1.Why should babies drink oral rehydration salts when diarrhea first occurs?
Both domestic and international guidelines point out that the primary principle of diarrhea treatment is to prevent dehydration and treat dehydration, requiring the use of oral rehydration salts III from the very beginning.
This is because the main danger of diarrhea is dehydration, and dehydration is the main cause of death from diarrhea. Water and electrolytes in the body are excreted along with stool and vomit during diarrhea, making it easy for dehydration and electrolyte disorders to occur.
In particular, children have a high demand for water and the level of extracellular fluid is not stable enough, so they are especially prone to dehydration.
Therefore, prevention of dehydration and treatment of dehydration are the top priorities in the treatment of diarrhea.
Oral rehydration salts III (Bo Ye) is a hypotonic oral rehydration salt recommended by the World Health Organization (WHO), which not only prevents and treats mild to moderate dehydration, but also reduces stool volume by 20%, vomiting by 30%, and intravenous rehydration by 33%, and WHO requires more than 90% of children with diarrhea to use oral rehydration salts III.
Therefore, parents should give oral rehydration salts III from the beginning of diarrhea to prevent dehydration, rather than waiting until the baby is dehydrated, which can avoid increasing unnecessary pain and risk to the child.
2.What is the specific dosage of Oral Rehydration Salts III?
The dose should be determined according to the degree of dehydration and the age and weight of the patient with diarrhea.
Situation 1: No dehydration symptoms
The general principle is to take a dose of Oral Rehydration Salts III after each loose stool, depending on the age of the patient, until the diarrhea stops. The details are as follows: see later pictures
Example: For a child with diarrhea around 1 year old, who has diarrhea 5 times a day and does not show obvious symptoms of dehydration, 100 ml should be given after each diarrhea, for a total of 100 ml/time x 5 times a day = 500 ml (i.e. 2 sachets).
Case 2: Mild to moderate dehydration
Mild to moderate dehydration: dry mouth and lips, irritable thirst, reduced urination, depression, little or no tears when crying, sunken eyes, etc.
Dose (ml) = (50~75) ml × body weight (kg), to be taken within 4 hours for children.
If dehydration is corrected after 4 hours, take the same amount as in case one to prevent dehydration until the diarrhea stops.
Example: For an 18-month-old child with diarrhea, weighing 10 kg and having mild dehydration, use the dose = 50 ml/kg × 10 kg = 500 ml (i.e., 2 bags), i.e., finish feeding 500 ml within 4 hours.
Situation 3: severe dehydration
Severe dehydration: apathy, coma, not drinking, deep sunken eyes, etc.
Patients with severe dehydration need to be immediately sent to the hospital for emergency treatment, first take intravenous rehydration, take intravenous rehydration at the same time, as long as the patient can take orally, that is, give oral rehydration salts III; wait for the correction of severe dehydration, can be completely changed to oral rehydration salts III until diarrhea stops.
3. What should I do if I feel that my baby cannot finish the required dose?
Many parents reflect that their babies cannot drink so much at one time, can they drink less?
No, it is not recommended. The child must be fed with the full dose because if the oral rehydration salts III are not replenished in sufficient doses in time, the water and electrolytes lost due to diarrhea and vomiting will not be adequately replenished in time, leading to dehydration.
Therefore, it is important for parents to give oral rehydration salts III to their children in adequate doses.
When giving oral rehydration salts III to children, it is important to follow the principle of small amounts, preferably 10-20 ml every 2-3 minutes. This will give the child 150 – 300 mL of fluid every hour. For smaller infants and children, feed frequently with a spoon, dropper or small cup until the required dose is given. If the child vomits, stop for 10 minutes and then feed slowly.
4, some books recommend diluting oral rehydration salts before feeding the baby to drink, in the end, do you need to dilute it?
If the feeding is oral rehydration salt III, it does not need to be diluted, according to the instructions of a bag of 250ml of warm water, and then take the dose.
Some books say that oral rehydration salts should be diluted and then taken, which means that dilution is recommended when traditional oral rehydration salts I and II are used when oral rehydration salts III are not available, because the sodium content of traditional oral rehydration salts I and II is slightly higher and hypernatremia may occur when they are used in children with good nutritional status, so dilution is recommended. However, in practice, on the one hand, it is more difficult to dilute to the optimal concentration and optimal osmolality, and on the other hand, dilution will also reduce the concentration of other electrolytes such as potassium in the solution.
Therefore, parents should try to choose the hypotonic oral rehydration salts III in full doses when their baby has diarrhea.
Oral rehydration salt III has reduced sodium and glucose content compared to traditional oral rehydration salt I and II, and has an optimal osmolality of 245 mOsm/L, which avoids the shortcomings of traditional oral rehydration salt, and also reduces the amount of stool and the number of vomiting in diarrhea while rehydrating quickly, shortening the duration of diarrhea. Therefore, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) recommended in the 2006 “Guidelines for the Treatment of Diarrhea (Second Edition)” that a complete switch to hypotonic oral rehydration salts III be made as the drug of choice for diarrhea instead of oral rehydration salts I/II.