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44 YOUNGS ONES FROM PAGE 43 for gastroenteritis.3 It’s important that a child with diarrhoea avoids foods high in simple sugars, which, with an osmotic load, might worsen the condition. Therefore, offering a child substantial amounts of carbonated soft drinks, juice, gelatine desserts, and other sugary liquids should be avoided.4 Additionally, when it comes to rehydration solutions, water by itself isn’t recommended as it doesn’t contain the sugars and salts a child needs.3 To ensure a child stays hydrated with oral rehydration solutions, Queensland Children’s Hospital suggests offering the child apple juice, as long as this is diluted by adding filtered or tap water to achieve a 50:50 mix. These fluids have a high sugar content and giving them to a child undiluted may make the diarrhoea worse. Another bowel issue that may arise as a result of poor gut health is constipation. In children, indications of constipation are often described as ‘a hard poo’ or not going to the toilet regularly.5 Signs and symptoms of constipation include stomach cramps, irritable behaviour, anal fissures (small splits of the skin around the anus) that cause pain and bleeding when going to the toilet, and decreased hunger.5 Some of the possible reasons for a child being constipated include the natural tendency of a slow gut movement; bowel habits, such as ignoring the urge to go to the toilet; a change in toilet environment; disease; and diet. A diet high in processed foods and low in fresh fruit and vegetables may lead to constipation. Children who drink large amounts of cow’s milk each day may also become constipated.5 The Royal Children’s Hospital Melbourne states that increasing fibre intake might help some children who have a natural tendency to be constipated. Examples of adding fibre to a child’s diet include: at least two servings of fruit each day; prune juice, which may have a mild laxative effect; at least three servings of vegetables each day; cereals that are less processed, such as bran cereals, shredded wheat, wholegrain cereals or oatmeal; and wholemeal or grainy bread instead of white.5 Maintaining a child’s gut health by including the appropriate amounts of fruit, vegetables and grains in their diet, while limiting simple-sugar intake can prevent the issues of diarrhoea, constipation and gastroenteritis. Solutions available in retail pharmacy “As health professionals, it’s our role to educate parents that unless their child has a pre-existing, medically diagnosed condition, which means their diet should be altered, children should be offered a variety of foods to ensure they’re getting the most out of their diet and reducing their need for supplements,” Ms Pratico said. She adds that resources are available that parents can turn to for further advice when it comes to their children’s nutrition and gut health. “When asked about what types of foods to offer children, we direct parents to reputable government made resources, such as the Dietitians Association of Australia website,” she said. Ms McGrice also suggests a reliable resource: “If a parent is trialling a new diet for their child, it’s essential that they ensure that the diet meets the requirements of the five core food groups and Australian Dietary Guidelines,” she said, recommending the eatforhealth.govcms.gov.au website if parents are unsure. With the appropriate nutrition and diet, children can maintain a healthy gut from the early stages of life, which is more likely – than if this isn’t the case – to prevent them from having other serious health issues in the future. Pharmacists and pharmacy assistants should be made aware of the reliable resources available, as well as knowing what other health professionals are available who can provide further help, to give the appropriate advice to parents on their child’s gut health. At times such as these, with the challenges of the COVID-19 pandemic, parents will no doubt be taking whatever precautions are deemed necessary to strengthen their child’s immunity. References 1. Healthdirect, 2020. ‘Groups at higher risk of developing COVID-19’. Accessed 20/4/20. healthdirect.gov.au/coronavirus-covid-19-groups-at- higher-risk-faqs 2. Childs CE, Calder PC, Miles EA. ‘Diet and immune function’. Nutrients, 2019; 11 (8): 193. 2019 doi:10.3390/ nu11081933. Accessed 20/4/20. 3. Emergency, Queensland Children’s Hospital, 2019. ‘Gastroenteritis’. Accessed 27/4/20. childrens.health. qld.gov.au/fact-sheet-gastroenteritis/ 4. Bresee JS, et al. 2003. ‘Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy’. Stephen B Thacker CDC Library collection. Accessed 27/4/20. 5. The Royal Children’s Hospital Melbourne, 2018. ‘Constipation’. Accessed 27/4/20. rch.org.au/kidsinfo/ fact_sheets/Constipation/ RETAIL PHARMACY ASSISTANTS • JUN 2020