[Box on page 24]

When Diarrhea Strikes: Guidelines in Treating Children

Do not stop feeding: Fluids should be given. Tea, rice water, barley water, and soups are beneficial. Have drinking water available. Keep giving breast milk to nursing babies. Meals should be given as soon as the child can eat. Small but frequent meals, however, are best. Easily digested, energy-rich foods such as cooked cereals and bananas are good.

Give oral rehydration drink from the outset: This replaces fluid loss and prevents dehydration. Where possible, use prepacked oral rehydration salts. If these are not available, prepare the following solution (Accuracy in mixing is important!):

Table salt: One level teaspoonful

Sugar: Eight level teaspoonfuls

Water: One liter (5 cupfuls at 200 ml each)

How much to give: Amount given should approximate fluid loss. Roughly, one cupful of rehydration drink should be given for each loose stool passed; half that for small children. (Babies can be spoonfed the solution.) LET THE CHILD DRINK AS MUCH AS HE LIKES!

When to stop giving rehydration drink: Usually as soon as diarrhea stops or when thirst for rehydration drink abates.

When to seek medical help:

When dehydration signs are evident.

When the person cannot drink.

When diarrhea continues for four days with no improvement (or after one day in babies with severe diarrhea).

When there is severe vomiting.

It was early evening when two-year-old Jeneba complained that her belly hurt. Her mother, Mariama, wasn’t overly concerned though. Jeneba had suffered the “runs” before. This time it would be the same.

But the diarrhea persisted​—frequent, watery, uncontrollable. Then came the vomiting. Jeneba lost strength rapidly. Mariama laid the child across her knees and rubbed her back. It did little to help.

As morning approached, Jeneba lay exhausted on the floor​—panting, weak, heart fluttering, her head restlessly turning from side to side, her lovely brown eyes now sunken and half closed, her cheeks hollow, her mouth parched. And Mariama felt utterly helpless.

Wailing greeted the rising sun. Jeneba was dead.

WHAT is the biggest killer of children and infants? Believe it or not, it is dehydration​—dehydration caused by ordinary diarrhea.a Five million youngsters under five years of age die every year from it​—about one every six seconds. In the developing countries, it snuffs out the life of one out of every 20 children before the age of five. And in economically developed nations, surgery aside, diarrhea ranks second only to respiratory disease as the chief reason why children are hospitalized.

Ironically, though, most of this suffering and death could be eliminated by a simple, salty drink.

How so? First of all, it is not diarrhea that kills. That usually clears up by itself without any treatment. The problem is that a person with diarrhea loses fluids and salts from the body​—he dehydrates. If too much fluid is lost and not replaced, death occurs.

An estimated 500 million youngsters in the developing world contract diarrhea annually. In poor areas the average child may have three or four bouts per year. Often, though, the disease is merely a mild inconvenience. But sometimes just a few hours of it, such as with cholera, can bring dehydration and death. Unfortunately, it is difficult to determine in its early stages whether the illness will be life threatening or not. Thus it is essential that parents not only recognize dehydration but also know how to act quickly to prevent and correct it.​—See boxes on pages 24 and 25.

Lost Fluids​—How Replaced?

If you want to maintain the water level in a leaking bucket, you simply keep adding water. The same is true with a child with diarrhea​—fluids in his body must be replaced. This is called rehydration.

The problem was that diarrhea not only drains fluids from the body but also restricts liquids from being absorbed through the intestinal wall. So simply drinking fluids was ineffective​—most of it passed straight through the body.