Vomiting intestinal infection in a child how to treat. Acute intestinal infection in children

Acute intestinal infections(OKI) - a group of infectious diseases transmitted by the fecal-oral route. Usually accompanied by digestive disorders (vomiting, diarrhea) and deterioration of the general condition (increase, weakness, etc.). The most common and most unpleasant intestinal infections are dysentery, salmonellosis, escherichiosis (E. coli) and rotavirus infection. Therefore, they will be discussed separately in the relevant chapters. Here we will analyze only general issues, what unites all intestinal infections.

Fecal-oral transmission mechanism. The causative agent is secreted into external environment with the feces of the patient and can get into the water with a poor sewerage system, into the writing, on the surrounding objects, and through them into the mouth of a person. Most often the fault is dirty hands. In order for the infection to get on your hands, it’s enough just to hold on to the handle of the door that the patient touched after visiting the toilet.

It is easy to become infected by eating unwashed vegetables, sharing utensils with a sick person, drinking contaminated unboiled water, or having lunch in a canteen where food was not cooked in the right way. sanitary norms. Flies play a role in the transmission of infection.

They occur both in the form of individual cases and in the form of epidemic outbreaks. The development of epidemics is facilitated by violations of sanitary and hygienic standards (for example, poor-quality disinfection of wastewater and their ingress into drinking water or bathing places). AIIs are ubiquitous and very easy to get infected. Among patients with intestinal infections, 70% are children. Due to insufficient hardening and relative immaturity digestive system children are more susceptible to them. In addition, immunity to intestinal infection is usually not stable, and you can easily get sick again. Particularly affected by intestinal infections infants: their disease usually proceeds hard and sometimes ends badly.

Factors contributing to the occurrence of AII:

• Bad water supply.
• Bad sewerage system.
• Poor sanitary and hygienic conditions.
• Failure to comply with elementary hygiene rules (wash hands before eating, drink boiled water, etc.).
• Violation of food storage.
• Early termination in infants. Breast milk is not only sterile and cannot go bad, but it also contains various immune defense factors against infections that are not found in any artificial formula.
• Contribute to the adoption of intestinal infections, the weakening and exhaustion of the child, poor immunity, chronic diseases - all that helps to reduce the body's defenses. Intestinal infections are:
• Bacterial (pathogens - bacteria).

Certainly pathogenic (necessarily cause AII):

• dysentery or shigellosis (causative agent - shigella);
• salmonellosis (causative agent - salmonella);
• escherichiosis (causative agent - Escherichia coli);
• cholera (causative agent - cholera vibrio);
• typhoid fever.

Conditionally pathogenic (cause or do not cause AII, depending on the accompanying conditions):

• campylobacteriosis (causative agent - campylobacter);
• staphylococcal infection (causative agent - staphylococcus aureus);
• proteus infection (causative agent - Proteus);
• Klebsiellosis (causative agent - Kleb-siella), etc.

Giardiasis (causative agent - lamblia), etc.

The growth of bacterial intestinal infections (dysentery, salmonellosis, escherichiosis) is usually observed in summer, and viral (rotavirus infection) - in winter.
In some cases (and even very often it happens), the causative agent of an intestinal infection cannot be determined. Then the patient is diagnosed with "acute intestinal infection of unknown etiology."

Symptoms of an intestinal infection in children

The incubation period for AEI ranges from several hours to several days. In the clinic, lesions of the digestive and central nervous system and signs of dehydration.

Vomiting, diarrhea and abdominal pain. All intestinal infections affect the digestive organs. The symptoms of gastrointestinal disorders depend more on the specific organ in which the inflammatory process is taking place, rather than what pathogen caused the acute intestinal infection. Therefore, with AII there will be one of the manifestations described below:

Gastritis is a pathological process at the level of the stomach. The main symptom of gastritis is vomiting. Usually vomiting is frequent, repeated, accompanied by nausea. Characteristic of AII caused by staphylococcus aureus.

Enteritis. The small intestine is affected. The main symptom is frequent, copious, watery stools, accompanied by abdominal pain, flatulence. It can be foamy (typical for rotavirus infection), with an admixture of greenery (typical for salmonellosis, etc.) and clear mucus.

Colitis. Injury to the large intestine. Symptoms: scanty, loose stools with blood and cloudy mucus, cramping abdominal pain, frequent urge to defecate, there may be painful false urges - tenesmus (the patient wants to go, but he does not succeed). Colitis is a typical symptom of dysentery.

Gastroenteritis. Combines signs of gastritis and enteritis: repeated vomiting and frequent loose copious stools.

Enterocolitis. Combines signs of enteritis and colitis: frequent loose, fetid stools with impurities of greenery, blood and mucus, endless urge to defecate.

Gastroenterocolitis. The child has vomiting, diarrhea, and mucus with blood in the stool.
Disorders of the central nervous system. Bacteria secrete toxins that poison the nervous system. Depending on the severity of the course, the following symptoms may occur in various combinations:

• High temperature up to 39 ° C and above.
• Weakness, lethargy, headache, deterioration of well-being.
• Motor and mental restlessness, followed by depression up to loss of consciousness and coma. Possible confusion, delirium, hallucinations, sleep disturbance, convulsions.
• Change in skin color. May be:

Pallor;
- gray shade skin with blue fingertips, lips and nasolabial triangle;
- marble skin (the look of the skin resembles the pattern of marble).

• Hands and feet are cold to the touch.
• Indomitable vomiting of central origin, associated with irritation of the vomiting center of the brain.
• Decrease or rise blood pressure, increased heart rate.
• Dyspnea.

Dehydration. The child loses a lot of fluid with loose stools and vomiting. In addition to water, diarrhea and vomiting leave the body with potassium and sodium salts, which are necessary for the functioning of the heart, muscles, nervous system and other organs. The more the child has lost fluids, the worse his condition. This is especially true for young children: their dehydration occurs very quickly and sometimes ends with emergency measures in the intensive care unit of the hospital.

The first signs of dehydration:
- thirst;
- dry skin and mucous membranes, decreased skin elasticity;
- weakness, lethargy, drowsiness, refusal to eat;
- urination rare, in small portions, urine concentrated, dark;

If fluid loss continues:
- retraction of the eyeballs;
- retraction of a large fontanel in infants;
- sharpening of facial features;
- weight loss;
- decrease in pressure, cold extremities, decrease in body temperature;
- further loss of fluid leads to the development of shock.

