Hesperian Health Guides
Dehydration
Dehydration means not enough fluid in the body. It is described in this chapter because the most common cause is diarrhea. Dehydration can also come from vomiting, getting too hot from the sun, overwork, or wearing too many layers of clothing. Especially in young children, dehydration can get worse quickly and become deadly.
No matter the cause, the treatment, which anyone can do at home, is rehydration (drinking fluids). You can save a person’s life by helping her drink fluids when she is dehydrated.
Contents
Signs
- Thirst
- Dry mouth and tongue (when you touch the inside of the person’s cheek, it feels dry)
- Urinating less often and the urine is dark-colored
Start treatment now, before the signs get any worse.
Signs that dehydration is getting worse
- Lethargy: tired, low-energy
- Fast heart beat
- Deep breathing
- Sunken, tearless eyes
- Skin stays in a pinched shape
- In infants, a sunken "soft spot" on the head
Treatment and prevention
It is always safer and easier to prevent dehydration than to try to treat it once it starts. Give fluids before signs of dehydration appear.
Dehydration is prevented and treated in
the same way — by drinking fluids.
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Do you believe that giving something to drink will make diarrhea worse? It is easy to think this as you watch liquid diarrhea come from a child. But fluids do not cause diarrhea.  Diarrhea happens because of infection with germs. It will continue whether the person drinks or not. But giving fluids helps a person to stay strong enough to recover from the infection. Someone with diarrhea who does not drink will dehydrate and may eventually die. You can save a life by giving fluids to replace what was lost. Holding back fluids does not protect children from diarrhea. It puts them in danger. Drinking fluids keeps you healthy when you have diarrhea, and helps you get well. |
Rehydration drinks
Rehydration means replacing what we lose during dehydration. When we have diarrhea, when we vomit, and when we sweat, we lose water. So rehydration drinks must include water. We also lose nutrients that we get from food, mainly salt and energy (that we get from eating sugar or grain or protein). To rehydrate, we must replace these nutrients too. Water + a little salt + energy food (sugar or rice or corn meal) = rehydration drink.
Give as much rehydration drink as the person will drink, one or more drinks after each stool. Each drink should be at least one cup for a small child, a cup or more for an older child or adult.
Keep giving rehydration drink until diarrhea has stopped and signs of dehydration are gone.
What are some good rehydration drinks? Almost any fluid that you can easily prepare at home is a good rehydration drink!
Salt and sugar drink
At home or at a clinic you can make a simple rehydration drink. It is just as good as the ORS (oral rehydration salts) packets you can buy, but costs much less.
1. In 1 liter clean water
2. Mix ½ teaspoon salt
Taste this mixture. It should be less salty than tears.
3. Then mix in 8 flat teaspoons sugar
| OR, instead of sugar, mix in 8 rounded teaspoons of cereal, such as ground rice cereal or maize meal. If you use cereal, cook the mixture for a few minutes before serving it. | 
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To mix a single serving of rehydration drink:
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| 1 glass water | + | 1 pinch of salt | + | 2 or 3 teaspoons of sugar or cooked grain cereal |
Rice water
Rice water works as well as salt and sugar solution for rehydration. Cook some rice in twice as much water as you would normally use. Add some salt to the water. (About ½ teaspoon salt per liter of water, or a big pinch in a glass of it). You can add a little sugar if you like. Drink as much as you can. You can eat the rice too.
Other home cereals
If you usually make porridge or gruel to eat or feed to young children, these can be watered-down for rehydration drink. Ground corn, dal, potato, or cassava will all help rehydrate someone (if they are well cooked and watered down to a thin liquid, and a little salt is added).
A thinned porridge like this does not replace food. If you thin down porridge for a rehydration drink, you can also give regular, thick porridge to eat. To recover from dehydration, give food as well as fluids.
Yogurt or fermented milk drinks
These are good rehydration drinks and provide needed protein too. If the yogurt drink is very thick, mix in some water. Add a pinch of salt per glass.
Breast milk
If you are breastfeeding a child who has diarrhea, continue to do so. Breastfeed the child more often – at least after every bowel movement. Let him breastfeed for as long as he wants. A child who has any signs of dehydration should also get some salt and sugar drink after each time he breastfeeds.
Avoid drinks that make dehydration worse
Very sugary drinks, drinks with caffeine, and alcohol worsen dehydration. So avoid:
- Sodas (Coke, Fanta, Pepsi) and sugary fruit drinks.
- Coffee and strong tea.
- Beer, wine and other alcohol.
What about plain water?
When you are dehydrated, plain water is not as good as the rehydration drinks above because it lacks the nutrients your body needs. When you are very dehydrated, drinking plain water can make you sick because you also need salt and energy. But it is better to give plain water than nothing at all – for a little while. Give water while you wait for rice water or cereal drink to cook.
Must water be boiled first?
Water that has been boiled or otherwise cleaned of germs (disinfected) is best. See information on how to make water safer to drink.
But if you do not have firewood for boiling water, or have trouble getting clean water, use the water you do have until you can make your water safe.
Pre-packaged ORS
Pre-made packets of Oral Rehydration Salts (ORS, ORT) may be available from your pharmacy, clinic, or market. Like homemade rehydration drink, these contain a mix of salt and sugar in the right amounts for treating dehydration. They also contain potassium, citrate, and zinc – which are helpful nutrients for people with diarrhea. Where these packets are available for free, they are a convenient way to make rehydration drink. Be sure to add the right amount of water – usually 1 liter of water per packet. (But check the instructions on the packet because adding too little or too much water can make sickness worse.)
If ORS packets are not free, it is better to make your own rehydration drink – it is much less expensive. Spend your money on vegetables, beans, eggs, or other healthy foods. Your homemade rehydration drink is just as good as the packet, and healthy food will help you recover faster.