There are three treatment plans for treating children with dehydration and diarrhoea:

Treatment for Severe Dehydration

A child with severe dehydration requires urgent referral first give ORS before referring the child.

Treatment for Some Dehydration With Plan B

Although this is not as serious as "severe dehydration", it is still important that you treat a child who has "some dehydration" to prevent his situation becoming worse.

Plan B: Treat of Some Dehydration With ORS

Give in clinic recommended amount of ORS over 4-hour period
DETERMINE AMOUNT OF ORS TO GIVE DURING FIRST 4 HOURS
AGE Up to 4 Months 4 months and up to 12 months 12 months and up to 2 years 2 years and up to 5 years
Weight in kg 6kg 6-10kg 10-12 12-19kg
ORS in ml 200-400 400-700 700-900 900-1400
Use the child's age only when you do not know the weight. The approximate amount of ORS required (in ml) can also be calculated by multiplying the child's weight (in kg) times:

  • If the child wants more ORS than shown, give more.
  • For infants, under six months who are not breastfed, also give 100 - 200 ml clean water during his period.

    • Show the mother how to give ORS solution.

  • Give frequent small sips from a cup or cup and spoon (one spoon every 1 - 2 minutes).
  • If the child vomits, wait 10 minutes. Then continue, but more slowly.
  • Continue breastfeeding whenever the child wants.
    		•

    After 4 hours:

  • Reassess the child and classify the child for dehydration.
  • Select the appropriate plan to continue treatment.
  • Begin feeding the child in the clinic.


    • If the mother must leave before completing the treatment:

  • Show her how to prepare ORS solution at home.
  • Show her how much ORS to give to finish 4-hour treatment at home.
  • Give her enough ORS packets to complete rehydration. Also give her a box of 10 packets Of ORS as recommended in Plan A.
  • Explain the 4 rules of home treatment; these are:
        1. Give extra fluids.
        2. Give Zinc supplements.
        3. Continue feeding.
        4. When to return.

    Treatment for No Dehydration With Plan A

    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 in the Box 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 breast milk.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 diarrhoea gets worse.
    • Teach the mother how to mix and give ORS.
    • Give the mother two 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.
      • Two 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 diarrhoea stops.

    2 . Give zinc supplements:

    • Up to 6 months, give 1/2 tablet for 10 days.
    • 6 months or more , give 1 tablet for 10 days.
    • For Infants: dissolve the tablet in a small amount of expressed breast milk, ORS or clean water in a cup.
    • For older children: give tablets that can be chewed or dissolved in a small amount of Clean water in a cup.

    3. Continue feeding

    4. Tell her when to return

    Last modified: Wednesday, 1 March 2017, 1:54 AM