Of course, the sufferer child's intestinal infection Not all of the above are present. The severity of clinical manifestations depends on the severity of the course of the disease. There are mild, moderate and severe forms of AII.

The severity of the course of the disease is affected by:

• The amount of the pathogen that has entered the body (the more, the more severe the AII).
• The type of pathogen and its aggressiveness (dysentery, salmonellosis, cholera, escherichiosis are especially severe).
• The age of the child (the younger, the more severe the AII).
• The initial state of health of the child (weakened or with good immunity).
• The adequacy of the treatment.

Attention! If a child develops vomiting, diarrhea, fever and deterioration of the general condition, you should immediately consult a doctor, and not self-medicate. Remember that OKI not only cause significant damage to the health of the child, but also pose a serious threat to others.

Diagnosis of intestinal infection in children

1. Bacteriological cultures of feces and, in some cases, vomit. This is the leading diagnostic method. Determines which microbe caused the intestinal infection.

To analyze the feces, a swab is taken from the child's anus (it is also called a "smear for the VD" or "smear for the intestinal group"). The resulting material is sown on special nutrient media. After a few days (usually 5-7 days), colonies of bacteria grow, which can be examined under a microscope and tested various methods. Unfortunately, it is not always possible to detect the pathogen.

2. Blood tests for the growth of antibody titer to any pathogen. The response of the immune system to a suspected infection is determined. If there is an increase in antibodies to a particular pathogen, then we can say with confidence that the person is sick (or was sick). This method is rarely used in practice.

3. Express diagnostics: enzyme immunoassay (ELISA) and other laboratory tests. They are used mainly in hospitals, and even then not all.

4. Coprological analysis of feces. In it you can see the degree of digestion of food, blood, mucus and protozoa (amoebae and giardia).

Principles of treatment of acute intestinal infection

First of all, you need to see a doctor.
Admitted to the hospital:

• Children with severe AEI. Small children and with moderate.
• Infants.
• Weakened children with any concomitant acute or chronic diseases.
• Children with typhoid and cholera.
• Children of food workers.
• Children from closed children's institutions (boarding schools, sanatoriums), from hostels and communal apartments.

Diet. Feeding a child with an intestinal infection is a must. Food should be as gentle as possible. Formula-fed infants are prescribed lactase-free, low-lactase, or soy formulas.

Adult children in the acute period are allowed to eat:

• Potato or other vegetable (pumpkin, zucchini, carrot) puree on water (you can add vegetable oil).
• White bread croutons, dry lean biscuits.
• Vegetable soup (potatoes, onions, carrots, zucchini, pumpkin) with rice.
• : rice and buckwheat on the water. Oatmeal-carrot broth.
• Boiled pureed meat.
• Sour-milk products (yogurt, kefir, curdled milk, cottage cheese) are low-fat.
• Fruits and berries: apples (preferably baked or grated), pears, bananas, watermelon, blueberries, lemon.
• Fruit and fruit and vegetable juices, preferably freshly squeezed without sugar, diluted with water.

Liquid. With vomiting and diarrhea, especially frequent and plentiful, the child must definitely drink so that dehydration does not occur. Replenishment of fluid in the body through the mouth is called oral rehydration.

The liquid is drunk slowly, and in no case in one gulp. One time drunk a large number of liquids can lead to vomiting. The child is “drinked” in small sips: 1-2 sips with breaks of 5-15 minutes. After each vomiting, a baby needs to drink about 50 ml of liquid, and an older child - 100-200 ml. If the child refuses to drink, liquid is dripped into his mouth from a pipette (it is possible during sleep). With a significant loss of fluid drinking regimen appointed by the doctor individually.

To replenish the fluid, special saline solutions (regidron) are used, as well as mineral water without gases (Borjomi). In addition to saline solutions, a child can drink tea or water with lemon, chamomile decoction, cranberry juice, highly diluted fruit juice. It is advisable not to add sugar to drinks or use it in minimal quantities.

If diarrhea and vomiting do not stop, symptoms of dehydration increase, and it is not possible to replenish the lost fluid through the mouth, the child is given solutions intravenously (this is already in the hospital).

Medications for intestinal infections

Antibacterial drugs (prescribed by a doctor).
CIP (complex immune preparation). Contains antibodies (immunoglobulins) to various pathogens of intestinal infections. Its action is based on increasing local immunity in the intestines.

Sorbents (or enterosorbents): enterosgel, activated carbon, polyfepam, entegnin, filtrum, etc.

Biological products: bactisubtil, linex, enterol, bifikol, etc.

Enzymes: festal, mezim-forte, creon, panzinorm, etc., according to indications.

Other treatment, depending on what symptoms the child still has (antipyretic, anticonvulsant, etc.).

Attention! Medicines for diarrhea, such as Imodium, are not recommended for children with AEI, and are prohibited for dysentery.

Prevention of intestinal infection

• The patient is isolated.
• In the focus of infection (the place where the patient with AII is located), disinfection is mandatory. Children are provided with separate dishes and items for personal use. The child's toilet bowl and potty are treated with bleach. When cleaning, don't forget to wipe door handles and switches.
• Persons who have been in contact with the patient are checked for the presence of microbes of the intestinal group (smear on the VD).
• After recovery, the child must undergo a repeated bacteriological examination of feces in order to make sure that the pathogen is no longer there, since sometimes after the infection, carriage remains (asymptomatic excretion of pathogens with feces).
• Children entering medical institutions (hospitals, sanatoriums), as well as workers in the food industry and children's institutions are required to be examined for the presence of pathogens of the intestinal group (smear on the VD).
• And, of course, do not forget about personal hygiene.

Acute diarrhea (diarrhea) - infectious diseases, characterized by damage to various parts of the gastrointestinal tract and the development of dehydration and intoxication 1 of varying severity, are among the most widespread diseases of children around the world. In our country, at least 500 thousand acute intestinal infections are recorded annually in children, and children of the first year of life are most often ill. The high incidence of children of this age is explained by the anatomical and physiological characteristics of the gastrointestinal tract, as well as the characteristics of the immune system of infants.

The main protective link of the gastrointestinal tract, which stands in the way of the penetration of pathogenic microbes, is the intestinal mucous barrier, one of the main components of which is secretory immunoglobulin A, the production of which in children under one year old is reduced. This deficiency is partly made up for by breast milk Therefore, formula-fed babies are more susceptible to infections of the gastrointestinal tract. In addition, in children, unlike adults, other protective systems of the gastrointestinal tract are weaker: they produce less hydrochloric acid in the stomach and less secretion of the pancreas, bile, which also prevent the introduction of pathogenic microbes.

