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Oral Rehydration Therapy

2024433-1398553-thumbnail.jpgOral Rehydration Therapy (ORT), is a simple, cost-effective treatment given at home using either packets of Oral Rehydration Salts (ORS) - costing about 10 cents each, or a simple home-made solution of sugar, salt and water.

Oral rehydration therapy involves the replacement of fluids and electrolytes lost during an episode of diarrheal illness. Children under the age of five are the major victims and account for over 3 million deaths a year due to dehydration associated with diarrheal illness. ORT can prevent about 90% of child deaths from diarrheal dehydration, and currently helps save more than 1 million children's lives each year.

The UNICEF recipe for a simple homemade solution contains five cupfuls of boiled water, eight teaspoons of sugar, and one teaspoon of salt, resulting in one liter of solution. In addition, fruit juices, coconut water, and other indigenous solutions can adequately approximate ORS.

Symptoms of dehydration

Symptoms of mild dehydration include thirst, decreased urine volume, urine that is darker than usual, tiredness, lack of tears when crying, headache, dry mouth, and dizziness when standing due to orthostatic hypotension.

In moderate to severe dehydration, there may be no urine output at all. Other symptoms in these states include lethargy or extreme sleepiness, seizures, sunken fontanel (soft spot) in infants, fainting, and sunken eyes.

Method for mixing oral rehydration salts (ORS):

  • Wash your hands.
  • Measure 1 liter, or the correct amount for the packet used, of clean drinking water (boiled and cooled if possible) into a clean container.
  • Pour all the powder from one packet into the water and mix well until the powder has completely dissolved.

After each loose stool give the following amount of ORS:

  • A child of less than 24 months - Half a cup
  • A child of between 2 and 10 years - One cup
  • A child of 10 years or more - As much as wanted
  •  

    Home made ORS recipe:

    Preparing a one liter oral rehydration solution using salt, sugar and water at Hhme.

    Ingredients:

    • one level teaspoon of salt
    • eight level teaspoons of sugar
    • one litre of clean drinking or boiled water and then cooled
    • 5 cupfuls (each cup about 200 ml.)

    If possible, add 1/2 cup orange juice or some mashed banana to improve the taste and provide some potassium.

    Molasses and other forms of raw sugar can be used instead of white sugar, and these contain more potassium than white sugar.

    Preparation Method:

    Stir the mixture till the salt and sugar dissolve.

     

    10 Things you should know about Rehydrating a child:

    1. Wash your hands with soap and water before preparing solution.
    2. Prepare a solution, in a clean pot, by mixing one teaspoon salt and 8 teaspoons sugar, -- or:
      • 1 packet of Oral Rehydration Salts (ORS)
      • with one liter of clean drinking or boiled water (after cooled)
      • Stir the mixture till all the contents dissolve.
    3. Wash your hands and the baby's hands with soap and water before feeding solution.
    4. Give the sick child as much of the solution as it needs, in small amounts frequently.
    5. Give child alternately other fluids - such as breast milk and juices.
    6. Continue to give solids if child is four months or older.
    7. If the child still needs ORS after 24 hours, make a fresh solution.
    8. ORS does not stop diarrhea. It prevents the body from drying up. The diarrhea will stop by itself.
    9. If child vomits, wait ten minutes and give it ORS again. Usually vomiting will stop.
    10. If diarrhea increases and /or vomiting persists, take child over to a health clinic.

    Traditional Recipes for Rehydration:

    • Breastmilk
    • Cooked Gruels (diluted mixtures of cooked cereals and water)
    • Carrot Soup
    • Rice water - congee
    • Fresh fruit juice
    • Weak tea
    • Green coconut water (from a young coconut)
    • Plain water, preferably boiled and cooled
    • Food-based drinks, such as soup and yoghurt

    Give as much fluids as the child will take. The child should drink every time watery faeces are passed.

    Give a child under 2 years of age between a quarter and one half of a large cup of fluid, with a spoon.

    Older children can sip between a half and a whole cup of fluid.

    These drinks should be given until the diarrhea has stopped. This usually takes from three to five days.

    A child with diarrhea needs food

    A lack of maternal education often leads to the common practice of withholding food during acute episodes of diarrhea out of fear that eating will exacerbate the symptoms. Because of the nutritional losses from diarrhea, children actually need up to a 30 percent increase in calories and a 100 percent increase in protein intake during the acute and recovery stages of diarrhea.

    Studies have shown that children who receive increased nourishment during this time suffer less from the acute and long-term effects of diarrhea. The WHO recommends the continuation of breastfeeding throughout an acute episode, as well as the use of mixed food cereals high in calories and protein.

    • Continue to breast-feed frequently.
    • Children who do not eat well are more likely to suffer from diarrhea and other diseases.
    • If children are already taking solid or semi-solid food make sure that they get all the different kinds of food that they need: soft well-mashed mixtures of the staple food and, if possible, pulses, vegetables, and meat or fish.
    • Fresh fruit juice or mashed banana provides potassium.
    • Gently persuade and encourage the child to eat.
    • Offer food at least six times a day.
    • When a child recovers they will need extra food to regain lost weight; give an extra meal each day for the next two weeks.

    Adapted in part from the Rehydration Project: http://rehydrate.org/rehydration/index.html and,

    Food Water and Family Health: A Manual for Community Educators. UNDP.