Rehydrate the child with diarrhea and continue feeding

2021-01-30 12:00 AM

Never give antidiarrheal or antiemetics to a child. This does not help with diarrhoea and some of these medications are dangerous

Examining the child with diarrhea, how to classify dehydration and choose one of the following treatment regimens:

Regimen A - Treatment of diarrhea at home

Regimen B - Dehydration treatment with ORS

Regimen C - Treat rapid dehydration

All three treatment regimens are described in the treatment regimen for the sick child. Rehydration guidelines are designed to replace the water and salt lost in diarrhea. A perfect way to rehydrate and prevent dehydration is to use an ORS solution. Intravenous infusion is only used in case of dehydration of crutches.

Antibiotics are ineffective in treating most cases of diarrhea. Using antibiotics when not needed can increase the resistance of some strains of the bacteria. In addition, antibiotics are expensive. Will waste money on ineffective treatment. Therefore, do not give routine antibiotics. Antibiotics only in severe dehydration caused by cholera or dysentery.

Never give antidiarrheal or antiemetics to a child. This does not help with diarrhea and some of these medications are dangerous. Dangerous drugs include drugs that reduce bowel movements (such as codeine, opioid derivatives, diphenoxylate, loperamide), or emetics medications (such as metoclopramide. Some of these harmful drugs can be fatal especially when given to young children. Some other medications, while not dangerous, are ineffective in treating diarrhea. These include absorption drugs such as kaolin, attapulgite, smectite and activated carbon. Using anti-diarrhea medicine may delay recovery of oral dehydration.

Protocol A: Treatment of diarrhea at home

Treat a child with non-dehydrated diarrhea with protocol A. The three principles of treating diarrhea at home are:

Drink more fluids (drink according to children's needs).

Continue to feed.

When to bring the baby to the doctor immediately.

Children with non-dehydrated diarrhea will be treated with regimen A. Children with severe dehydration or dehydration need to be rehydrated according to regimen B or C, and then continue with regimen A.

Protocol A involves consulting a mother or caregiver on the three principles of home treatment. Therefore, you’re mentoring and counseling skills are very important to Sketch A.

Principle 1: Drink more fluids

Advise the mother:

For translation according to children's needs. The purpose of rehydration is to replace fluid lost in diarrhea and thus prevent dehydration. It is important to give more fluids than usual as soon as diarrhea begins.

Advise mothers to breastfeed regularly and for longer each time. At the same time, it is possible for the child to drink additional fluids. ORS is just one of the many fluids recommended at home for dehydration.

If your baby is exclusively breastfed, it is important to continue breastfeeding more often than usual. As well as giving oral ORS or clean water. Children breastfed under 4 months of age should firstly breastfeed before giving ORS.

If the baby is not exclusively breastfed, add one or more of the following fluids:

ORS solution.

Translation of food origin: broth, soup, vegetable juice.

Clean water.

In most cases, the child is not dehydrated, and does not really need an ORS solution. Give your child more food-based solutions such as soup, rice water or yogurt, and clean water (usually included with food). In your locality, the national diarrhea control program may have identified a variety of food-derived solutions for home use.

Regimen A lists 2 situations in which a mother should give an ORS solution at home:

Young has been tr ị regimen B or C in times renders this:

In other words, the child has just been rehydrated. For this child, drinking an ORS solution will prevent dehydration again.

Children unable to return to health facilities:

For example, the home is far away or the mother has a job that cannot be left.

Instruct mothers on how to prepare and drink ORS. For 2 packages of ORS for home use.

When giving an ORS mother, show the mother how to make the ORS solution and how to give it to her child. Ask the mother to practice and observe herself.

The steps for mixing ORS solutions are:

Wash hands with soap and clean water.

Put all of the powder in an OR S sachet into a clean jar. Use any lumpy tool, such as a bottle, bowl, or bottle that holds 1 liter of water.

Measure out 1 liter of clean water (or the correct amount for the number of ORS packs used). It is best to keep boiled water to keep it low, but if you don't have one, use the cleanest drinking water possible.

Put in the container. Stir well until the ORS powder is completely dissolved.

Taste this solution to see what it tastes like.

Explain to the mother that a fresh ORS solution should be mixed every day in a clean bottle, covered with a lid, and discarded any excess fluid from the previous day.

Give mothers 2 packages of ORS for home use (2 packages of 1-pack ORS in a liter of water or equivalent).

Instruct mothers on the amount of fluid to be given with pear fluids.

Explain that the mother should drink the usual amount of fluid each day and the number of extra fluids. Instructions for mothers how much fluid should they drink after each bowel movement:

Children under 2 years old: 50-100ml after each loose bowel movement.