In children, unlike adults, severe forms of intestinal infections are more often noted, since they become dehydrated faster, as a result of water loss with vomiting and loose stools, and children's cells, as you know, are 90% water and salts.

It should be noted that in the event of any infectious pathology, including intestinal infections, not only the number and pathogenicity of microbes that have entered the baby's gastrointestinal tract are important, but also the initial state of the child's health.

Risk factors for intestinal infections:

• artificial feeding;
• the introduction of complementary foods that are not subjected to heat treatment - there is a possibility of contact with pathogens with complementary foods;
• summer time of the year - elevated air temperature contributes to the reproduction of pathogens in water, soil, products;
• prematurity;
• immunodeficiency states in children;
• perinatal pathology of the central nervous system.

pathogens

Intestinal infections are caused by various microorganisms (viruses, bacteria, fungi, protozoa), in our country it is predominantly bacteria (dysentery bacillus, salmonella, escherichia).
Other bacterial infections also occur. In young children, opportunistic bacteria can become their causative agent - microbes that are part of the normal microflora, but under certain conditions cause a disease. In children of the first year of life, such conditions are the immaturity of the immune system, frequent uncontrolled use of antibiotics.
Viruses can also be causative agents of intestinal infections; the most common among these infections is rotavirus, this is the so-called "stomach flu", which is usually ill in winter time but other viral infections also occur.

Ways of infection

The main route of infection with intestinal infections is fecal-oral, in which the causative agent of the disease enters the child's mouth. This way of infection is realized through contaminated water, toys, nipples, food, household items. So, taking a fallen toy or nipple into his mouth, a child can get a portion of pathogens of intestinal infections. But it should be remembered that an adult cannot "sterilize" the nipple with his saliva, because in this way the mother contributes to the transfer of microflora from her mouth to the child's mouth and gastrointestinal tract.

Salmonella, the most common pathogens of acute intestinal infections, widespread throughout the world due to industrial poultry farming, most often enter the gastrointestinal tract with poultry meat and eggs. During evisceration of infected chickens, these bacteria infect the entire line that processes poultry meat. Salmonella are resistant to freezing, they die only during heat treatment. But if you carry the meat of an infected bird from the store in one bag, for example, with bread, then in the future the infection will occur precisely through the bread, and not through the chicken that has undergone heat treatment. If there are small cracks in the eggs, Salmonella can also enter them, so the eggs can also become a source of infection. Salmonella is also spread through milk.

Dysentery bacillus more often enters the gastrointestinal tract with low-quality dairy products, water.

In summer, pathogens of intestinal infections are often found in water bodies, especially stagnant ones. A child can become infected not only by drinking water, but also by inhaling it or swallowing splashes.

Any microbes and viruses can get into the baby's mouth from parents or people who care for the child, through the dirty hands of adults. If the period of introduction of complementary foods occurs in the summer, then along with “fresh vitamins”, parents can reward the child with intestinal infections. This path is most likely with the introduction of self-made juices from insufficiently washed fruits and berries.

Infection can also occur when children come into contact with infected animals, if the child, after stroking an animal on whose fur there were pathogens of intestinal infections, then puts his hands in his mouth or touches toys, and even more so food, with unwashed hands.

Duration incubation period- the period from the entry of pathogenic bacteria or viruses into the body until the onset of symptoms of the disease - depends on the number of microorganisms that have entered the child's mouth: the more pathogens, the shorter this period. This time can range from several hours to seven days (more often it does not exceed 3 days).

Symptoms

Various microorganisms that cause intestinal infections affect one or another section of the gastrointestinal tract. So, for example, salmonella "choose" mainly the small intestine. Depending on which parts of the gastrointestinal tract are affected, there are:
gastritis - damage to the stomach, manifested mainly by vomiting;
enteritis, colitis - damage to the small and large intestines, manifested by rapid stools;
lesions of several parts of the gastrointestinal tract are more common: enterocolitis, gastroenteritis.

What mom will notice: since the baby cannot tell that he has a stomachache, this symptom will manifest itself as anxiety, the baby often cries, it is difficult to calm him down, vomiting,
increased stool, bloating, elevated body temperature.

By the nature of the stool, acute intestinal infections are:
1. Secretory (watery). Such diseases are manifested by liquid watery stools. Viruses and toxins produced by bacteria, as it were, make the cell "cry", and epitheliocytes - the cells lining the gastrointestinal tract, lose their ability to absorb water; so there is a liquid watery stool.
2. Inflammatory (invasive). In this case, the microbe enters the cell, destroying it. In the stool, you can see mucus, blood, greens, pus, which indicates the destruction of intestinal epithelial cells. These are often bacterial infections.

Their manifestations:

• temperature increase;
• refusal to eat, weight loss;
• lethargy, vomiting, abdominal pain;
• the severity of the disease is indicated by retraction of the eyes, sharpening of facial features, retraction of a large fontanel, dry lips, convulsions;
• a formidable symptom, indicating the extreme severity of the disease, is the absence of urine in a child for more than 6 hours.
  The severity of the disease is also determined by the frequency of stools, vomiting and the amount of fluid lost.
  For the duration of intestinal infections can be:
• acute (loose stools last no more than 2 weeks);
• protracted (loose stools - from 2 weeks to 2 months);
• chronic (the concept of chronic infection is more related to dysentery;
• but since chronic dysentery is not recorded now, tk. Since modern antibacterial drugs have appeared that can adequately fight this infection, at present chronic intestinal infections practically do not occur).

Diagnostics

For diagnosis, in addition to observing the dynamics (development) clinical symptoms, apply:
Coprological analysis of feces, in which it is possible to detect a pathogen (for example, protozoa), or to identify inflammatory changes in the gastrointestinal tract, digestive disorders.
Bacteriological culture. The method is based on the fact that a particular pathogen grows on a special nutrient medium. To obtain the result of such a study, it is necessary long time(5-7 days).
To assess the general condition of the child, general blood and urine tests, a biochemical blood test, and the acid-base state of the blood are also prescribed.
For the recognition of viral diseases, there are also newer diagnostic methods that more accurately recognize the causative agent of the infection, but they are quite expensive and are performed only in large research institutes.
Since the manifestations of various intestinal infections are similar, they are successfully treated without recognizing the pathogen.

