Diarrhoea in a child: how to give ORS at home

Children die from diarrhoea not because of the diarrhoea itself, but because of the water and salts they lose with it. Replacing that fluid is simple, cheap, and one of the most effective treatments in medicine.

The short version: keep giving fluids, keep feeding, get zinc from the clinic, and watch for the danger signs below. Do not give anti-diarrhoea tablets to a child.

Oral rehydration salts (ORS)

ORS sachets are the best option. They are cheap, available at most dispensaries, chemists and many shops, and the mixture is balanced correctly. Keep a few sachets at home before you need them.

Using a sachet

1. Wash your hands.
2. Empty the whole sachet into the exact amount of clean water written on the packet — usually one litre. Do not use half a sachet, and do not use less water to make it “stronger”.
3. Use water that has been boiled and cooled, or is otherwise safe to drink.
4. Stir until fully dissolved. Do not add sugar, milk or juice.
5. Throw away anything left after 24 hours and mix fresh.

If you have no sachet

A home mixture can be used until you can get proper ORS. Into one litre of clean water, stir six level teaspoons of sugar and half a level teaspoon of salt.

Taste it before giving it. It should be no saltier than tears. If it tastes very salty, throw it away and mix again with less salt — too much salt makes a child worse, not better.

How much to give

• After every loose stool: a child under two needs roughly a quarter to half a large cup. An older child needs about half to a full cup.
• Give it in small sips with a cup and spoon, not in big gulps.
• If the child vomits, wait ten minutes, then start again more slowly — a spoonful every minute or two. Vomiting is not a reason to stop.
• Keep going until the diarrhoea stops.

Keep feeding

Do not starve a child with diarrhoea. This is old advice and it is wrong.

• Keep breastfeeding, and breastfeed more often than usual.
• Keep offering normal food to children who eat solids — small amounts, more often.
• Avoid very sugary drinks such as sodas and packaged juices. They pull more water into the gut and make diarrhoea worse.

Zinc

Zinc given for 10 to 14 days shortens the illness and reduces the chance of it coming back over the following months. Your health worker will give the right dose for your child’s age. Complete the full course even after the diarrhoea stops.

Go to a facility today if the child

• Cannot drink or breastfeed, or vomits everything
• Has blood in the stool
• Has sunken eyes, no tears when crying, or passes no urine for many hours
• Has skin that stays tented when you gently pinch the abdomen
• Is unusually sleepy, floppy, or difficult to wake
• Has a fit or convulsion
• Is under six months old
• Still has diarrhoea after 14 days

What not to give

Do not give anti-diarrhoea tablets that stop the gut moving to a child. They trap the infection inside and can cause serious harm. Do not give antibiotics unless a health worker has prescribed them — most childhood diarrhoea is viral, and antibiotics do nothing for it.

Preventing the next episode

• Wash hands with soap after using the toilet, after cleaning a child, and before preparing food or eating.
• Treat drinking water — boil it, or use a water treatment product, and store it in a covered container with a narrow opening or tap.
• Use a latrine and keep it clean. Dispose of children’s stools in the latrine, not in the open.
• Keep food covered and reheat leftovers thoroughly.
• Keep rotavirus and other childhood immunisations up to date.

This article is general health education for families. It is not a diagnosis and does not replace assessment by a qualified health worker. If you are worried about a child, seek care.