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Assessment and treatment of diarrhoea
If the child’s eyelids become puffy, stop the ORS and give plain water or breast milk.
Give ORS according to Plan A when the puffiness is gone.
Monitoring the progress of oral rehydration therapy
Check the child frequently during rehydration.
Ensure that ORS solution is being taken satisfactorily and the signs of dehydration are
not worsening.
After four hours, reassess the child fully following the guidelines in Table 1 and decide
what treatment to give.
If signs of severe dehydration have appeared, shift to Treatment Plan C.
If signs indicating some dehydration are still present, repeat Treatment Plan B. At the
same time offer food, milk and other fluids as described in Treatment Plan A, and
continue to reassess the child frequently.
If there are no signs of dehydration, the child should be considered fully rehydrated.
When rehydration is complete:
skin pinch is normal;
thirst has subsided;
urine is passed;
child becomes quiet, is no longer irritable and often falls asleep.
Teach the mother how to treat her child at home with ORS solution and food following
Treatment Plan A. Give her enough ORS packets for 2 days.
Also teach her the signs that mean she should bring her child back to see a health
worker.
If oral rehydration therapy must be interrupted
If the mother and child must leave before the rehydration with ORS solution is completed:
Show her how much ORS to give to finish the 4‐hour treatment at home.
Give her enough ORS packets to complete the four hour treatment and to continue oral
rehydration for two more days, as shown in Treatment Plan B.
Show her how to prepare ORS solution.
Teach her the four rules in Treatment Plan A for treating her child at home.
When oral rehydration fails
If signs of dehydration persist or reappear, refer the child.
Giving zinc sulfate
Begin to give supplemental zinc sulfate tablets, as in Treatment Plan A, as soon as the
child is able to eat following the initial four hour rehydration period.
Giving food
Except for breast milk, food should not be given during the initial four‐hour
rehydration period.
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If the child’s eyelids become puffy, stop the ORS and give plain water or breast milk.
Give ORS according to Plan A when the puffiness is gone.
Monitoring the progress of oral rehydration therapy
Check the child frequently during rehydration.
Ensure that ORS solution is being taken satisfactorily and the signs of dehydration are
not worsening.
After four hours, reassess the child fully following the guidelines in Table 1 and decide
what treatment to give.
If signs of severe dehydration have appeared, shift to Treatment Plan C.
If signs indicating some dehydration are still present, repeat Treatment Plan B. At the
same time offer food, milk and other fluids as described in Treatment Plan A, and
continue to reassess the child frequently.
If there are no signs of dehydration, the child should be considered fully rehydrated.
When rehydration is complete:
skin pinch is normal;
thirst has subsided;
urine is passed;
child becomes quiet, is no longer irritable and often falls asleep.
Teach the mother how to treat her child at home with ORS solution and food following
Treatment Plan A. Give her enough ORS packets for 2 days.
Also teach her the signs that mean she should bring her child back to see a health
worker.
If oral rehydration therapy must be interrupted
If the mother and child must leave before the rehydration with ORS solution is completed:
Show her how much ORS to give to finish the 4‐hour treatment at home.
Give her enough ORS packets to complete the four hour treatment and to continue oral
rehydration for two more days, as shown in Treatment Plan B.
Show her how to prepare ORS solution.
Teach her the four rules in Treatment Plan A for treating her child at home.
When oral rehydration fails
If signs of dehydration persist or reappear, refer the child.
Giving zinc sulfate
Begin to give supplemental zinc sulfate tablets, as in Treatment Plan A, as soon as the
child is able to eat following the initial four hour rehydration period.
Giving food
Except for breast milk, food should not be given during the initial four‐hour
rehydration period.
319