Treatment

First of all, you should consult a doctor. The local pediatrician or the doctor on duty at the clinic, hospital or children's medical center will help the child. Some parents try to cope with the disease on their own, because they are afraid that the child will end up in an infectious disease hospital. Firstly, hospitalization is currently recommended for severe diseases (stools up to 10-15 times a day, indomitable vomiting, severe dehydration), and discharge can be made when the child's condition improves, that is, it is not necessary to wait for a negative analysis of bacteriological culture, which is performed within 7 days. Secondly, only a doctor can correctly diagnose and prescribe the right treatment. When home treatment the child should be visited daily by a doctor or nurse from the clinic.

Since fluid and salts are lost with loose stools and vomiting, in order to restore the required amount of fluid in the body, oral rehydration is performed - fractional drinking of a sick child with special solutions. For this, glucose-salt solutions are used (Regidron, Citroglucosolan). If it is not possible to give the child these solutions (for example, you and your baby are in the country and health care will be provided only upon returning to the city), then you can prepare at home a solution of the following composition: 4 tablespoons of sugar, 1 teaspoon of baking soda, 1 teaspoon of salt per 1 liter of boiled water. It should be noted that in solutions prepared in a factory way, baking soda replaced by citrate salts, which are better absorbed by children. You need to start drinking with 1 teaspoon; young children need to drip the solution on their lips even during sleep. Bottled solutions should not be given, as the baby will grab the nipple due to thirst, drinking too much solution, which may cause vomiting. In the future, the required volume is calculated by the doctor, taking into account the initial weight of the child, loss of fluid with feces and vomiting. In cases of severe dehydration, fluid replacement is carried out using intravenous drip.

In cases of severe gastritis (frequent vomiting), if a little time has passed since the onset of the disease, the ambulance team or hospital doctors can do a gastric lavage to the child.

From the first hours of the onset of intestinal dysfunction, along with oral rehydration, it is advisable to use enterosorbents. Preferably - "Smecta" - a drug of natural origin that binds microbes, toxins and protects the mucous membrane of the gastrointestinal tract. A small infant is enough for one package of powder per day; the powder is given in three doses.

Antibacterial drugs are used in children only under strict indications. The fact is that any antibacterial drugs change the intestinal microflora, tk. they have a detrimental effect not only on pathogenic microbes, but also on normal, very important inhabitants of the intestine, and in cases of acute intestinal infections, the normal microflora (lacto- and bifidobacteria) is more than ever designed to protect the intestinal surface from the penetration of pathogenic microbes. Parents should especially be warned against trying to treat children on their own with such “old” antibacterial drugs as levomycetin and tetracycline drugs, because these antibiotics are not only harmful to normal microflora, but also toxic.

Antibiotics are never used for watery diarrhoea, with the exception of cholera.

Currently, only intestinal infections that occur with inflammatory changes in the intestines are treated with antibacterial drugs, in which mucus, greens, and blood can be seen in the feces. But even with these diseases, mild forms in children older than 2 years do not require the appointment of antibacterial drugs. However, there are infections in which antibiotics are always given. These are dysentery, amoebiasis (amebic dysentery), typhoid fever, cholera. In these diseases, antibacterial drugs are given regardless of their severity. Needless to say, only a doctor can distinguish one intestinal infection from another, as their manifestations are often very similar. In no case should an analogy be drawn with sick adult family members taking this or that drug, even as prescribed by a doctor. A baby who has diarrhea and vomiting after an adult should definitely consult a specialist, since many antibacterial drugs that have proven themselves for treating intestinal infections in adults are not used in pediatric practice. For example, fluoroquinolones can affect growing cartilage and are therefore approved for use in children over 12 years of age.

Diet - since with any intestinal infection the intestine is not affected throughout, the unaffected areas are able to absorb nutrients. The main principle of feeding during the period of illness is feeding according to appetite. At breastfeeding one should adhere to the principles of feeding on demand, and with artificial feeding, offer the child in each feeding the amount of food that corresponds to his age, but if the child does not eat all the proposed mixture, then you should not try to force feed him. In this case, it is desirable to give food more often, in small portions. In the acute period of the disease, preference is given to sour-milk mixtures ("Agusha", "Nan-sour milk"), since many microbes do not like acid environment. During the illness, new components should not be introduced into the diet. It is better to give cereals dairy-free, given that during the acute period of infection, secondary lactase deficiency occurs - a lack of an enzyme that digests milk, and it is less digestible. During the period of diarrhea, the child is not given fresh fruit, juices, yolk, pastries and meat broths.

Usually, by the 5th day of treatment, they return to the original amount of food and diet. Dietary restrictions (do not introduce new foods, dairy-free cereals into the diet) last up to 2 weeks.

Symptomatic therapy is also used, including antipyretics when the temperature rises above 38 ° C. Can be used physical methods cooling (the baby should not be wrapped up, it can be wiped with a half-alcohol solution, but not rubbed). Of the drugs, preference is given to drugs containing paracetamol and ibuprofen.

More attention should also be paid to care. You need to wash your baby regularly. Since the stool is quickened, the skin around the area should be treated to prevent diaper rash. anus ointment "De-panthenol", "Drapolen". During the acute period of the disease, it is desirable to use not disposable, but cloth diapers, since it is very important to monitor urination, and this is not possible when using disposable diapers.

Prevention

To prevent intestinal infections, specific methods such as vaccinations have not been developed. Prevention of these diseases consists in the obligatory observance of elementary hygiene rules, control over the foods that the child eats. The more carefully parents will monitor what can get into the baby's mouth, from food to toys, the less likely the child will get an acute intestinal infection.

All food and water that people use, unfortunately, is very far from sterility. Every day and every hour, billions of different bacteria enter our bodies. Nothing terrible happens from this, because nature has come up with effective ways neutralization of microbes. "Good" bacteria, saliva with bactericidal properties, poisonous gastric juice do not allow strangers to take root in the body and destroy it.

But the child's body is very delicate and receptive, so miracles do not always happen to him. Unfortunately, Dr. Komarovsky argues, intestinal infections happen to children with almost the same frequency as SARS. What should parents do if they suspect an intestinal infection in their toddler, and are there ways to prevent a dangerous infection? Let's try to figure this out.

Cause of intestinal infection

There is not a single person who has never caught an intestinal infection. This is so because there are many ways to neutralize a huge amount of the body's defenses: neutralizing acidic gastric juice with an alkaline drink, destroying one's own microbes with antibiotics, swallowing food without chewing it, and many others.

