Solutions: Made at Home

• Recipes for Salt and Sugar Solutions

• Questions on Solutions made at Home
• 10 Things you should know about Rehydrating a child

The "simple solution" - Do-It-Yourself .... Encouraging self-reliance

The most effective, least expensive way to manage diarrhoeal dehydration

To prevent too much liquid being lost from the child's body, an effective oral rehydration
solution can be made using ingredients found in almost every household. One of these drinks
should be given to the child every time a watery stool is passed.

Ideally these drinks (preferably those that have been boiled) should contain:

• starches and/or sugars as a source of glucose and energy,

• some sodium and
• preferably some potassium.
• The following traditional remedies make highly effective oral rehydration solutions and
are suitable drinks to prevent a child from losing too much liquid during diarrhoea:
• Breastmilk
• Gruels (diluted mixtures of cooked cereals and water)
• Carrot Soup
• Rice water - congee
• A very suitable and effective simple solution for rehydrating a child can also be made
by using salt and sugar, if these ingredients are available.

If possible, add 1/2 cup orange juice or some mashed banana to improve the taste and
provide some potassium.

Molasses and other forms of raw sugar can be used instead of white sugar, and these
contain more potassium than white sugar.

If none of these drinks is available, other alternatives are:

• Fresh fruit juice

• Weak tea
• Green coconut water

If nothing else is available, give

• water from the cleanest possible source

(if possible brought to the boil and then cooled).

The "Simple Solution"

Preparing a Salt and Sugar Solution at Home
Mix an oral rehydration solution using one of the following recipes; depending on ingredients
and container availability:

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 Recipe 1

Making a 1 (one) litre solution using Salt, Sugar and Water

Ingredients:

• one level teaspoon of salt

• eight level teaspoons of sugar
• one litre of clean drinking or boiled water and then cooled
5 cupfuls (each cup about 200 ml.)

Preparation Method:

Stir the mixture till the salt and sugar dissolve.

Recipe 2

Making a 1/2 (half) litre solution using

Salt, Sugar and Water

Ingredients:

• a 3 finger pinch of salt ( approx. 1.75 gms.)

• a scoop of sugar ( approx. 20 gms.)
• 1/2 (half) litre of clean drinking or boiled water
2.5 cupfuls (each cup about 200 ml.)

Preparation Method:

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Pour 1/2 (half) litre of clean drinking or boiled water, after it
has cooled, into a large vessel.

Add a 3-finger pinch of salt (approx. 1.75gms).

Taste the solution. It shouldn't be more salty than your tears.

Add a scoop of sugar ( approx. 20 gms.)

Stir the mixture till the salt and sugar dissolve.

Recipe 3

Making a quart or litre solution

using Sugar or Honey, Salt, Baking Soda, and Water

Ingredients:

• 1 quart or liter of drinking or boiled Water

5 cupfuls (each cup about 200 ml.)
• 1/4 teaspoon of Salt
• 1/4 teaspoon Baking Soda (bicarbonate of soda).
• 2 tablespoons of Sugar or Honey
• Preparation Method:
• Stir the mixture till the salt and sugar dissolve.
Notes: If baking soda is not available, add another 1/4 teaspoon of salt.

Questions on Solutions made at Home

How do I measure the Salt and Sugar?

Different countries and different communities use various methods for measuring the salt and
sugar.
Finger pinch and hand measuring, and the use of local teaspoons can be taught successfully.
A plastic measuring spoon is available from Teaching Aids at Low Cost (TALC) with
proportions to make up 200 ml of sugar/salt solution.
Whatever method is used, people need to be carefully instructed in how to mix and use the
solutions.

Do not use too much salt. If the solution has too much salt the child may refuse to drink it. Also,
too much salt can, in extreme cases, cause convulsions. Too little salt does no harm but is less
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effective in preventing dehydration.

A rough guide to the amount of salt is that the solution should taste no saltier than tears.

How much solution do I feed?

Feed after every loose motion.

Adults and large children should drink at least 3 quarts or liters of ORS a day until they are well.

Each Feeding:

• For a child under the age of two

Between a quarter and a half of a large cup
• For older children
Between a half and a whole large cup
• For Severe Dehydration:

Drink sips of the ORS (or give the ORS solution to the conscious dehydrated person)
every 5 minutes until urination becomes normal. (It's normal to urinate four or five times
a day.)

How do I feed the solution?

• Give it slowly, preferably with a teaspoon.

• If the child vomits it, give it again.

The drink should be given from a cup (feeding bottles are difficult to clean properly). Remember
to feed sips of the liquid slowly.

What if the child vomits?

If the child vomits, wait for ten minutes and then begin again. Continue to try to feed the drink to
the child slowly, small sips at a time.

The body will retain some of the fluids and salts needed even though there is vomiting.

For how long do I feed the liquids?

Extra liquids should be given until the diarrhoea has stopped. This will usually take between
three and five days.

