Diarrhoea is one of the leading causes of dehydration in children, and dehydration can become dangerous within hours of onset. The good news is that the vast majority of cases can be managed safely at home with one simple, evidence-based intervention: Oral Rehydration Solution. As a Paediatrician and Allergy Asthma Specialist at Pratiksha Rainbow Children's Hospital, Guwahati, I see children with dehydration that could have been prevented if parents had started ORS at the first loose stool rather than waiting to see how things progressed. World ORS Day on 29 July is a reminder that this simple solution, correctly used, saves lives.
Why ORS works - and what it is not
One of the most important things I want parents to understand is what ORS does and does not do. ORS does not stop diarrhoea. It replaces the water and electrolytes that are being lost, keeping the child hydrated while the gut recovers. This is why only WHO-recommended ORS should be used - it has the precise balance of glucose and electrolytes that allows absorption to work correctly. Soft drinks, juices, and sports drinks do not have the right composition and can worsen dehydration. Home remedies and over-sweetened fluids carry the same risk.
ORS should be started with the very first loose stool, not once the child already appears unwell. Give it in small, frequent sips - even if the child is vomiting, small amounts can be absorbed between episodes. Continue breastfeeding throughout. Do not stop age-appropriate feeding during diarrhoea - the gut needs nutrition to recover, and stopping feeds slows that process.
The five golden rules for diarrhoea management
Follow these five steps from the first episode:
- Start ORS immediately - do not wait.
- Continue breastfeeding and age-appropriate feeding.
- Give zinc for 10 to 14 days as advised by your doctor - zinc reduces the duration and severity of diarrhoea and helps prevent further episodes.
- Wash hands with soap after every nappy change and before preparing food.
- Watch for danger signs and seek medical care promptly if they appear.
Danger signs that mean your child needs medical care now
Go to your paediatrician or emergency immediately if your child has:
- Extreme thirst or inability to drink
- Repeated vomiting that prevents ORS from being given
- Blood in the stools
- Lethargy or excessive sleepiness - a child who cannot be roused
- Sunken eyes or no tears while crying
- Reduced or absent urine output
Antibiotics are not needed for most episodes of childhood diarrhoea. The majority of cases are viral and resolve with good supportive care. Starting antibiotics unnecessarily contributes to resistance and does not speed recovery. Trust the evidence: Early ORS plus zinc plus continued feeding is the cornerstone of diarrhoea management, and it works. My message to every parent this World ORS Day is straightforward: know your ORS, start it early, give the zinc, and know the signs that tell you when to come in.
To book a consultation with Dr Nayan Mani Deka at Pratiksha Rainbow Children's Hospital, VIP Road, Borbari, Guwahati, Assam 781036, call +91 9436732863 / +91 6000714825.
Written by Dr Nayan Mani Deka, MBBS (Gauhati Medical College, 2003), MD Paediatrics (GMCH Gauhati, 2008), Diploma in Allergy and Asthma (CMC Vellore), Certified PALS, APLS, NSSK, Consultant Paediatrician, Asthma Allergy Specialist and Immunotherapist, Pratiksha Rainbow Children's Hospital, Guwahati, Assam.
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