how do we tell the parents to treat with children with diarrhea at home and prevent dehydration?

Four rules for home treatment of diarrhoea 4.2.1 Rule 1: Give the child more fluids than usual What fluids? If it is available at home, the mother should give ORS solution, as ORS can not only treat dehydration but it can also prevent dehydration to occur in a child with diarrhoea. If ORS is not available at home she should give the recommended home fluid or food-based fluids, such as gruel, soup, or rice water. If an infant is breastfed continue to breastfeed, but more frequently and for longer each feed. If the infant or child is exclusively breastfed give ORS or clean water in addition to the breast milk. If an infant is not breastfed give one or more of the following: ORS solution, food-based fluids (such as soup, rice water, and yoghurt drinks), or clean water.

Good Liquids Without Salt Good Liquids With Salt Clean Water ORS Solutions Unsalted rice water Salted Soup Unsalted yoghurt drink Salted yoghurt drink Green coconut water Salted rice water Weak tea Unsweetened fresh fruit juice Advise the mother what liquids not to give. Do not Give Soft drinks Sweetened tea Sweetened fruit drinks Coffee Some local medicinal teas or infusions How much? Give children under 2-years-old, approximately 50-100ml ( large cup) of fluid after each loose stool. Give older children to 1 large cup. Older children and adults should drink as much as they want. When to stop ORS or recommended home-fluids should be given until the diarrhoea stops. This may last several days. 4.2.2 Rule 2: Zinc supplementation (these recommendations are based on a 20 milligram tablet) Why? Zinc decreases the length and severity of the diarrhoea. Zinc is important for the childs imm une system and will help the child fight off new episodes of diarrhoea in the 2-3 months following treatment. Zinc improves appetite and growth. How much? Children less than 6 months of age should receive tablet once a day for 10/14 days. Children 6 months and older receive 1 tablet per day for 10/14 days. How is it administered? Describe how to give and demonstrate with the first tablet in the clinic: Infants: Dissolve the tablet in a small amount (5 mil) of expressed breastmilk, ORS, or clean water in a small spoon. Older children: Tablets can be chewed or dissolved in a small amount of clean water in a small spoon. Importance of giving the entire dose Remind the mother that it is important to give the full 10/14-day dose to the child even if the diarrhoea ends. Again tell the mother that zinc will improve the overall health, growth, and appetite. Emphasize the importance of the entire zinc dose for this sick child, not to be saved for later cases or other children.

4.2.3 Rule 3: Continue to feed the child What foods? If the child is breastfeding, breastfeed more frequently and for longer at each feed. Give the child above 6 months of age foods with the highest amount of nutrients and calories relative to bulk. Depending on the childs age, these should be mixes of cereal and locally available beans, or mixes of cereal and meat or fish. Add oil to these foods to make them energy-rich. Dairy products and eggs are also suitable. Fresh fruit juices and bananas are helpful because they contain potassium. Avoid: High fibre or bulky foods, such as coarse fruits and vegetables, fruits and vegetable peels, and whole grain cereals. These are hard to digest. Very dilute soups. These are recommended as fluids, but are not sufficient as foods because they fill up the child without providing sufficient nutrients. Foods with a lot of sugar. These foods can worsen diarrhoea. How to prepare the food Prepare foods by cooking well, fermenting, mashing or grinding. This will make the food easier to digest. Give freshly prepared foods to minimize chance of contamination. If previously prepared foods must be offered, first reheat them to a boil. How much food? Encourage the child to eat as much as he/she wants. Offer food every 3 to 4 hours (six times each day) or more often to a young child. Small frequent feedings are best because they are more easily digested and preferred by the child. After the diarrhoea has stopped, give the child one extra meal each for a week. This extra food helps the child regain the weight lost during the illness. Some children will continue to need extra foods to reach their preillness weight, or a normal weight for height. Why feed the child? Starving a child who has diarrhoea can cause malnutrition or make it worse. Mothers may withhold food, believing this will decrease diarrhoea. But it is more important to give nutrients the child needs to stay strong and grow. A strong child will resist illness better. During and after diarrhoea give special attention to feeding the child nutritious food frequently. Even though absorption of nutrients from food is lessened somewhat during diarrhoea, most of the nutrients will be absorbed. Fluids given to the child do not replace the need for food. 4.2.4 Rule 4: When to return to the clinic If a child passes many stools, is very thirsty, or has sunken eyes, the child probably is dehydrated. The child may need more treatment than the mother can give at home. The mothers should bring the child to a health worker if the child shows any of the following: Passes many stools, Is very thirsty, Has sunken eyes, (The above 3 signs suggest your child is dehydrated) Seems not to be getting better after 3 days, Has a fever, Does not eat or drink normally.

Why we should choose rl over ns in dhiarrea treatment? Normal saline has slightly higher amounts of sodium and chloride than body fluid and aggressive fluid resuscitation can result in acidosis. Lactated Ringers consists of 130 mmol/L of Na+, 4 mmol/L of K+, 3 mmol/L of Ca2+, and 109 mmol of Cl -. (Ho et al., 2001; Freeman & Natanson, 2005) The lactate in the solution is metabolized in the liver by two routes, gluconeogenesis and oxidation. Both of these processes remove a hydrogen atom from the lactate molecule, leaving an OH- free to combine with circulating CO2 to form bicarbonate, HCO3.

Why we should give ors during diarrhea and not the others solution?

This ORS composition has passed extensive clinical evaluations and stability tests. The pharmacokinetics and therapeutic values of the substances are as follows: glucose facilitates the absorption of sodium (and hence water) on a 1:1 molar basis in the small intestine; sodium and potassium are needed to replace the body losses of these essential ions during diarrhoea (and vomiting); citrate corrects the acidosis that occurs as a result of diarrhoea and dehydration.