Acute diarrhoea is among the most common reasons young children are brought to a doctor. It almost always resolves on its own within a few days. What makes it serious is not the number of stools: it is dehydration, which can develop within hours in an infant.
Recognising dehydration
Watch the child rather than counting stools.
| Sign | Reassuring | Concerning |
|---|---|---|
| Behaviour | Alert, playing | Drowsy, floppy, or very irritable |
| Thirst | Drinks normally | Drinks greedily, or refuses to drink |
| Mouth and tongue | Moist | Dry |
| Tears | Present | Absent when crying |
| Urine | Nappies as wet as usual | No urine for 6 hours |
| Eyes | Normal | Sunken |
ORS: the actual treatment
Oral rehydration salt sachets are sold in pharmacies without prescription. They contain the precise balance of sugar and salts that lets the gut absorb water even during diarrhoea. Plain water, fizzy drinks and fruit juice do not do this job — sugary drinks actually make diarrhoea worse.
- Preparation: one sachet in the volume of water stated on the box, never more concentrated or more diluted. Use safe or boiled-then-cooled water.
- Giving it: in small sips, a teaspoon every one to two minutes. A vomiting child usually keeps down small amounts given very slowly.
- How much: offer ORS after each loose stool, and let the child drink freely in between.
- Storage: made-up solution keeps 24 hours in the fridge, then is discarded.
Zinc is often given alongside for 10 to 14 days: it shortens the episode and reduces the risk of another in the following months. Ask your doctor or pharmacist for the dose appropriate to your child's age.
Keep feeding
This is the most commonly misunderstood point. Withholding food prolongs diarrhoea and weakens the gut lining.
- Breastfeeding: continue, and offer more often.
- Formula: continue without diluting it.
- Older children: usual meals in smaller, more frequent portions. Rice, semolina, banana, cooked apple, carrot, bread and yoghurt are well tolerated.
- Limit during the episode: fruit juice, sugary and fizzy drinks, very fatty dishes.
What not to give
Gut-slowing medicines are not indicated in children: they mask the losses without correcting them and can cause digestive complications. Antibiotics are useless in the large majority of cases, since the cause is viral. Never use a leftover antibiotic or anti-diarrhoeal from a previous prescription.
When to seek care immediately
- A child under 6 months, whatever the appearance.
- Any dehydration sign from the table above.
- Blood or mucus in the stools.
- Repeated vomiting preventing any ORS intake.
- Persistent high fever, a hard or very painful abdomen.
- Diarrhoea lasting more than 7 days.
For a child over 6 months in good general condition, a remote opinion is often enough to assess the situation and set up rehydration: the doctor observes the child, checks their behaviour and tells you whether you need to travel. You can see a paediatrician by video quickly.