How do I store the ORS solution?

Store the liquid in a cool place. Chilling the ORS may help. If the child still needs ORS after 24
hours, make a fresh solution.

10 Things you should know about Rehydrating a child.

• Wash your hands with soap and water before preparing solution.
• Prepare a solution, in a clean pot, by mixing

- one teaspoon salt and 8 teaspoons sugar

or
- 1 packet of Oral Rehydration Salts (ORS)
- with one litre of clean drinking or boiled water (after cooled)

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 Stir the mixture till all the contents dissolve.

• Wash your hands and the baby's hands with soap and water before feeding solution.
• Give the sick child as much of the solution as it needs, in small amounts frequently.
• Give child alternately other fluids - such as breast milk and juices.
• Continue to give solids if child is four months or older.
• If the child still needs ORS after 24 hours, make a fresh solution.
• ORS does not stop diarrhoea. It prevents the body from drying up. The diarrhoea will
stop by itself.
• If child vomits, wait ten minutes and give it ORS again. Usually vomiting will stop.
• If diarrhoea increases and /or vomiting persists, take child over to a health clinic.

Footnote:

People often refer to home-prepared oral rehydration solutions as "home-brew." This should be
discouraged because the word brew implies:
• either fermenting which in fact is an obstacle to some home-prepared solutions
especially those made with rice-powder
• or it implies boiling (as in tea) which, especially with sugar and salt or using packets of
ORS, should not be done because it decomposes the sugar, or caramelises.

A 7-point plan for comprehensive diarrhoea control

Treatment package
The treatment package focuses on two main elements, as outlined in a 2004 joint statement from
UNICEF and WHO:
1) uid replacement to prevent dehydra-tion and 2) zinc treatment. Oral rehydration therapy
– which has been heralded as one of the most important medical advances of the 20th century
2 – is the cornerstone of Fluid replacement. New aspects of this approach include low-
osmolarity oral rehy- dration salts (ORS), which are more effective at replacing uids than the
original ORS formulation, and zinc treatment, which decreases diarrhoea severity and duration.
Important additional compo-nents of the package are continued feeding, including
breastfeeding, during diarrhoea episodes and the use of appropriate uids available in the home
if ORS are not available, along with increased uids in general.
Prevention package
The prevention package highlights ve main ele-ments that require a concerted approach in their
implementation. The package includes: 3) rotavirus and measles vaccinations, 4) promotion of
early and exclusive breastfeeding and vitamin A supplemen-tation, 5) promotion of handwashing
with soap, 6) improved water supply quantity and quality, includ-ing treatment and safe storage
of household water, and 7) community-wide sanitation promotion.
New aspects of this approach include vaccinations for rotavirus, which is estimated to cause
about 40 per cent of hospital admissions due to diarrhoea among children under ve worldwide.
3 In terms of community-wide sanitation, new approaches to increase demand to stop open
defecation have proven more eective than previous strategies. It has been estimated that 88 per

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cent of diarrhoeal deaths worldwide are attributable to unsafe water, inadequate sanitation and
poor hygiene.
4 Actions needed to take interventions to scaleIn many countries, progress has been made in the
delivery or promotion of several of these inter-ventions, particularly vitamin A supplementation
and exclusive breastfeeding. However, a substantial reduction in the diarrhoea burden will
require greater emphasis on the following actions:
■ Ensure wide availability of low-osmolarity ORS and zinc, which could have a profound impact
on child deaths from diarrhoea if scaled up immedi-ately. Possible strategies to increase their
uptake and availability could include the development of smaller ORS packets and avoured
formulas, as well as delivering zinc and low-osmolarity ORS together in diarrhoea treatment
kits.
■ Include rotavirus vaccine in national immuniza-tion programmes worldwide, which was
recently recommended by the World Health Organization.
■ Develop and implement behaviour change interventions, such as face-to-face counselling, to
encourage exclusive breastfeeding.
■ Ensure sustained high levels of vitamin A supplementation, such as by combining its delivery,
where eective, with other high-impact health and nutrition interventions.
■ Apply results of existing consumer research on how to motivate people to wash their hands
with soap to increase this benecial and cost-eective health practice. Handwashing with soap
has been shown to reduce the incidence of diarrhoeal disease by over 40 per cent.
5■ Adopt household water treatment and safe storage systems, such as chlorination and ltration,
in both development and emergency situations to support reductions in the number of diarrhoea
cases.
■ Implement approaches that increase demand to stop community-wide open defecation. As with
handwashing, the new approach employs behav-ioural triggers, such a pride, shame and disgust,
to motivate action, and leads to greater ownership and sustainability of programmes.
We know what works to immediately reduce deaths from childhood diarrhoea. We also know
what actions will make a lasting contribution to reducing the toll of diarrhoeal diseases for
years to come. But strength-ened eorts on both fronts must begin right away.