All the same, these pests enter the body quite often, says Dr. Komarovsky. Intestinal infections are really not needed by either an adult, or even a child. Their main reason was, is and will be non-compliance with the simplest hygiene standards: unwashed hands, improper storage of food products, swarms of flies flying between the toilet and the dining table. No matter how magnificent the protective forces of the human body in general and the baby in particular, there will always be microbes that cannot be neutralized.

An intestinal infection in any family member is a huge alarm for everyone else. The patient needs separate dishes, and the rest need to wash their hands more often, organize perfect cleanliness, all the dishes should be boiled, sparing no disinfectants.

The main principle of help in getting an intestinal infection is to make up for the loss of salts and fluids as soon as possible. Dried fruit compote, green tea will do.

causative agents of infections

Like many others, intestinal infections in babies can be viral or bacterial. By their name it is clear that the difference is in the nature of the pathogen. Among the huge number of infections in children, the most common is rotavirus.

In addition, there are still the most common infections in babies: dysentery, enterovirus and salmonellosis.

Every year (according to WHO statistics), about 2 million children under the age of 5 die from a disease called intestinal infection in children. Komarovsky believes that if all the necessary measures were taken, this figure would be much lower.

Self-treatment or the experience of professionals?

But parents should not be afraid and despair. Not the worst thing that can happen to their baby is eterotavirus intestinal infection. Komarovsky claims that over 90 percent of all cases of infections can be overcome without the use of special drugs. But the remaining 10% are the most insidious and terrible. This is exactly the case when self-medication should never be used! The most important thing in this situation is to bring the baby to the infectious disease specialists as soon as possible.

Indications for calling a doctor

Urgent medical attention is needed if your child has the following symptoms:

• there are blood clots in the baby's vomit or feces;
• it is impossible to drink a child - he either spits up water or cannot swallow it;
• present clear signs dehydration - a “dry” tongue, the baby has not peed for the last 5-6 hours, there is dryness of the skin and mucous membranes, no sweat and tears;
• a rash appeared on the child's body;
• the baby complains of a headache;
• body temperature rises sharply and strongly;
• with diarrhea or vomiting, parents can see that the baby's skin is rather pale and he is very chilly.

Signs and symptoms of intestinal infection in babies

All of the above signs and symptoms describe a situation in which an intestinal infection in children (Komarovsky declares this with all responsibility) has already acquired a rather severe or even deadly form. Fortunately, such situations are not frequent.

Most cases of infection are usually expressed by several universal symptoms:

• the baby refuses to eat;
• have vomiting or diarrhea;
• slightly increased body temperature;
• the baby is drowsy, lethargic and pale.

Who brings the infection into the body?

Not in all cases, an intestinal infection in children is terrible and dangerous. Treatment (Komarovsky is convinced of this from the height of his professional experience) must be timely and accurate.

The causative agents of intestinal infections include bacteria (cholera vibrio, typhoid bacillus, staphylococcus aureus) and some viruses. They can perfectly multiply in the intestines and lead to disruption of the digestion process. They will contribute to the inflammation of all cells of the intestinal mucosa. A common and characteristic consequence of these processes is diarrhea as the main symptom in a situation where Komarovsky explains that initially the very concept of a disease obtained by infection varies. For a person who is not versed in medical terms, diarrhea is a guarantee of the presence of an infection in the body. For the doctor, it is not the symptoms themselves that are important, but the ways of infection.

Some of the symptoms are not yet a disease

"Any disease in babies that is transmitted through the mouth (the so-called fecal-oral route of infection) shows what an intestinal infection is in infants" (Komarovsky). Most good example- Botkin's disease. The virus penetrates the gastrointestinal tract, in most cases there is no diarrhea, and the liver is affected. That is why you should not focus only on diarrhea. After all, there are also other signs of the disease - pain in the baby's tummy, heat body, nausea and vomiting, no appetite, the child is weak. Such signs are quite common, but they do not always indicate that there is an intestinal infection in children. Symptoms, treatment (Komarovsky, as a representative of a clan of talented doctors, is convinced that the result will be much better than before the parents went to the doctor) should be: the first ones should be well studied, and the second should be applied according to the doctor's prescriptions.

Dehydration of the child's body

Only an insignificant part of the diseases called "intestinal infection", the treatment (Komarovsky as a doctor with many years of experience is convinced of this) which does not require hesitation, should be carried out with the help of antibiotics. And the rest pass without such intervention, accompanied by the baby's immune system. After a few days, she begins to develop the necessary protection against this disease. The main task of any baby is to hold out for these few days. And the most dangerous risk during this period, the most common dehydration for a child, reports Dr. Komarovsky. Intestinal infections cause fluid to leave the body during diarrhea or vomiting. That is why it is so important to renew it.

If mom and dad know exactly how to protect their child's body from dehydration, then their little one is not afraid of any intestinal infection.

Peculiarities in babies: high fever and antibiotics

Intestinal infection in children - symptoms, treatment (Komarovsky dwelled on this point in detail in his programs), and in the event of a situation - must first be detected in time, and then eliminated with the help of correctly prescribed drugs.

It is usually believed that if the baby has a body temperature of about 38 ° C, then it does not need to be knocked down (the body fights itself). But according to Dr. Komarovsky, intestinal infections are a dangerous thing, so bringing down the temperature is not only possible, but necessary. This follows from the fact that heat removes huge reserves of fluid from the body, and it is dehydration during an intestinal infection that is especially dangerous for babies.

The peanut (if the body temperature has risen) should be given an antipyretic so that there is no dehydration and intoxication. You should constantly give the baby to drink.

Parents, remember: the higher the baby's body temperature during an intestinal infection, the more he needs to drink!

It was previously mentioned that only a small percentage of intestinal infections require the use of antimicrobial agents to cure. And the use of any antibiotics in this case is strictly regulated by WHO.

According to Dr. Komarovsky, the intestinal thing is dangerous, but not fatal. It is only necessary to adhere to all the recommendations of the doctor and not self-medicate. Antibiotics can be used in cases of diarrhea that has lasted for several days, hemocolitis (when there is an admixture of blood in the feces or vomit) and in severe forms of cholera. Only in these cases is the use of antibiotics for babies justified and quite effective.

