Victorian Childcare centers have been hit with another large gastro outbreak over the last few weeks. Most cases are not serious, however there has been an increase in hospitalizations. Here’s a reminder of the warning signs, prevention tips and possible complications.
Gastro Tips in Kids: Treatment & Prevention
What is gastroenteritis?
Gastroenteritis also known as gastro or the stomach flu is an infection of the intestines which causes a variety of gastrointestinal symptoms including; vomiting, nausea, loose bowels, stomach pain, cramps and sometimes a raised temperature.
It is usually self-diagnosable and in most cases is not serious.
Gastro - Causes
There are a number of different causes of gastroenteritis these may include a number of different viruses, a bacteria, parasites, bacterial toxins sometimes found in foods, certain environmental chemicals and medications which may trigger symptoms in some individuals.
Whilst all of these things can cause gastro the most common cause is a virus the main types being rotavirus and norovirus. These viruses are contagious and can be easily spread from an infected person specifically while symptoms are present. In an environment such as a child care due to shared surfaces/toys, close contact and reduced awareness of hygiene procedures due to age, gastroenteritis can spread very easily.
Gastro - Treatment
In most cases gastroenteritis is treated with conservative methods.
Such as ensuring to keep an infected child hydrated with water or electrolyte drinks
Avoiding stomach irritants such as spicy, rich, fatty and creamy foods.
Offer ibuprofen or paracetamol for fever management
Keeping the child home and encouraging sleep and rest.
In cases where the infection is bacterial, antibiotics may be required. Or if the infection is due to a parasite, other medications may be needed to kill the parasite. In severe cases, the doctor may prescribe anti-nausea or anti diarrhoea drugs to help alleviate symptoms.
In children under 6 months old it is important to get medical attention as soon as possible.
Older children can usually be cared for at home. If they are not having fluids, there is blood in vomit or faeces, they are showing signs of dehydration, have green vomit, are in extreme pain or symptoms are not improving they should see a GP.
Gastroenteritis Tips
Prevention
Prevention of gastroenteritis in childcare centres is around preventing bacterial infections and stopping the spread.
We can prevent bacterial infections by ensuring food safety;
washing all food thoroughly
ensuring hands are washed before food prep
ensuring foods are cooked correctly to kill of any bacteria
storing food correctly after cooking and,
reheating correctly.
We can stop the spread of gastroenteritis by keeping children home if they are sick. Best practice suggests children should not return to childcare until they have been clear of symptoms for 48 hours.
Childcares should also be diligent in hand hygiene ensuring children are washing their hands before eating and after using the bathroom. Ensure that any toys and play equipment is cleaned regularly and alerting families if an outbreak has occurred so that they can monitor and be aware of symptoms.
The most common complication of gastroenteritis is dehydration.
Dehydration when severe can cause a high temperature, urinary and kidney issues, seizures if electrolytes become severely deranged and hypovolemic shock in instances where blood volume becomes too low.
Thankfully these complications are rare when the case is mild – moderate and the individual is otherwise healthy. Groups which are at increased risk of developing complications include small children, those with weakened immunity and the elderly. Whist risk is higher it is not cause for panic rather a call to be alert and monitor for early signs of dehydration. If you suspect a child is becoming dehydrated, it is always best to seek a medical opinion as in extreme cases or in cases where fluids are unable to be kept down orally IV fluids may be necessary.
Signs of dehydration
Dark and strong-smelling urine
Failure to urinate
Urinating minimal amounts
Dry and sticky tongue
Headache
Muscle weakness
Increased lethargy
Fever
Other complications of gastroenteritis, though rarer, include damage to the intestine causing malabsorption and ongoing stomach sensitivities (IBS). If these are suspected a doctor should be contacted for diagnosis. For issues with persistent stomach sensitivities a dietitian can help to identify triggers and ensure a nourishing diet.
Diet for those with gastroenteritis
There is no specific diet for those with gastroenteritis however due to stomach pain, diarrhoea, nausea and vomiting it is quite common for individuals to not want to eat anything. It is encouraged that children are eating small amounts whilst sick but it is most important that they are getting adequate fluids.
A regular diet cannot be consumed while unwell as it may exacerbate and increase the duration of symptoms. Therefore in lieu of a normal diet easy to digest items are advised these may include;
Crackers
dry toast
bananas
soft drink such as lemonade
apple sauce
rice and,
chicken
These are good options whilst symptomatic and for the first 48 hours post symptoms subside. Items that are known to exacerbate symptoms in some individuals include dairy products, caffeine, fatty or highly seasoned foods.
Aftercare for those who’ve suffered gastroenteritis
The virus is considered to have ‘passed’ 48 hours after a person is free of diarrhoea and vomiting. Whilst no longer considered ill after 48 hours, it is quite common despite being free from prominent symptoms that children still aren’t feeling up to consuming a normal diet. Whilst going back to a normal diet instantly can cause a relapse in some individuals, a bland diet and easily digested diet as outlined above lacks many nutrients and therefore is inappropriate for long term use. It is best to reintroduce foods back gradually building back up to a child’s regular diet.
Small amounts of dairy may be added followed by mildly seasoned dishes and small amounts of fats until they are back to a regular diet. It should not take more than a couple of days to be back to a normal diet after symptoms have subsided.
Most children will recover from gastroenteritis well, returning to normal after a few days. If children start eating poorly, appear more tired and lethargic, appear to have lost weight or are behaving differently consulting with a doctor is beneficial. If a child appears to be suffering from nutrition deficiencies, you may like to discuss a dietitian referral with your doctor.