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CLINICAL MANAGEMENT OF ACUTE DIARRHEA (UNICEF 2004)

Recommendations:-
Mothers and other care givers

      • Prevent dehydration through early administration of increased amounts of appropriate fluids available in the home, and ORS if on hand.
      • Continue feeding (or increase breast feeding) during, and increase all feeding after the episode.
      • Recognize signs of dehydration and familiarize themselves with other symptoms requiring medical treatment (e.g. bloody diarrhea) and take child to health care provide.
      • Give children 20 mg/day for zinc for 10-14 days (10 mg/day for infants under 6 months old)

Health care workers

      • Should counsel mothers to begin early administration of available home fluids upon onset of diarrhea.
      • Treat dehydration with ORS (or IV solution in case of severe dehydration)
      • Emphasize continued feeding or increased breast feeding during and increased feeding after the diarrheal episode.
      • Use antibiotics only when appropriate i.e. in presence of bloody diarrhea or shigellosis, and abstain from administering antidiarrheal drugs.
      • Provide children with zinc supplementation.

New Developments in Diarrhea Treatment

      • Development of an improved formula for ORS with reduced levels of glucose and salt which shortens the duration of diarrhea and need for unscheduled IV fluids.
      • Demonstration that zinc supplements given during an episode of acute diarrhea reduces the duration and severity of episode.
      • Zinc supplementation given for 10-14 days lowers the incidence of diarrhea in the following 2-3 months.


Further Reading
Clinical Management of Acute Diarrhea. The United Nation's Children's Fund/World Health Organization, May 2004.

Last Updated : 1st May 2009

 

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