There are a number of different brands of commercially available oral rehydration solution (e.g. Sorol). They all contain a balanced mixture of electrolytes and water together with glucose. They are usually sold in the form of a powder which is packaged in a sachet (small packet). One sachet of powder should be mixed in one [...]
Oral rehydration solution (ORS) is a mixture of water, electrolytes (salts) and glucose which is given by mouth to provide energy and replace the fluid and electrolytes which have been lost. Oral rehydration solution can be: Bought commercially. Made up in the home as a sugar and salt solution.
Oral rehydration therapy (ORT) is the most important part of managing acute diarrhoea and saves the lives of millions of children worldwide each year. ORT consists of giving oral rehydration solution by mouth early in acute diarrhoea to prevent or treat dehydration. Give frequent small sips from a cup. Oral rehydration therapy saves million of [...]
Children with mild diarrhoea and no visible signs of dehydration can be treated at home with continuing feeds and oral rehydration solution. If the diarrhoea becomes worse or does not recover in 2 days the child must be seen at a clinic. Children who refuse to drink or who vomit repeatedly must be taken to [...]
Infants with acute diarrhoea may vomit. However, the vomiting usually stops once the dehydration is corrected. If the oral rehydration solution is vomited, a smaller amount should be given slowly about 10 minutes later. The best way to avoid vomiting is to give small sips of fluid frequently by cup. If severe vomiting continues, a [...]
Most cases of acute diarrhoea are caused by a virus and do not respond to antibiotics. Indication for antibiotics are: Suspected septicaemia (very ill with a high fever) Small infants (under 1 month) Severely malnourished children Dysentery (blood in the stools) Suspected cholera Infants who are sick enough to receive antibiotics should be referred to [...]
Medicine is usually not necessary and may even be dangerous in small children. Anti-diarrhoeal medication such as codeine, Imodium (loperamide) and Lomotil (diphenoxylate) decrease peristalsis and may cause ileus. They improve cramps in older children but do not prevent the loss of fluid and electrolytes from the gut. Medications which absorb water like pectin and [...]
If the child is already receiving solid food, this should be continued unless the child is vomiting a lot. Small feeds should be given frequently (at least every 4 hours). This is particularly important in children who are malnourished as diarrhoea can make the malnutrition rapidly worse. Extra feeds should be given while the child [...]
Although continuing milk feeds in infants may appear to make the diarrhoea worse, it is important to continue feeds as it helps to provide energy and replace fluid and electrolyte losses. Infants recover from diarrhoea faster if milk feeds are continued. Breastfeeding or full-strength formula should be used. There is no need to dilute feeds. [...]
The most important aspect of management is to start oral rehydration therapy as early as possible to prevent dehydration from occurring. Oral rehydration solution should be used. With frequent, small drinks most children with mild diarrhoea can be adequately managed without developing dehydration. Breastfeeding, formula or solid feeds should be continued unless the child has [...]
These children should be referred to hospital for investigation and treatment. Correct dehydration. An antibiotic is needed. Usually, nalidixic acid is given 6 hourly for 5 days (2.5 ml if 12 to 24 months; 5 ml if 2 to 5 years; 7.5 ml if older than 5 years). Dysentry is usually due to Shigella, which [...]
Children with persistent diarrhoea should be referred to hospital for investigation and further management. Correct dehydration if present. Offer oral rehydration solution even if the child is not visibly dehydrated. Consider HIV in any child with persistent diarrhoea. The stool should be cultured and examined under a microscope in an attempt to identify the cause. [...]
Most children with acute diarrhoea can be managed at home or at a primary care clinic. However, the following children should be referred to hospital for further management: Children with signs of severe dehydration or shock Children who have lost more than 10% of their body weight Children who continue to vomit despite being given [...]
It is best to give the oral rehydration solution frequently and in small volumes. Too much fluid at one time may cause vomiting. Give as much fluid as the child will take. Most children with no or only some dehydration will drink as much oral rehdration fluid as they need to replace the fluid lost. [...]
As soon as the diarrhoea is noticed. It is very important to start oral rehydration therapy as early as possible to prevent dehydration. The earlier it is started the quicker the child will get better. It is important to start oral rehydration therapy before taking the child to a doctor or nurse. Oral rehydration therapy [...]
Every mother or caretaker should know how to make up a sugar and salt solution and have the necessary ingredients at home. The recipe for making sugar and salt solution is given in some Road-to-Health Cards.
Home made sugar and salt solution (SSS) is not quite as good as commercial oral rehydration solution as it does not contain potassium. However, it is immediately available and often lifesaving. The commonest recipe for a sugar and salt solution is: 1 litre of clean water. 8 level teaspoons of sugar. ½ of a level [...]
