Gastrointestinal Infections In Infants

November 04, 2020

Gastrointestinal (GI) infection is a common cause of hospital admission for young children especially infants (children less than 1 year old). It is estimated each year, approximately 1.9 million children younger than 5 years of age die of acute diarrhoea.

In medical terms, generally we call GI infection as gastroenteritis, which is the inflammation of the digestive tract by viral, bacterial, or parasitic infection. Viruses are the most common cause of GI infection in both developed and developing countries. In young children, rotavirus is the most common virus which causes them to develop gastroenteritis. Bacterial cause of GI infection is relatively more common in young infants especially those less than 3 months old and this requires urgent medical attention.
 
Symptoms to Watch Out For
The symptoms of GI infection in infants are mainly vomiting, followed by an increase in frequency and watery consistency of stools (called diarrhoea) as well as low grade fever, loss of appetite, tummy distension and discomfort, or even blood in the stools. Diarrhoea mainly lasts 4 to 8 days but can last longer in young infants.

In babies less than 3 months old, the symptoms will be slightly different as the cause of bacterial infection may be slightly higher. They will have less vomiting or diarrhoea; instead, the baby will have fever, tummy distension and will generally be less active. If a baby has such symptoms, urgent medical treatment is required.
 
The Risk Factors
The main risk factors for a GI infection are environmental, demographics and personal. Poor environmental hygiene, poor handling of the baby, incorrect technique of changing diaper and improper washing of the milk bottle and milk preparation can contribute to gastroenteritis.

Young children with malnutrition, lack of proper protein and balanced nutrition intake or with immunodeficiency will also have higher risk of GI infection.
 
Getting the Right Treatment
Most of the time, gastroenteritis amongst children can be monitored at home. As most of the GI infections are viral, antibiotics are not effective against it.

Treatment is taking mainly oral rehydration salt (ORS). It’s important to try to encourage babies to take them orally as much as possible even if just in small, frequent amounts.

If the child cannot drink, and vomiting or diarrhoea has increased, or present with dehydration, the child should be admitted to hospital. In the hospital, intravenous fluid is the mainstay for treatment, while paracetamol can be given to relieve the fever or abdominal discomfort.

Antibiotics will be given if bacterial infection is suspected or in small infants less than 3 months of age.
 
Preventing GI Infection
Breastfeeding is a simple way to prevent gastroenteritis in infants. Breastfed infants have significantly lower chance of gastroenteritis compared to formula-fed infants. For infants who are bottle-fed, caregivers should wash their hands properly with soap and water before preparing milk.

Caregivers should also wash their hands thoroughly after changing diapers. Children with GI infection should not return to childcare centres until they are fully recovered. Additionally, young children should not touch reptiles and birds because these animals typically carry Salmonella bacteria, and infection is more severe in young children.

There are 2 vaccines available which are effective in preventing a Rotavirus infection. Both are to be given orally. However, the vaccine is not yet listed in our national immunization schedule. These vaccines should be given as early as 6 weeks and completed before 6 to 8 months of age to ensure its effectivity against Rotavirus.

 
Dr. Sam Zhi Heng
Consultant Pediatrician
Columbia Asia Hospital - Petaling Jaya

MMBBS (UM), M. Paeds (UM)
   
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  This article first appeared in BabyTalk Magazine, 1 October 2020

 
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