Children dehydrate much faster than adults. Dehydration from diarrhoea, vomiting, fever, or poor feeding is a leading cause of child death in Africa. It is entirely preventable and treatable.
Recognise dehydration early. Mild: thirsty, slightly dry mouth, urine darker than usual. Moderate: no urine for 6 to 8 hours, dry mouth and tongue, sunken eyes, no tears when crying, irritable. Severe: very sunken eyes, skin that stays pinched when you lift it, extremely weak or unconscious.
Test skin turgor: gently pinch the skin on the child's abdomen, hold for 2 seconds, release. In a well-hydrated child skin returns to normal instantly. Slow return indicates dehydration. Skin that stays tented is severe dehydration.
For mild to moderate dehydration: begin oral rehydration solution immediately. ORS sachets mixed exactly as directed — not more concentrated. Give small amounts frequently.
ORS dosing for children: for every episode of diarrhoea or vomiting, give 50 to 100ml of ORS for a child under 10kg. Give 100 to 200ml for a child over 10kg.
Give with a spoon or syringe — not a bottle or cup which leads to gulping and more vomiting. Small sips every 1 to 2 minutes.
If the child vomits after ORS: wait 5 to 10 minutes then resume more slowly. Do not stop — continue giving small amounts.
Continue breastfeeding throughout. Breast milk provides both hydration and immune support.
Home ORS recipe if sachets unavailable: 1 litre of clean water, 6 level teaspoons of sugar, half a teaspoon of salt. Mix completely.
Do not give plain water alone as the only rehydration — it dilutes the blood's sodium level and can cause dangerous hyponatraemia in young children.
Once the child is tolerating ORS, reintroduce breast milk or formula and then soft food.
Child has had no urine for more than 8 hours.
Skin remains tented after pinching.
Child is very weak, limp, or cannot be woken.
Sunken fontanelle (soft spot) in an infant — the spot appears sunken inward.
Blood in stool with dehydration.
Child is less than 3 months old with any dehydration.
Child cannot keep any ORS down after 2 hours of trying.
Do not give plain water as the only fluid in a dehydrated child — it worsens electrolyte imbalance.
Do not give fizzy drinks, undiluted juice, or sports drinks — high sugar content worsens diarrhoea.
Dehydration in a newborn is an emergency — go to hospital.
Do not make home ORS too salty — too much salt is dangerous, especially in infants.
✓ What Helps
· ORS sachets — the single most important treatment, every home should have these
· Zinc tablets 20mg daily for 10 to 14 days for children under 5 with diarrhoea — reduces severity and duration
· Continue feeding — do not starve a dehydrated child
✗ What To Avoid
· Fizzy drinks and undiluted juice
· Plain water as the only fluid
· Anti-diarrhoea drugs like loperamide in children under 5
→ Ask The Pharmacist For
· ORS sachets — available at every pharmacy
· Zinc sulphate for children under 5 with diarrhoea
· Intravenous fluids at a clinic if child cannot tolerate oral rehydration
🏥 Get Professional Help
Go to hospital immediately if the child has no urine for 8 hours, skin stays tented when pinched, child is very weak or unconscious, or if the child is under 3 months. Children can deteriorate from moderate to severe dehydration within hours.
How do I know if my baby is dehydrated?
Check for: no wet nappy for 6 hours, sunken soft spot on head, dry mouth, no tears when crying, and very dark urine. Pinch the skin on the tummy — if it stays pinched, go to hospital immediately.
Can I make ORS at home?
Yes. Mix 1 litre of clean water with 6 level teaspoons of sugar and half a teaspoon of salt. Stir completely. Give in small sips frequently.
Should I stop breastfeeding if my baby has diarrhoea?
No. Continue breastfeeding throughout diarrhoea and vomiting. Breast milk provides hydration, nutrition, and antibodies that help fight the infection.