Treatment of intestinal infection in babies: sorbents

Indeed, there is some reason to use sorbents for intestinal infections in children. They can absorb poisons, toxins and other harmful substances inside the digestive tract, get rid of an excess of gases. Practicing pediatricians are convinced that, to some extent, sorbents protect the child's body from dehydration and intoxication. So far, no one has been able to prove that the use of such funds poses a threat to the child.

Baby food after getting rid of an intestinal infection

So, what is the diet after an intestinal infection? Komarovsky recalls that during the illness, the baby had a temporary one. After the illness, it does not last long. This is important to consider when compiling the baby's menu.

In the first days after the illness, it is necessary to restrain the appetite of a recovering child.

It often happens that after the recovery phase begins, the baby's condition improves, appetite comes. Parents (especially grandmothers) are happy to try - they put everything tasty on the table - fatter and thicker. But purely physiologically, the child's body is not yet ready for such excesses: it still does not have enzymes that would digest all this deliciousness.

Do not feed him "heavy" and fatty foods. Better to prolong therapeutic diet, which include vegetable soups, cereal porridges on the water, cookies, fruit puree. This is only for 5-7 days, until the enzyme activity is restored.

Be sure to follow the child's diet after an intestinal infection. Komarovsky advises that you can do it differently: for some time, give the recovering baby special enzymes. Although many pediatricians believe that an extended diet is better than "feeding" pharmaceutical enzymes to a child.

Health to you and your children!

Alas, intestinal infections "happen" with children almost as often as SARS. How should parents behave if they suspect an intestinal infection in their children? And are there ways to prevent a dangerous infection?

Intestinal infections in children are manifested by a number of diseases that are caused by the activity of pathogenic viruses or bacteria that affect the gastrointestinal tract. Not surprisingly, the main and most obvious symptoms of almost all intestinal infections are vomiting and diarrhea.

Intestinal infections in children: situations when a child needs a doctor

Intestinal infections (like any other) in children can be both viral and bacterial - the difference, as the names indicate, is in the nature of the pathogen. Among .

In addition to rotavirus, the most common intestinal infections in children include:

• Enterovirus
• Dysentery

According to WHO statistics, about 2 million children under the age of 5 die every year worldwide from intestinal infections.

However, do not be afraid and despair! Pediatricians say that more than 90% of all cases of intestinal infections in children can be overcome without the use of any special medications, at home, only by observing measures against dehydration of the child's body.

However, the insidious and terrible 10% of intestinal infections in children remain - these are cases of the disease when there can be no talk of any self-treatment. When the main task of the parents and relatives of the baby is to deliver the child to the hospital to infectious disease professionals as soon as possible.

So, if you suspect an intestinal infection, the child immediately needs urgent medical attention if:

1. It is impossible to drink it (the child either cannot swallow water, or immediately spits it back);
2. Blood clots are found in feces or vomit;
3. Obvious signs of dehydration are found, which include:

• dry skin and mucous membranes;
• the so-called "dry" language;
• lack of tears and sweat;
• lack of urination (never wrote in the last 5-6 hours).

1. With diarrhea or vomiting, the following accompanying symptoms are present:

• the child is very chilly;
• his skin is pale;
• or ;
• there is a sharp and strong increase in body temperature;
• The child complains of a severe headache.

Signs and symptoms of intestinal infection in children

The above signs and symptoms describe situations when a particular intestinal infection becomes severe or even deadly. But, fortunately, such situations do not occur often. In most cases, infection with an intestinal infection, as a rule, is expressed by a number of universal symptoms:

• A slight increase in body temperature;
• Lethargy, pallor, drowsiness;
• Refusal to eat;
• diarrhea (diarrhea);
• Vomit.

Alas, most parents instantly associate infection with one or another intestinal infection exclusively with diarrhea - they say, since my child has diarrhea, then he must have “caught” at least dysentery. In fact, any intestinal infection always has several symptoms (and not just one), among which diarrhea is far from the most important and not the very first.

How do intestinal infections occur?

Infection occurs when a pathogenic virus or bacterium enters the child's body, namely, into his gastrointestinal tract. There are three major factors that influence the infection of intestinal infections in children:

• Carrier people(that is, you can get infected from a sick person, for example, through a kiss or eating one apple for two with him);
• Food(you can catch a pathogenic virus or bacterium by eating a poor-quality or stale product);
• Water quality(this is the most common and ubiquitous way of spreading intestinal infections - through contaminated water).

Features of the treatment of intestinal infections in children

Prevention of dehydration. Only a few intestinal infections in children are treated with antibiotics. Most pass on their own, under the onslaught of the immune system of the child's body, which, after a few days, develops the necessary protection against the disease. The task of the child's body is to hold out for these few days. And the most dangerous risk at this time for the child is by no means the activity of harmful microbes or bacteria, but banal dehydration.

If parents know exactly how to protect the child's body from dehydration, their baby is not afraid of almost no intestinal infection.

How and what to drink a child during an intestinal infection, we will tell a little lower and as detailed as possible.

Fighting high temperatures. We are accustomed to believing that an elevated body temperature in a child, for example, with ARVI, does not need to be brought down if it has not gone beyond 38 ° C. However, in the case of intestinal infections in children. Basically, precisely because the heat provokes significant fluid loss by the body, namely dehydration is especially dangerous for intestinal infections in children.

If a child has an intestinal infection accompanied by an increase in body temperature, he must be given an antipyretic to avoid dehydration and intoxication of the body. But besides this, it is extremely important to constantly water the child.

Remember: the higher the baby's body temperature during an intestinal infection, the more intensively it needs to be watered!

Treatment of intestinal infections in children with antibiotics. We have already mentioned that only a small percentage of intestinal infections require the use of antimicrobial agents in the treatment. Moreover, the use of antibiotics for intestinal infections is strictly regulated by WHO.

So, indications for the use of antibiotics for intestinal infections in children, approved World Organization Health:

Only in these three cases, the use of antibiotics for intestinal infection in a child is justified and effective. In all other cases, antimicrobial therapy is practically meaningless and unfounded.

Treatment of intestinal infections in children using sorbents. Some reason in the use of sorbents (special medicines, capable of selectively absorbing most poisons, toxins and other harmful substances inside the gastrointestinal tract) is present in intestinal infections - indeed, due to their absorbing ability, they can rid the body of an excess of toxins, gases and other "harmful things".

