Dr Ruaan Stander, paediatrician
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When to consult a doctor #Diarrhoea

8/19/2016

 
When does my baby, infant or toddler have diarrhoea? When there is a significant increase from the usual bowel movement frequency, associated with a change in the character of the bowel movement to a liquid consistency.

Consult a doctor when your baby/infant/toddler has diarrhoea in the presence of any of the following :
  • If he or she is not drinking for more than a few hours or is vomiting repeatedly or is having many watery stools (risk of rapid dehydration)
  • The presence of dehydration (dry mouth; being thirsty; absence of tears when crying; sunken eyes, no urine/wet diapers for 4-6 hours)
  • If he or she has fever
  • Blood-containing bowel movements
  • Severe tummy pain
  • If the diarrhoea does not stop within 5 days

When to consult a doctor #Vomiting

8/19/2016

 
Consult a doctor in the case of:
  • Bile (yellow-green) or blood-tinged (red or brown) vomit
  • Forceful vomiting in a newborn
  • An infant not drinking or not holding down anything for more than a few hours
  • Accompanying diarrhoea, which poses the risk of rapid dehydration
  • Presence of dehydration (see signs of dehydration under “Excessive crying”)
  • Vomiting more than twice in 24 hours
  • Continued vomiting despite the use of an anti-emetic (a medicine used for vomiting and nausea)
  • Severe tummy pain
  • A distended tummy
  • Bloody bowel movements
  • Fever higher than 39 °C
  • Headache

When to consult a doctor #Constipation

8/18/2016

 
Constipation occurs when bowel movements occur less frequently than normal despite a good intake of food and/or if stools are hard, large and/or difficult or painful to pass.Constipation occurs when bowel movements occur less frequently than normal despite a good intake of food and/or if stools are hard, large and/or difficult or painful to pass.
When are bowel movements too few?
When there is a significant decrease from the usual bowel movement frequency (for example usually having 1-2 bowel movements per day and then skipping two days despite a good intake of food). Newborn babies pass approximately four soft/liquid stools per day in the first week of life, with breastfed babies passing more in comparison to formula-fed babies. Young infants below three months of age usually pass 2-3 stools per day. The frequency of bowel movements in breastfed babies has a wide range of normality: from having a bowel movement shortly after each feed to having one (large) bowel movement every seven days. An infant with the latter infrequent normal pattern should be distinguished from the infant who is not getting enough : the former shows good weight gain despite the infrequent bowel movements. Formula-fed babies shouldn’t go more than three days without a bowel movement. Toddlers should have 1-2 bowel movements per day, depending on intake.
When to consult a doctor when your baby or toddler is constipated:
  • Severe tummy pain
  • A distended tummy
  • Vomiting
  • In an infant less than four months of age: no bowel movement within 48 hours of his/her normal pattern or the presence of hard stools
  • Poor appetite and/or losing weight
  • Presence of blood in the bowel movement
  • Having repeated episodes of constipation
  • No stool passed within 24 hours of starting laxative treatment

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