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Example 5: Oral rehydration—which method is most appropriate?
Diarrhea is one of the main causes of death in small children. However, most
of these children actually die from dehydration—the loss of too much water. It
is generally agreed that the most important way to manage diarrhea is to replace
the liquid that the child is losing. But there is less agreement about how to do
this.
A few years ago, most doctors treated even mild dehydration by giving
intravenous (I.V.) solution. But this was expensive, and many children died in
diarrhea epidemics because there was not enough I.V. solution, or not enough
skilled workers to give it.
Today, most health planners recognize that oral rehydration—or giving liquid by
mouth-is the best way to manage most cases of diarrhea and dehydration. Even
in clinics where I.V. solution is available, it usually makes more sense to
replace liquids by mouth. This way parents learn how to prepare and give liquids
so they can begin treatment early, at home, the next time a child gets diarrhea.
A Special Drink or Rehydration Drink can be made from water mixed with small
amounts of sugar and salt. It is even better if the drink contains a little baking
soda (bicarbonate of soda) and a mineral called potassium—found in orange juice,
coconut water, banana, and other foods.
• The salt in the Special Drink replaces the salt lost through diarrhea, and helps
the child’s body to keep liquid.
• The sugar provides energy and also helps the body absorb liquid more
quickly.
• The baking soda prevents ‘acid blood’, a condition that causes fast, heavy
breathing and shock.
• The potassium helps keep the child alert and willing to drink and eat.
The amounts of sugar and salt
in the Special Drink do not have
to be very exact. In fact, there
is great variation in the amounts
recommended by different experts.
However, too little sugar or salt does
less good, and too much salt can be
dangerous.