Ellen Campbell-Grizzle, Contributor
DEHYDRATION, CAUSED by diarrhoea ('running belly'), is the leading killer of young children in developing countries. The World Health Organisation (WHO) estimates that, since 1978, 3.7 million young lives have been saved by the use of Oral Rehydration Salts (ORS) to treat this illness.
The Ministry of Health recently announced that three children died from gastroenteritis. This illness causes diarrhoea that can lead to dehydration. In these cases, giving ORS at the first sign of diarrhoea is the first and best thing to do.
ORS was first developed in 1940. It took almost 30 years for its full value to be appreciated and now many experts assert that it is a modern miracle. A simple solution of sodium and glucose, it replaces fluids and salts lost to diarrhoea and vomiting. This prevents the body from drying up and saves vital organs from collapsing leading to death. ORS replenishes those body fluids and salts which a child loses in critical amounts during attacks of diarrhoea.
Diarrhoea is defined as the loss of more than 200mL of water in the stool during a 24 hour period. The germs that cause diarrhoea also interfere with one of the mechanisms by which the body absorbs water. The capacity of the combination of glucose and sodium contained in ORS solutions to pull water is generally not affected by these infectious agents. In fact, this combination accelerates the body's absorption of water and salts.
ORS does not stop the running belly but it prevents the body from drying up. The watery stools will stop eventually. The use of anti-diarrhoea medicines to harden stools should be avoided in children. It is also important to remember that many antibiotics cause diarrhoea and should not be used 'just in case'. Mixing ORS is simple:-
Wash your hands with soap and water
Put the correct amount of clean water (boiled and cooled) in a clean container
Empty contents of the pack into the water while stirring
Give the child as much as he or she needs
If your child vomits, wait for 10 minutes and then try again
Make a fresh mixture after 24 hours.
ORS is widely available in Jamaica. There are inexpensive brands and the more expensive but better tasting, flavoured tablets and liquids. If your child complains about the taste of the ORS, chill the solution to mask the taste. Do not add sugar, syrup or other artificial sweeteners as this will interfere with the sodium and glucose balance in the formulation.
When your infant is having diarrhoea, the breast is best. You may alternate breast milk with the ORS. Juices may be given also (except apple juice that can cause diarrhoea). In emergency situations, there are homemade formulae that you can make. Continue to give solids if the child is over four months. If vomiting persists or increases, take the child to a doctor.
The body is composed of 75 per cent water and severe dehydration occurs when fluid loss causes body weight to decrease by 10 per cent or more. This situation requires immediate medical attention. Children are very vulnerable to dehydration and those who are malnourished are at greatest risk.
We can prevent the spread of gastroenteritis and diarrhoea by washing hands at mealtime, keeping food and water clean, and using latrines for faeces disposal. However, at the first sign of 'running belly', give ORS. It is good practice to always have some at home. If you want to know more about ORS and how it works to prevent dehydration, ask your pharmacist, you have the right to know.
Ellen Campbell Grizzle, President of the Caribbean Association of Pharmacists (CAP) and Director, Information and Research, National Council on Drug Abuse (NCDA), Kingston.
