A child with diarrhoea, even if classified as having no dehydration, still needs extra fluid to prevent dehydration occurring. A child who has no dehydration needs home treatment and the steps for this are set out in Plan A below.

Plan A: Treatment for a child with diarrhoea but no dehydration

Counsel the mother on the 4 Rules of Home Treatment

Give Extra Fluids, Give Zinc Supplements, Continue Feeding, When to Return

1 Give extra fluids (as much as the child will take):

Tell the mother:

– To breastfeed frequently and for longer at each feed.

– If the child is exclusively breastfed, give ORS in addition to breastmilk.

– If the child is not exclusively breastfed, give one or more of the following: ORS solution, food-based fluids (such as soup, rice water and yoghurt drinks), or clean water.

It is especially important to give ORS at home when:

– The child has been treated with Plan B or Plan C during this visit.

– The child cannot return to a clinic if the diarrhoea gets worse.

● Teach the mother how to mix and give ORS.

● Give the mother 2 packets of ORS to use at home.

● Show the mother how much fluid to give in addition to the usual fluid intake:

Up to 2 years 50 to 100 ml after each loose stool
2 years or more 100 to 200 ml after each loose stool

Tell the mother to:

– Give frequent small sips from a cup.

– If the child vomits, wait 10 minutes. Then continue, but more slowly.

Continue giving extra fluid until the diarrhoea stops.

2 Give zinc supplements:

● Tell the mother how much zinc to give:

Up to 6 months 1/2 tablet for 10 days
6 months or more 1 tablet for 10 days

Show the mother how to give Zinc supplements

– Infants — dissolve tablet in a small amount of expressed breastmilk, ORS or clean water in a cup;

– Older children — tablets can be chewed or dissolved in a small amount of clean water in a cup.

3 Continue feeding

4 Tell her when to return

You should now have a good understanding of how to treat a child with any of the three dehydration classifications.

Last modified: Thursday, 22 May 2014, 10:23 PM