2 years and older: 100-200ml after each loose bowel movement.

Explain to the mother that the diarrhea will limit itself. ORS will not stop the diarrhea. The benefit of ORS is that it replaces the fluids and salts a child loses in diarrhea and prevents the baby from getting worse. Tell the mother:

Give your child frequent sips from a cup or spoon.

Use a spoon to give the baby water.

If your child vomits, wait 10 minutes to give another drink, but give it more slowly.

Continue to rehydrate until diarrhea is gone.

Use the mother's ticket and check the mother's understanding.

Some establishments have a Maternal Mother Card on the spot or give it to the mother to take home. Maternal card helps mothers remember important information, including what kind of fluids and foods for their babies. The sample mother's form is in Appendix D. Indicate the type of solution and the mother needs to give the baby, using the “solution” section of the form.

If you give the ORS to your child, look and check the ORS box.

If the baby is not breastfed, check and check the food solution. Absolutely breastfed babies should not add any extra food fluids such as soup, rice water, or yogurt.

See and check the box "clean water". Exclusive breastfed babies should breastfeed more often and can drink clean water or ORS solution.

Before the mother returns, check her understanding of how to rehydrate according to regimen A. Use the following questions:

What kind of fluids will you give your baby to drink?

How much fluid will you give your child?

How do you give your child ORS?

How much water do you need to mix 1 pack of ORS?

How do you give ORS to your child?

What will you do if your child vomits?

Ask if the mother had any difficulty when she gave her ORS. For example, the mother says that she does not have time, please help her guide someone else to give the baby to drink. If the mother says she doesn't have a 1-liter container to mix ORS, show her how to measure 1 liter in a smaller container. Or, show mom how to measure one liter in a larger container and mark the appropriate place.

Principle 2: Continue to feed

You will learn how to teach the mother about feeding in school 29. If a baby is classified as persistent diarrhea, you will teach the mother some special diets.

Principle 3: When to bring the baby to the doctor immediately

Instructions for mothers to show the signs that the baby needs to be immediately examined are:

Cannot drink or suck


Have a fever or a high fever

If the child has diarrhea, instruct the mother to bring the baby back to the clinic immediately if:

There is blood in the stool

Children are very thirsty.

Regimen B: Treatment of dehydration with ORS

Treat children with diarrhea and dehydration following B regimen. This regimen includes the 4-hour initial treatment period at a health-care facility. During 4 hours, the mother gave the baby a slowly concentrated amount of ORS with a spoon or sip.

A child with a heavy classification and dehydration needs to be referred quickly to hospital. Do not try rehydrating before letting your baby go. Quickly give the mother some ORS packages. Show the mother how to give ORS to the baby on the way to the hospital. One exception is that a child with a severe category of severe persistent diarrhea should first rehydrate the child before moving.

If the dehydrated child needs treatment for other problems, you should treat dehydration first. Newly treated other problems.

After 4 hours of ORS, re-examine and classify dehydrated children using assessment and classification protocols. If there is no sign of dehydration left, your child will be treated according to regimen A. If dehydration is still present, repeat the B regimen. If the child shows signs of severe dehydration at this time, he or she should be treated according to the regimen. C.

Determine the amount of ORS for oral administration in the first 4 hours.

Refer to the infant treatment regimen and use the chart in regimen B to determine the amount of ORS to take. See the child's weight (or age if weight is unknown) to find the amount of ORS solution needed. For example, a 5kg child will need 200 -400ml of ORS solution for the first 4 hours.

Dosage is listed on the instruction sheet. The child's age or weight, the degree of dehydration and the amount of stool lost while rehydrating will all affect the amount of ORS needed. Children will usually drink more ORS solution than they need. Let your child drink according to their needs.

Another way to estimate the amount of ORS required (in ml) is described in the table. Multiply the child's weight (in kg) by 75ml. For example, an 8kg child needs:

8kg x 75ml = 600ml of ORS solution in 4 hours

The amount of ORS fluid was not related to the normal diet of the breastfed infant. The mother should breastfeed her baby when the baby wants to drink and then drink the ORS solution. A child under 6 months of age who is not breastfed, the mother should give 100-200ml of clean water for 4 hours with the amount of ORS fluid. Breast milk and water will help prevent hypernatremia.

Instruct mothers on how to give ORS solution

Find a comfortable place in the clinic where mothers sit with their babies. Instruct mothers to give their babies how much ORS to drink in 4 hours. A guide to the mother of the unit of measure used locally. If the child is under 2 years old, teach the mother how to give the child a spoonful regularly. If the child is older, show the mother how to drink from a cup. Sit with the mother as she gives the baby the first sip of solution from a cup or spoon. Ask if the mother has any questions.

