Red flag: Risk of acute diarrhoea in infants

Infants are susceptible to dehydration, with a relative high body surface area for mass, raising insensible losses, and poor urinary concentrating ability.

Causes

Infections (remember endemic illnesses after return from foreign travel):
- Viruses: rotavirus, norovirus, adenovirus type 40/41, calicvirus, astrovirus
- Bacteria: Camplylobacter, Escherichia coli, Salmonella, Shigella, cholera
- Since 50% of neonates and young infants are colonised with Clostridium difficile, symptomatic disease is unlikely in children younger than 12 months
- Parasites: Cryptosporidium, Giardia, Entamoeba
Drugs: laxatives
Food additives, e.g. sorbitol in medications
Food allergy or cow’s milk protein intolerance
Neonatal abstinence syndrome, e.g. opiate or amphetamine withdrawal