MANAGEMENT OF DEHYDRATION: 4.

When to return: - A total of 100ml/kg of fluid is

Advise the mother to return immediately with given over 6 hour in children <
Plan A- Treatment of diarrhoea at the child if the child develops any danger sign 12months and 3 hr in children >12
home. (lethargy, unconsciousness, convulsions, months.
inability to eat or drink) - The child should be also given
Counsel the mother on the 4 rules of home Follow up in 5 days if there is no
ORS solution if IV fluid cannot be
improvement.
treatment. assessed.
Plan B- Treatment for some dehydration - Then nasogastric feeding is given
1) Give extra fluid 20ml/kg hr for 6 hours (120ml/kg).
with ORS.
2) Give zinc supplements - The child should be assessed every
3) Continue feeding  Give recommended amounts of ORS 15- 30 min for pulse and hydration
4) When to return over a 4 hour period
status after the bolus of 100ml/kg
 Determine amount of ORS to give
1. Give extra fluid (as much as the child during first 4 hours. of fluid.
will take)  Show the mother how to give ORS
solution
Breastfeed frequently and for longer at each  After 4 hours
feed. -Reassess the child and classify the
If the child is exclusively breastfed, give ORS child for dehydration.
or clean water in addition to breast milk. -Select the appropriate plan to
If the child is not exclusively breastfed, give continue treatment.
one or more of the following: food-based -Begin feeding the child in clinic.
fluids (such as soup, rice water, and yoghurt  Explain the 4 Rules of home treatment.
drinks) or ORS. -Give extra fluid
-Give zinc supplements
2. Give zinc supplements -Continue feeding
Up to 6 months: 1/2 tablet daily for 14 -When to return
days(10mg)
6 months or more: 1 tablet daily for 14 Treatment Plan C:
days.(20mg)
- Intravenous fluids should be started
3. Continue feeding immediately using ringer lactate
with 5% dextrose, N/4.
MANAGEMENT WITH MANAGEMENT OF
DIARRHOEA
DEHYDRATION AND
- Treat dehydration as per plan A, B or DIARRHOEA
C depending on the level of
dehydration.
- Advise mother on how to feed her
child.
- Give multivitamin supplement every
day for 2 weeks if possible.
- Identify and treat infections.
- Do not give antibiotics to children with
diarrhoea unless they have dysentery
or severe cholera.
- Monitor the child's feeding and
treatments and the child's response
(e.g. weight gain).
- Treat for dehydration.
- Administer zinc
o for children less than 6 months: 10
mg/day for 14 days
o for children 6 months or older: 20
mg/day for 14 days.