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Dr. C. Shaalini, MD (Ped), DNB (Ped), (MRCPCH), Pediatrician at Diha Clinic, Nanganallur, Chennai, explains dehydration and the benefits of ORS.
What is dehydration?
#1 During diarrhoea, both water and body salts (electrolytes) are lost in the stool.
#2 This loss of water and salts is called dehydration.
#3 The process of replacing this loss with water and electrolyte solution is called rehydration.
#4 When such a solution is given orally, it is called Oral Rehydration Solution (ORS).
Signs & symptoms of dehydration:
#1 Urination less than normal, or diapers not wet in 6-8 hours.
#2 Sunken eyes or fontanelle.
#3 Lack of tears while crying.
#4 Dry mouth.
#5 Excessive thirst but may vomit.
#6 Skin after pinching doesn’t fall back flat.
How do I know that my child has diarrhoea?
#1 Stool more watery than normal or completely watery stool.
#2 Change in the frequency of stool (more than 3 times per day)
#3 Change in consistency of stool (loose, watery)
Difference between diarrhoea and dystentry?
When the stool has frank blood, it is called dysentery. The cause and treatment is different in the two conditions.
When should one take ORS?
When an adult or child is having diarrhoea. ORS is to prevent dehydration.
Even 1 episode of loose stool is an indication that you need ORS.
What are the Benefits of ORS?
#1 Fulfils the deficiency of salts, electrolytes & other vital nutrients in the body.
#2 Hydrates the body & leads to faster recovery from diarrhoea.
#3 Reduces vomiting due to the ideal composition of salts & sugar.
ORS is available commercially in 2 strengths:
Composition of WHO recommended ORS:
Sodium – 75 mM
Potassium – 20 mM
Chloride – 65 mM
Citrate – 10 mM
Glucose – 75 mM
Total Osmolarity-245
Note: The composition is the same for both. Only the strength differs
How to mix ORS? (Embed video)
Mix in 4.4 grams (small) in 200 ml water.
If it is a 21 grams pack (regular), mix in 1 litre water.
Do not use more water or less water. Just use the above-mentioned quantity.
Stir until the powder till it dissolves completely.
How to administer ORS?
Give in small sips at regular intervals.
Give in a spoon for a child. 1 spoon followed by 2 mins gap followed by the next spoon.
How much ORS should I give?
Less than 2 months old: 5 spoons of solution after every loose motion.
Under 2 years – 1/4 cup to 1/2 cup after every loose motion (50-100ml).
2 years – 10 years 1/2 cup to 1 glass (100-200 ml).
Above 10 years – as much as needed up to 2 litres per day.
What are the medications I can give my child during diarrhoea?
ORS and ZINC are the only two medications needed in case of diarrhoea.
Indian academy of Pediatrics has announced the two medications as JODI NO 1 in the treatment of diarrhoea.
What are the Benefits of zinc?
Reduces duration and intensity of diarrhoea.
Protects from further episodes for 3 months.
Helps in the recovery of the intestinal villi
Increases immunity.
Common FAQS about ORS
1.Can I mix 1/2 sachet in 500 ml water?
A strict NO.
This composition is designed to be mixed and given in above-mentioned composition.
Giving either less or more water can make it dilute or concentrated in electrolytes.
This can aggravate the dehydration rather than treating it due to salt imbalance.
2. How long can I store it?
ORS should be used within 24 hours after mixing. The remaining should be discarded and freshly prepared again, if needed.
3. Can I give ORS in a feeding bottle?
ORS should never be given a bottle as the child may drink it very fast. ORS should always be taken in small sips.
It should never be gulped as it can cause vomiting.
4. Can I store in refrigerator?
Please don’t store in a fridge. Store at room temperature.
5.Can I give plain water instead of ORS.
Please don’t do that. Body loses both water and salts. Plain water cannot compensate for electrolyte loss.
Myths about diarrhoea in children.
Myth #1
Usage of loperamide in diarrhoea helps in the immediate treatment of diarrhoea.
Truth
A strict NO.
Usage of loperamide is contra-indicated especially in children. It causes more harm than good.
Myth #2
Probiotics treat diarrhoea immediately.
Truth
Probiotics replenishes the good bacteria in the gut.
It does not actually treat the diarrhoea.
Recovery of diarrhoea is gradual . It is normal to take 3-5 days for the diarrhoea to settle.
Myth #3
Antibiotics can be used to treat diarrhoea.
Truth
95% of diarrhoea in children are caused by viral infections.
Antibiotics are used only in infectious diarrhoeas.
The mainstay of treatment in children is ORS and zinc
Myth #4
Breast Feeding Should be Stopped in Children Having Diarrhoea
Truth
Myth #5
Child has to be kept fasting during diarrhoea.
Truth
Rice based, simple, home cooked food can be given.
Raw banana has been proven to be an excellent stool binder during diarrhoea.
Rice based steamed food like idly, idiappam, dhal rice, curd rice along with steamed raw banana helps prevent weight loss in diarrhoea.
No 6, 6th Main Road, Opp.Indian Bank. Nanganallur, Chennai - 600061
About Diha Clinic
Diha is a multi-speciality clinic that brings high-quality healthcare at a reasonable cost to Nanganallur, Chennai, and the surrounding areas. It is a not-for-profit clinic, set up by the Diha Trust.
It’s an outpatient facility that offers quality healthcare across General Medicine, Diabetology, Orthopaedics, Obstetrics & Gynaecology, Paediatrics, Cardiology, Dermatology, ENT & Physiotherapy. It has an NABL accredited Lab and also offers ECG, Echo, TMT, X-Ray and Ultrasound inhouse.
Places we serve: Our customers mostly come from Nanganallur, Adambakkam, Madipakkam, Alandur, Medavakkam, Pazhavanthangal, Keelkattalai, Puzhuthivakkam, Ullagaram, Guindy, St. Thomas Mount, Meenambakkam, Velacherry & more.
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