No dehydration
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 Box 5.5.
Box 5.5 Plan A: Treatment for a child with diarrhoea but no dehydration
Counsel the mother on the 4 Rules of Home Treatment
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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: |
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| Up to 2 years | 50 to 100 ml after each loose stool | |
| 2 years or more | 100 to 200 ml after each loose stool | |
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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. |
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2 Give zinc supplements: ● Tell the mother how much zinc to give: |
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| Up to 6 months | 1/2 tablet for 10 days | |
| 6 months or more | 1 tablet for 10 days | |
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● 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 |
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You should now have a good understanding of how to treat a child with any of the three dehydration classifications. Next you are going to look at how to classify diarrhoea, beginning with persistent diarrhoea.