What is the management of a child with diarrhoea but no visible dehydration?

These children are losing excessive amounts of fluid and electrolytes in their stools and therefore must still be given extra fluid and electrolytes to prevent signs of dehydration from appearing.

  1. These children should be managed at home or at a clinic using commercial oral rehydration solution or sugar and salt solution to replace fluid losses. Give as much fluid as the child will take. Continue with extra fluids until the diarrhoea stops.
  2. Normal feeds should be continued. breastfeeding mothers should continue to give breastfeeds.
  3. The child should be closely observed for continuing loose stools or vomiting. Signs of dehydration must also be looked for.
  4. The mother should bring the child to the clinic immediately if the child becomes more sick, develops signs of dehydration, refuses feeds or vomits a lot.
  5. Children with diarrhoea but no visible dehydration, who are managed at home, should return to the clinic in 5 days if the diarrhoea has not stopped.

The aim of early home care is to prevent dehydration and continue feeding. The mother must know what fluids to use and how much to give. She must also know when to return to the clinic.

Home care with oral rehydration solution can usually prevent dehydration.

Children with ‘no visible’ dehydration who do not meet the criteria needed to be classified as ‘some’ dehydration may still have lost about 5% of their body fluid (about 5% loss in body weight and therefore need extra fluids).

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