Babies diarrhoea

Lactase The disaccharide lactose is the only carbohydrate present in milk, which is essential for survival of an infant. Consequently, the enzyme lactase is essential for babies. Caucasians retain lactase activity into adulthood, whereas many Asian or African groups progressively lose its activity in adult life. This could, therefore, be described as an adult deficiency disease. Ingestion of milk in these individuals causes nausea, diarrhoea and stomach cramps. Symptoms disappear if milk is excluded from the diet or if a source of lactase is ingested along with or before ingestion of milk. The bacteria that are involved in the production of yoghurt contain the enzyme lactase. 

Babies under 3 months with diarrhoea and infants under 1 year presenting with diarrhoea that persists for more than 24 hours require referral. Diarrhoea accompanied by vomiting does not usually warrant referral unless the vomiting or diarrhoea are severe. 

Warning. Antimotility drugs should not be used for acute diarrhoea in children, especially babies, or in patients with active inflammatory bowel disease, for there is danger of causing paralytic ileus and, in babies, respiratory depression. 

Galactosaemia This delect is present in approximately 1 100 000 babies in the UK. A deficiency of galactose 1-phosphate uridyl transferase means that the baby cannot utilize the galactose component of the lactose which is present in milk. Such infants may present with failure to thrive, vomiting and diarrhoea and if untreated may die in the neonatal period or go on to develop liver disease, mental retardation, cataracts and renal tubular damage... 

A 3-year-old boy presented with a well-demarcated diamond-shaped skin erosion with bullae. His parents reported the ingestion of several chocolafe squares of the laxative Ex-lax , which he mistook for candies, the night before. The baby was wearing diapers af nighf, which led to overnight contact of his skin with senna-induced diarrhoea. The patient was treated with polymyxin B and bacitracin ointment, with a dramatic improvement in his symptoms within 3 days [67 ]. 

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