Oral Rehydration Therapy (ORT) for Diarrheal Disease

One of the most important things to do when a kid is sick is to keep them hydrated. Kids have a lot less fluid in them than adults. Dehydration is a big cause of concern when it comes to small kids with diarrhea. If you suspect that your child is dehydrated, talk to your pediatrician about the best plan for rehydration.

About Oral Rehydration Therapy

Mild cases of dehydration can be treated with oral rehydration in the form of a carefully blended electrolyte and sugar solution ("Oral Rehydration Therapy" or "ORT") or with frequent breast milk or formula feeding. Although oral rehydration may be acceptable for milder cases of dehydration, IV therapy may be necessary for more moderate to severe cases. Talk to your medical provider to determine which is needed.

It's important to seek medical attention if you need it. A doctor or nurse can help by providing an IV of fluids if your child cannot drink enough. A child who is vomiting or who just won't drink may not be able to keep up with their fluid losses.

Most of us have heard of Pedialyte for rehydration therapy. There are also many commercially available pre-made and powdered oral rehydration solutions that are carefully designed to safely rehydrate your child with the correct ratios of salts, sugar, and water that he or she needs. But there are home recipes that work as well. The Rehydration Project recipe is as follows:

For a young baby, breast milk is best for rehydration.

For Older Kids

• 1/2 teaspoon salt
• 6 teaspoons sugar
• 1 liter drinking water or 5 cups drinking water (about 200 ml each)

Mix until salt and sugar dissolve. Store in a cool place for up to 24 hours.

A teaspoon is 5ml. It's the size of a small spoon.

It's important that the drinking water is clean drinking water. If not sure, boil the water and then cool it. Be sure it is cool before anyone drinks it.

It's important not to dilute this out with other drinks. Sometimes parents will add a bit of oral rehydration salts (ORS) to apple juice, but this won't have the same benefit. It's the concentration—the ratio of salt and sugar to the water that makes the difference.

There are packets of ORS that can be bought and added to water. Some of these come in orange flavoring which can make it easier for kids to drink.

Dosage and Feeding

Talk to your pediatrician about how to best administer the solution. For mild dehydration in the case of diarrhea, here's an example of a rehydration schedule.

After each diarrheal episode, give the following amount slowly in a teaspoon:

• Children under 2 years of age: 1/4 to 1/2 of a large cup per feeding.
• Older children: 1/2 to 1 large cup per feeding
• Adults and large children: A total of at least 3 quarts per day

If your child vomits, wait 10 minutes and try again.

Why a Salt Solution Helps

An effective oral rehydration mixture contains a starch or sugar, sodium, and sometimes potassium. When you have a diarrheal disease, your intestines are not absorbing the needed amount of water and salts.

When you add starch or sugar (sources of glucose), your body uses a new mechanism that “co-transports” both sodium and glucose. By allowing sodium to be transported across your intestinal walls, the absorbed sodium draws in water as well, allowing rehydration.

Talk to your doctor or other healthcare providers about other treatment. You may need to find treatment for what is dehydrating your child. There may be an infection that needs to be treated. In cholera, zinc is used with the oral rehydration fluids to help reduce the amount of fluids needed.