Alas, WHO does not have any instructions on the use of sorbents for intestinal infections in children (since there is no direct evidence of the advisability of using such drugs yet). However, many practicing pediatricians believe that the use of sorbents really helps to some extent protect the child's body from dehydration and intoxication during intestinal infections. There is no consensus yet, but in any case, no one has yet been able to prove that the use of sorbents is clearly harmful to the body.

Famous pediatrician, Dr. E. O. Komarovsky: "Moderate efficiency of the use of sorbents in intestinal infections in children is definitely present"

How and how to solder a child during vomiting and diarrhea with intestinal infections

by the most the best drugs for the speedy replenishment of the physiological norms of the body fluid are means for oral rehydration. These include drugs such as: Regidron, Humana Electrolyte, Orasan, Gastrolit, Maratonic and others.

These drugs are effective against any dehydration and are useful for any infections, not only intestinal ones. But there is a nuance!

If, for example, during SARS, a child loses fluid from a fever and at the same time flatly refuses to drink a salty (to tell the truth, frankly tasteless) solution, you may well offer him a much more delicious tea, compote or fruit drink as a replacement.

However, with intestinal infections, such a “trick” will not work: in order to restore the vital water-salt balance of the child’s body, he will have to replenish fluid losses with the help of saline solutions. Because it is the loss of salts during intestinal infections that is especially large and most dangerous.

If for some reason you cannot buy pharmacy products for oral rehydration, then in extreme cases you can prepare a similar solution yourself (the recipe is recommended by WHO). This will require:

• 1 liter of water
• 2 tbsp. spoons of sugar
• 1 teaspoon salt
• 1 teaspoon baking soda

All ingredients must be thoroughly mixed - and now the solution is ready for use. But before giving it to a child, it is necessary to heat the solution to the temperature of the child's body (that is, if the baby has a body temperature of 36.6 ° C, the solution must also be heated to 36.6 ° C, and if the child has 38 ° C, then the solution should be heated to 38 ° C). What is it for? It's simple - the rate of absorption of fluid into the blood becomes maximum only when the temperature of the fluid is compared with body temperature.

Dr. Komarovsky: “If you manage to effectively and timely replenish the fluid loss in a child with an intestinal infection, then with a 90% probability it will go away on its own in 4-5 days, without any drug therapy”

How and what to feed a child with an intestinal infection

It is quite obvious that almost any food against the background of any intestinal infection (and especially meat products, dairy products, etc.) significantly worsens the course of the disease. This is due to the fact that during the course of an intestinal infection (and for some time after recovery), the enzymatic activity in the child's gastrointestinal tract is sharply reduced.

Therefore, theoretically, ideally, a child with an intestinal infection, in the name of his speedy recovery, should be "planted" on a 1-2-day fast, or at least - on strict diet with a lot of restrictions.

Meanwhile, far from all children, and even more so - far from all parents are ready (not only mentally, but also physically!) To endure such a “therapeutic starvation”. In this regard, WHO recommendations insist that a child during an intestinal infection can be fed almost exactly the same as before infection. And this is especially true for children with low body weight - it is generally catastrophically dangerous for them to starve or “fast” during the course of an intestinal infection.

However, if your child has a normal body weight, it is very helpful to switch him to a liquid vegetarian diet (that is, the diet should consist mainly of liquid meals based on cereals and vegetables) during an illness.

How to feed a baby immediately after an intestinal infection

Recall: during most intestinal infections, a child develops a temporary enzymatic deficiency - that is, the activity of enzymes for some time is significantly reduced. But more than that - this insufficiency persists for some time after the illness. This is extremely important to consider when compiling a menu for a recovering child.

The situation often develops as follows: the baby recovers from an intestinal infection, his condition improves and his appetite wakes up. And now parents (and especially grandmothers) joyfully put food on the table, as in that famous film - “fatter and thicker”. But physiologically, the child's body is not yet ready for such feasts - it simply does not have the enzymes to digest such a meal. And now the under-digested food enters the intestines, where it begins to ferment and rot, becoming a new reason for what.

Intestinal infections are very common among children. And this is not surprising, because babies love to taste the world, and as soon as they acquire the ability to grab various objects with their hands, they first of all begin to drag these objects into their mouths. Evgeny Komarovsky, a well-known pediatrician, tells how to prevent unpleasant consequences, how to treat a child with an intestinal infection and what you should know about it in general.

What it is

Intestinal infections are not a separate disease, but a whole large group diseases that are associated same symptoms - diarrhea, vomiting, fever. Bacteria and viruses can cause disease. The disease does not develop immediately, but only 10-45 hours after the pathogen enters the body.. The most dangerous are salmonellosis, dysentery, staphylococcus, cholera. Among viral infections, the leaders in the frequency of occurrence are enterovirus and rotavirus infections.

Doctor Komarovsky about the problem

There is nothing to be ashamed of, says Yevgeny Komarovsky. Even the cleanest mother, even if she chooses only the best products for her child, the baby may well get sick with an intestinal infection. According to the statistics of the World Health Organization, every day a huge number of children fall ill with these ailments on the planet. More than 2 million babies under the age of 5 die every year from these infections. But there is also a comforting figure among official statistics - 90% of all cases of intestinal infections among babies can be quickly and effectively cured without the use of any medications on their own at home.

Most parents are well aware of the symptoms: diarrhea (loose stools), nausea, vomiting, complaints of pain in the abdomen. It is precisely on the localization of pain that Evgeny Olegovich recommends paying attention first of all.

If bacteria or viruses have affected the stomach, then the child has gastritis. If inflammation develops in the small intestine, this is enteritis, and if the large intestine is affected, then we can talk about colitis. But here, too, not everything is simple, and often children have mixed diagnoses - enterocolitis, gastroenteritis.

Despite the fact that intestinal infections are popularly considered the “disease of dirty hands”, Yevgeny Komarovsky argues that this would be too simple. After all, children can play in the same sandbox, eat the same apples bought in the same store, but one child will get sick, and nothing like this will happen to another. The main risk is not even dirty hands, the doctor says, but a combination of three important factors in the development of an intestinal infection: the environment of the child, the food he eats, and the liquid he drinks.

If there is a person in his environment who is a source of infection, there are enough common toys, household items, the slightest physical contact for infection to occur. Easiest when it comes to food large families- food is not stored there for a long time, which means that the risks of bacterial growth directly in food are reduced tenfold. Quality water is a common problem in many regions of Russia. Therefore, parents should carefully monitor what the baby drinks, and if the tap water is not very good, it is better to boil it even before brushing your teeth.

