Diarrhoea in young children: preventing dehydration

Young children have less fluid reserve than adults, so diarrhoea can dehydrate them quickly. The treatment that matters most is replacing fluids and salts, not stopping the diarrhoea.

Oral rehydration salts

ORS sachets are available at pharmacies and clinics and are inexpensive. Mix one sachet with the exact volume of clean water stated on the packet: too concentrated is harmful and too dilute is ineffective. Give small amounts frequently, by spoon or cup. If the child vomits, wait ten minutes and start again slowly.

Continue breastfeeding throughout. For older children, keep offering food as they are able to eat.

Zinc

Zinc supplementation for several days is recommended for childhood diarrhoea and can shorten the episode and reduce recurrence. Ask your clinician or pharmacist for the right dose and duration for your child’s age.

What to avoid

• Anti-diarrhoeal medicines designed for adults, which are not safe for young children
• Antibiotics unless prescribed after assessment, since most cases are viral
• Sugary sodas or undiluted juice, which can make diarrhoea worse
• Stopping feeds, which slows recovery

Signs of dehydration

• Fewer wet nappies, or no urine for many hours
• Dry mouth, no tears when crying
• Sunken eyes or a sunken fontanelle in babies
• Unusual sleepiness, floppiness or irritability
• Skin that is slow to spring back when gently pinched

Severe dehydration needs hospital treatment, often with fluids through a drip.

Go to a facility if

• There is blood in the stool
• The child has a high fever
• Vomiting prevents them from keeping ORS down
• Diarrhoea lasts more than a few days
• The child is under six months old
• They are drinking poorly, or you see any dehydration sign above

Preventing the next episode

• Hand washing with soap after the toilet, after changing nappies and before preparing food
• Safe drinking water: boiled, treated or from a reliable source
• Thorough washing of fruit and vegetables, and proper cooking and storage of food
• Exclusive breastfeeding for the first six months, which protects strongly against diarrhoeal disease
• Rotavirus vaccination as part of the routine schedule
• Safe disposal of nappies and stools