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Ovid: Oxford Handbook of Tropical Medicine

Editors: Eddleston, Michael; Pierini, Stephen; Wilkinson, Robert; Davidson, Robert Title: Oxford Handbook of Tropical Medicine, 2nd Edition Copyright ©2005 Oxford University Press (Copyright 2005 by M. Eddleston, S. Pierini, R. Wilkinson, and R. Davidson) > Table of Contents > Chapter 2 > Chapter 2D – Diarrhoeal diseases > Some difficulties encountered in home therapy for diarrhoea Some difficulties encountered in home therapy for diarrhoea

  • The mother is disappointed because she is not given a prescription for drugs or the child does not receive an injection. Explain that the diarrhoea will stop by itself after a few days. Also, explain that drugs do not help to stop diarrhoea, but that fluid replacement and continued feeding will help shorten the illness and maintain her child’s strength and growth.
  • The mother believes that food should not be given during diarrhoea. Ask her to explain her beliefs about how diarrhoea should be treated. Discuss with her the importance of feeding in order to keep her child strong and to support normal growth, even during diarrhoea. There are almost always some foods which are acceptable — find out and encourage these alternatives.
  • The mother does not know what fluids to give her child at home. Ask her what fluids she can prepare at home and reach an agreement on appropriate fluids for her child.
  • The mother does not have the ingredients to make a recommended fluid. Ask her if she can obtain the necessary ingredients easily. If she cannot, suggest another home fluid.
  • The child vomits after drinking ORS or other fluids. Explain that more fluid is usually kept down than is vomited. Tell her to wait 10 mins and then start giving fluid again, but more slowly.
  • The child refuses to drink. A child who has lost fluid will usually be thirsty and want to drink, even when there are no signs of dehydration. If the child is not familiar with the taste of ORS, some persuasion may be needed at first. When a child drinks well to begin with but then loses interest, it usually means that sufficient fluid has been given.
  • The mother is given some packets of ORS for use at home but is afraid they will be used up before the diarrhoea stops. Explain that after the ORS has been used up she should give a recommended home fluid (e.g. rice water) or water or she should return to the health facility for more packets of ORS. In any event, she should continue to give extra fluid until the diarrhoea stops.

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