How younger child, the more likely he is to get an intestinal infection. Komarovsky recalls that gastric juice performs important function- it destroys most bacteria and viruses that enter the body through the mouth. However, in young children, the juice has less acidity than in adults, and therefore bacteria and harmful agents of viral origin have a much higher chance of surviving in the children's stomach.

Antibodies that a child's body produces in response to the penetration of a pathogen do not remain for life, as happens with chickenpox. Bacterial infections (staphylococcal or salmonellosis) cannot be defeated by antibodies to the corresponding pathogens alone, it is required drug treatment. But viral intestinal infections (the most common of which is rotavirus) can stimulate the appearance of specific antibodies that will protect the child from similar pathogens for quite a long time. For a long time, but not always.

Treatment

In the treatment of acute intestinal infection, according to Komarovsky, the main thing is not even medicines that parents want to deal with pathogens as soon as possible. Much more important is to create favorable conditions for the baby's immunity to work. There are very few infections that require serious antibiotic treatment. In most cases, no special treatment is required, the doctor emphasizes. The child just needs to be helped to “hold out” for 3-5 days until his immune defenses cope with the pathogen.

How to treat intestinal infections will tell Dr. Komarovsky in the next video.

The main danger these days is the risk of dehydration. In severe cases, they die not from infection, but from dehydration, emphasizes Komarovsky. Therefore, drinking plenty of water should be the main means of treatment.

And in order not to replenish the sad figures of the statistics mentioned above, parents should remember the alarming symptoms like twice two and know the possible situations when self-medication should be completely excluded. You should go to the doctor, to the hospital of the infectious diseases hospital, and as soon as possible, if:

• The baby is too small or has very intense vomiting, as a result of which the child cannot drink water.
• In feces or vomit, you notice blood impurities, even the smallest.
• If diarrhea and vomiting attacks are accompanied by a very high temperature. Severe intoxication, the appearance of excessive pallor, a rash on the skin.
• If there are signs of dehydration. These include dryness of the skin and mucous membranes, the absence or small amount of urine that the baby secretes, dryness of the tongue. If a child does not pee for more than six hours in a row - this is a very disturbing symptom, if he cries without tears - this is also a sign of dehydration. Outwardly, sunken eyes are noticeable, and in babies up to a year old, the fontanel on the head also sinks.

High body temperature during intestinal infection performs an important task - it stimulates the production of interferon, which is involved in immune defense. And if, for these reasons, it is usually not recommended to reduce it without extreme need, then with an intestinal infection, the attitude towards heat should be somewhat different.

Yevgeny Komarovsky emphasizes that at high temperatures the child sweats more, breathes through his mouth, and this leads to drying of the mucous membranes, he breathes more often, the heart beats faster in the heat. All this contributes to additional fluid loss. The heat becomes an extra burden on the already exhausted body of the child. Usually, Evgeny Olegovich advises to lower the temperature after 38.5, but in the case of intestinal infections, the reason for taking an antipyretic (such as Paracetamol) should be the thermometer reading at 37.5.

In matters of the use of sorbents for intestinal ailments, doctors can not come to a consensus. The World Health Organization does not recommend doing this, but so far no one has been able to prove that sorbents harm the child's body. Dr. Komarovsky recommends that parents decide this issue on their own or consult with their doctor, who knows the child better, but emphasizes that moderate use of sorbents is more likely to only benefit. Sorbents are "Bactistatin", "Polysorb", "Enterosgel" and the well-known activated carbon.

To solder a child with vomiting and diarrhea should be special preparations for oral rehydration. If during the flu it is enough to give the baby sweet tea or fruit juice, then in the case of an intestinal infection, the child during liquid stool and vomiting loses a large amount of not only important liquid for him, but also mineral salts, without which he also cannot live.

That is why compotes are best left for later. And give the child large quantities solutions "Regidron", "Gidrovita", are suitable for replenishing the water-salt balance of both "Humana Electrolyte" and "Maratonik". All these preparations are sachets with glucose and mineral salts, which can be simply dissolved in water and given to the child to drink. Not too pleasant to taste (salty!), but very useful and important.

Feeding a child during the treatment of intestinal infections, according to Komarovsky, is far from useful. Dairy, meat food only worsens the condition of the baby, slow down recovery. However, if we are talking about thin children, with a deficiency of body weight, then such a child definitely should not starve, it can be deadly. It is necessary to feed such a child in the same way as before the intestinal infection, with the foods he is used to, do not limit him in food. If the little one is not a goner, then it is better to temporarily limit food, preferring liquids (broth, jelly). For children older than a year, it is best to give meals that will not contain meat and fatty components. Under the ban are milk, eggs, meat products. Kashi is best boiled in water.

• If a child has an acute intestinal infection, it is important to ensure that dehydration does not occur. If with older children you can control the amount drunk and allocated, then with babies everything is different. To determine how much the baby peed, Komarovsky advises mothers to use electronic scales. They need to weigh the used diaper. This will give more or less accurate data on the amount of fluid released.
• Do not panic if the child suddenly has more loose stools. If there are no accompanying symptoms, then we are most likely not talking about an intestinal infection as such. It has several symptoms combined. Komarovsky recommends not to sound the alarm and not to start self-treatment of “what I don’t know what” folk remedies or medicines.
• Actively drink a baby with an intestinal infection with a high fever is also needed because the most common complication of an intestinal disorder is, oddly enough, pneumonia, says Komarovsky. If there is enough moisture, the mucous membranes of the nasopharynx, bronchi, trachea and lungs will not dry out, and the risk of pneumonia will be minimized.
• If financial resources do not allow you to buy a sufficient number of sachets of oral-rehydration mixture, Komarovsky advises you to prepare the solution at home yourself. The recipe is not the work of some homegrown traditional healers, it is officially approved by the World Health Organization. For cooking, you need a liter of water, two tablespoons of sugar, and one teaspoon of soda and table salt.
• Drinking for a child should not be cold or hot. Ideally, it should fully correspond to body temperature, only then the absorption rate of such a solution will be maximum, which is very important in the treatment of intestinal infections.
• During an illness with an intestinal disorder, against the background of a decrease in appetite, children often develop enzyme deficiency. Therefore, as soon as the baby feels better and he asks for food, you should not give him too much food or fatty foods, since there are still not enough enzymes in the body.
• The best prevention is the observance of hygiene requirements. The child should wash their hands more often, and the mother should properly store food and give the child clean or boiled water to drink.

• Doctor Komarovsky