Chronic diarrhea is defined as diarrhea lasting more than 14 days. This condition often leads to severe malnutrition and can be fatal.
When a child suffers from prolonged diarrhea, their food intake decreases, and the absorption capacity of the intestinal mucosa is reduced while nutritional needs increase to support metabolism (due to fever), the recovery of damaged intestinal cells, and to compensate for protein loss through the intestines.
In the first year of life, one in five children with acute diarrhea will develop chronic diarrhea. This risk decreases to 1 in 10 during the second year and 3% in the third year. Children at higher risk for chronic diarrhea include those who are malnourished, have micronutrient deficiencies (such as vitamin A, zinc, iron), are living with HIV/AIDS, frequently experience diarrhea or suffer from measles or dysentery, have prolonged antibiotic use causing dysbiosis, are formula-fed, have lactose intolerance, or are allergic to animal milk protein.
Nutrition plays a crucial role in the treatment of chronic diarrhea. Proper nutrition can promote early recovery of intestinal mucosal damage and shorten the duration of diarrhea. Therefore, easy-to-digest foods with high nutritional value and sufficient protein and energy content should be used. Attention should be paid to conditions such as lactose intolerance, cow’s milk protein allergy, and foods or drinks with high concentrations of sugar and salt that can increase osmolarity and cause diarrhea.
Dietary Guidelines for Children with Chronic Diarrhea
Children under 6 months:
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| When a child has diarrhea, feed them frequently throughout the day (Photo: Dan Tri) |
Continue breastfeeding and ensure the child is fed frequently throughout the day. If the child is not breastfed, temporarily dilute animal milk or use lactose-free cow’s milk or soy milk.
Children 6-12 months: Continue breastfeeding. Dilute animal milk with rice porridge to reduce lactose concentration by 50%, or use yogurt or soy milk. Supplementary foods should include all four food groups (grains, animal protein or legumes, vegetables, oils) that are easy to digest and have appropriate osmolarity. Divide meals into multiple servings throughout the day.
Children 1-3 years: Continue breastfeeding or provide diluted animal milk, yogurt, or soy milk. Ensure an energy intake of 100-110 kcal/kg per day. Prepare food in soft, liquid forms. Finely chop chicken and mix it into porridge with added vegetable oil. Chicken is easily absorbed and helps recover intestinal mucosal damage, shortening the duration of diarrhea.
As the child’s diarrhea improves, gradually transition to a normal diet appropriate for their age, adding an extra meal each day for one month after recovery.
Medication for Chronic Diarrhea
Use antibiotics when the child has dysentery or bacterial co-infections.
Supplement with vitamins (A, B1, C) and trace minerals (iron, zinc).
If the child is severely malnourished, provide high doses of vitamin A: 50,000 units for children under 6 months, 100,000 units for children under 1 year, and 200,000 units for children over 1 year.
Preventing Dehydration: Home treatment should focus on oral rehydration when the child has diarrhea without signs of dehydration (the child is alert, not thirsty, and skin pinch returns quickly). If diarrhea continues with a risk of dehydration, the child must be treated at a medical facility.
