Q. My children, two and six years old, get frequent attacks of diarrhea during the summer. I want to know what causes this condition and what I can do to avoid it happening?
A. Diarrhea is the most common medical problem encountered by children during the summer months. The factors that increase the incidence of diarrhea during the summer are mostly related to environmental conditions. It is a fact that our body temperature (37C) is the most suitable temperature for the multiplication of germs and bacteria. Meanwhile, the environmental temperatures in our countries are usually within this range, also making them suitable for enhanced bacterial multiplication in the environment. Therefore, the presence of any bacteria under these conditions favors its rapid multiplication, and hence increases the risk of infection if it reaches our gastro-intestinal system. It is therefore extremely important to observe strict hygienic conditions in preparing our children’s food during the summer months and to take into account that food should always be frozen or placed in refrigerators to decrease or stop the multiplication of bacteria, which would inevitably occur if food is left to lie in the warm summer temperature.
Following are some examples that are known to cause diarrhea during summer months that you should be aware of:
It is common for mothers who use formula for their infants to sometimes wait for a while when the infant has not finished the bottle, and then resume feeding again if he is willing after a short period of rest. In this case the formula has been contaminated by germs from the baby’s mouth then left to multiply in a suitable medium (milk) and a suitable temperature (warm). When the infant resumes feeding even after a period as short as 15 minutes, the germ count in the formula may have as much as doubled or more, reaching levels capable of causing illness and diarrhea.
Summer is also a period when people spend more time outdoors in parks and on beaches. It is a common practice for mothers to prepare food for their children (sometimes even a warm cooked meal placed in a container) to try to feed their children while they are outdoors. Mothers should realize that no food is completely sterile, and germs in the container are multiplying between the time of preparation to the time of consumption. The longer the time, the more the multiplication, contamination, and the higher the germ count.
Fruits are a common item in our children’s summer menus because of the increase in variety and the ease of consumption. During the winter months the common fruits are oranges, tangerines and bananas, which are all covered and peeled before eating. They are also protected by the cold winter temperatures. Summer fruits are more variable and some are eaten without peeling. Grapes are particularly difficult to wash and clean, as well as being laxative in nature. There is also a growing concern about consumption of some fruits that may be contaminated by insecticides and pesticides and there has been an observation by some of an association between some of these fruits and diarrhea. Vigorous washing and soaking in water will decrease the risk of contamination. Peeling the fruits may also add safety in some cases. However, this may be at the expense of losing some of the nutritional value that may be present in the outer coat of the fruits.
The Importance of Hydration
If diarrhea occurs, it is important to know that the major medical problem resulting from severe diarrhea is dehydration (loss of body fluids). It is therefore important to properly hydrate children who have diarrhea until medical advice is sought. Proper hydration is by replacing fluid lost from diarrhea by increasing fluid intake, either in the form of water or even better, oral rehydration solution if the child is willing to drink it. It is wise to give the fluids slowly by spoon to avoid initiation of vomiting, and it is usually sufficient to replace every two stool motions by one glass of fluid if tolerated, until medical evaluation of the condition and advice are available.