Most children with acute gastroenteritis and mild-to-moderate dehydration can be rehydrated orally, without intravenous fluids or routine blood tests. Give low-osmolarity oral rehydration solution in small, frequent amounts, and continue feeding.
Add zinc for 10–14 days in children under five, which shortens the episode and reduces recurrence. Reserve intravenous fluids for shock, persistent vomiting or failed oral rehydration, and avoid antidiarrhoeal drugs and routine antibiotics, which add risk without benefit in most cases.
- Use low-osmolarity ORS in small, frequent amounts as first-line for mild-to-moderate dehydration.
- Give zinc for 10–14 days to children under five with acute diarrhoea.
- Reserve IV fluids for shock, persistent vomiting or failed oral rehydration.
- Avoid antidiarrhoeal drugs and antibiotics unless there is a specific indication.
Why it matters
Oral rehydration and zinc are cheap and effective but under-used, while IV fluids and antibiotics are over-used in childhood diarrhoea.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for paediatrics, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free