Baby Diarrhoea and ORS: Winning the Race Against Dehydration

In Pakistan's heat, a baby with diarrhoea can slide from "a bit loose" to dangerously dry in a matter of hours. Diarrhoea is still one of the biggest killers of under-fives here — yet the main treatment is cheap, sits in every medical store, and works.

ORS first — not tea, not "band" medicine

The single most useful thing you can do is replace the water and salts your baby is losing. That means oral rehydration salts (ORS) — the ready-made low-osmolarity packets sold under names like Nimkol and many others.

• Mix one full sachet into the exact amount of clean, boiled-then-cooled water printed on the packet — no more, no less.
• A stronger "concentrated" mix is not better; too much salt is dangerous.
• Make a fresh batch each day and throw away what's left after 24 hours.

Please avoid the old kitchen recipe of a random pinch of salt and spoon of sugar unless a health worker has shown you the exact measure — get it wrong and it can harm. Skip the anti-diarrhoea syrups and needless antibiotics too; most baby diarrhoea is viral and settles with fluids alone.

How to give it

1. After every loose stool, offer ORS — small sips or spoonfuls, slowly.
2. If your baby vomits, wait about ten minutes, then start again even more slowly.
3. Keep breastfeeding right through — breast milk is fluid, food and comfort in one. Formula-fed babies carry on as normal.
4. Over six months and on solids? Offer easy foods too: khichri, mashed banana, dahi, a little daal.

Don't forget the zinc

Ask the doctor or pharmacist for zinc, given daily for the couple of weeks they advise. It shortens the illness and, importantly, makes the next bout less likely — a small, cheap addition that too many families skip.

Red flags — go now

Head to a doctor or hospital without delay if your baby:

• Is under six months old and passing a lot of watery stools
• Passes blood in the stool or has a high fever
• Vomits everything and can't keep ORS down
• Has sunken eyes, a sunken soft spot, no tears, or very few wet nappies
• Is unusually drowsy, floppy or hard to wake

These mean the fluids are running out faster than you can top them up.

Stopping the next round

• Rotavirus drops are now part of the free EPI schedule and prevent the worst infant diarrhoea — don't miss those doses.
• Wash hands with soap before feeds and after nappy changes.
• Boil or filter drinking water, especially in monsoon and after floods, when supplies get contaminated.
• Keep made-up feeds and cut fruit out of the heat.

If the loose stools keep coming or your baby refuses the ORS, let a doctor see them the same day — dehydration in little ones moves faster than most parents expect.