If the baby vomits, the mother can wait 10 minutes before giving more ORS solution. Then should drink more stinging drink.

Encourage mothers to breastfeed when their babies ask for a drink. When the baby is finished breastfeeding, continue to give the ORS solution. Mothers should not feed their babies during the first 4 hours of treatment with ORS.

Instruct mothers where mothers change diapers, babies can use the toilet or potty. Instructions on where to wash hands for mothers and babies.

Check every now and then to see if the mother has any questions. If your child is unable to drink the ORS solution, try a different approach. You can use a dropper or a needle-free syringe.

While mothers give ORS at the health-care facility for 4 hours, you have plenty of time to teach how to take care of your baby. However, the problem of keeping the plate first is still rehydrating the child. As the baby gradually recovers, the mother can pay more attention to read. Instruct the mother on how to prepare and administer the ORS solution and about the A. It is a good idea to have printed materials that the mother can read while she sits with the baby. This information can also be reinforced with pictures on the wall.

After 4 hours of treatment according to B regimen, use assessment and classification regimen to re-examine the child. Classification of water loss. Choose the right regimen to continue treatment.

Note: Re-examine the child before 4 hours if the child does not take ORS or the disease progresses worse.

If the child is improving and not dehydrated, choose regimen A. Instruct mothers on regimen A, if you have not been able to do so in the past 4 hours. Before the mother leaves the health facility, ask the test questions. Help the mother to solve any questions when the mother gives the baby rehydration water at home.

Note: If the child's face is puffy, it is a sign of water overload. This is not a sign of danger or a sign of hypernatremia. This is simply an indication that the child is rehydrated and does not need an ORS translation at this time. Babies should be given clean water and breast milk. Mothers should give ORS according to regimen A when the baby is gone.

If the infant is still dehydrated, re-choose regimen B. Start breastfeeding at a health-care facility. Give food, milk or juice. After breast-feeding, repeat B-regimen for 4 hours. Give food, milk or juice every 3 to 4 hours. Breastfed babies should be breastfed regularly. If the health facility closes before you finish treatment, instruct the mother to continue the treatment at home.

If the child worsens and is currently severely dehydrated, you will need to start C regimen.

If the mother has to leave the clinic before completing treatment.

Sometimes the mother has to leave the facility while the baby is still on regimen B, that is, before the baby is fully rehydrated. In these cases, you may need:

Instruct mothers on how to prepare ORS at home. Let the mother practice before leaving.

Instruct mothers how much ORS to take to complete 4 hours of home treatment.

Provide mothers with enough ORS packs needed to rehydrate. Also add 2 more packages as required in protocol A.

Explain the 3 principles of home treatment: 1. Rehydration, 2. Continue feeding, and 3. When to follow up (refer to guidelines for protocol A).

Regimen C: Rapid treatment of severe dehydration

Children with severe dehydration need salt and water replenishment quickly. Intravenous infusion is often used for this purpose. Intravenous or oral rehydration is indicated for severe dehydration. Treating a child with severe dehydration depends on:

Papillary devices are available at your medical facility, either at the nearest facility or at the hospital.

Your skills.

Can the child drink it?

To determine how to treat the treatment, you need to learn protocol C, refer to the chart in the child's protocol and Appendix A.

Treat young children with diarrhea

Child regimen tells you how to treat your child and gives you advice on how to treat diarrhea. You have learned regimen A to treat diarrhea at home and regimen B and C to rehydrate an older or young child with diarrhea. However, there are a few special features to remember when treating young children.

Protocol A: Treatment of diarrhea at home

All children and older children with diarrhea need to stay hydrated and continue to feed to prevent dehydration and provide energy. The best way to rehydrate and feed your baby is to breastfeed more times and for longer at each time. Rehydration in young children can be given ORS solution and clean water. If your baby is exclusively breastfed, it is important not to offer another liquid food.

If your baby is given ORS at home, you will instruct the mother how much volume of ORS to drink after each diarrhea. First of all, the mother needs to breastfeed, and then drink the ORS solution. Remind the mother to stop giving the ORS solution when the diarrhea stops.

Regimen B: Treatment of dehydration

Infants who are dehydrated need to use ORS solution as described in regimen B. During the first 4 hours of rehydration, mothers are encouraged to breastfeed their babies when they demand feed, then give the baby ORS solution. Give non-breastfed infants an additional amount of 100 -200ml of clean water at this time.

Treat prolonged diarrhea

Treatment of prolonged diarrhea requires a special diet. Instruct mothers of babies with persistent diarrhea about their child's diet. Refer to Maternal counselling regimen for children with prolonged diarrhea.