 2 to 3/hpf is normal and expected as per the baby's illness. No need for any specific treatment. It shall get normalized over a period of time. Yes, stool culture is important. I expect that there should be no growth in the culture. I am pretty sure she will improve.

Just continue what I have suggested. If you feel that the stool frequency has decreased and consistency has improved from liquid to semi-solid, no need for the Enuff sachet to start. Do not worry, make sure she is smiling, playing, and taking semi-solid to liquid meals throughout the day. Let the mother and you spend more time with her if possible. A positive and happy state of mind and surroundings helps speedy recovery in children.

I hope that you get your answer.

Please let me know if you want some help.

Thank you.

Answer 3

Hi,

Welcome back to icliniq.com.

I read your query and understand your concern.

Great to know that the stool culture report is good for the baby. It suggests no organisms, so no antibiotic treatment is required (attachment removed to protect patient identity). I am also happy to hear that the baby is active and playful. She is in the recovery phase.

Continue the same medications as suggested. You can stop Decolic INF (Dimethicone and Dill oil) if you are continuing. Continue Zinconia for a total of 14 days, even if loose motion stops, it gives more gut immunity. Enterogermina (Bacillus clausii) and ORS, you can continue for two more days. ORS you can give only when the baby is passing loose stool (volume replacement). Give coconut water as much as she likes.

I hope that you get your answer.

Please let me know if you want some help.

Thank you.