Frequent loose or watery stools. The second leading cause of death in children under 5 globally. Deaths are almost always from dehydration which is entirely preventable with ORS.
Begin ORS immediately at the first loose stool. Do not wait to see if it gets worse. Early rehydration prevents serious dehydration.
Give ORS after every loose stool: 50 to 100ml for children under 2 years. 100 to 200ml for children 2 to 10 years. As much as they want for older children.
Continue breastfeeding throughout. Breast milk reduces the severity and duration of diarrhoea.
Continue feeding age-appropriate food. The old advice to starve a child with diarrhoea was wrong. Food speeds gut recovery. Offer frequent small amounts of easily digestible food.
Give zinc for 10 to 14 days: 10mg daily for infants under 6 months. 20mg daily for children 6 months and over. Zinc significantly reduces diarrhoea severity and prevents recurrence.
Keep the child clean and dry. Change nappies promptly. Apply barrier cream to prevent nappy rash from frequent stools.
Wash hands thoroughly with soap before preparing food, before feeding the child, and after changing nappies.
Monitor hydration closely — check for wet nappies, tears when crying, moist mouth, and normal activity level.
Most acute diarrhoea in children is viral and resolves within 5 to 7 days with ORS and zinc.
Blood in the stool — dysentery requires antibiotic treatment.
No urine for 6 to 8 hours.
Child is very weak, limp, or difficult to wake.
Sunken eyes and dry mouth — moderate to severe dehydration.
Diarrhoea more than 10 times in 24 hours.
Vomiting preventing ORS from being kept down.
Diarrhoea lasting more than 7 days.
Diarrhoea in a newborn or infant under 3 months.
Do not give anti-diarrhoeal drugs like loperamide to children under 5.
Do not give antibiotics unless specifically prescribed — most childhood diarrhoea is viral.
Do not withhold food.
Do not give plain water as the only fluid — give ORS.
✓ What Helps
· ORS sachets — most important treatment
· Zinc tablets 20mg daily for 10 to 14 days for children over 6 months
· Zinc 10mg daily for infants under 6 months
✗ What To Avoid
· Loperamide in children under 5
· Fizzy drinks and undiluted juice
· Antibiotics without prescription
→ Ask The Pharmacist For
· ORS and zinc from any pharmacy
· Medical assessment for blood in stool or diarrhoea lasting more than 7 days
· Cotrimoxazole or metronidazole for dysentery if blood in stool — requires prescription
🏥 Get Professional Help
Go to hospital immediately for blood in stool, no urine for 6 hours, very weak or unconscious child, or a child who cannot keep down any ORS. See a doctor for diarrhoea lasting more than 7 days or diarrhoea in a child under 3 months.
What is the best thing to give a child with diarrhoea?
ORS (oral rehydration solution) is the most important treatment. Continue feeding and breastfeeding. Add zinc tablets for 10 to 14 days. Do not give anti-diarrhoea medications to children under 5.
When should I take my child to hospital for diarrhoea?
Go immediately if there is blood in the stool, no urine for 6 hours, the child is very weak or cannot be woken, sunken eyes, or if the child cannot keep any ORS down after 2 hours of trying.