Few things worry a parent like a small child with loose motions who is growing quiet and dull. Diarrhoea remains one of the biggest killers of children under five in Pakistan — yet almost every one of those deaths is preventable with two humble heroes available at every corner store: ORS and zinc. This guide explains what actually works, what does not, and exactly when to rush to hospital.
What causes diarrhoea in children?
Most childhood diarrhoea in Pakistan is caused by viruses (especially rotavirus), and by bacteria and parasites from contaminated water and food. Loose motions themselves are the body flushing out infection; the real danger is dehydration — the loss of water and salts — which can become life-threatening in a small child within hours, far faster than in adults.
Pakistan sees seasonal surges: viral diarrhoea in winter, and bacterial diarrhoea in summer and monsoon months when water contamination peaks and typhoid also circulates — a child with fever and loose motions may need checking for that too; see our typhoid guide.
Symptoms and what to watch
Loose or watery stools, sometimes with vomiting, cramps and mild fever, usually settle in 3 to 7 days. Your real job as a parent is watching hydration:
Early dehydration signs:
- Thirst, dry lips and mouth
- Fewer wet nappies or less urine than usual
- Irritability or unusual quietness
- Crying with few or no tears
Danger signs — go to hospital now
WHO and UNICEF (IMCI guidelines) teach these red flags. Go to an emergency department, or call Rescue 1122, if your child has:
- Sunken eyes, or a sunken soft spot (fontanelle) in a baby
- Skin that stays pinched up when gently squeezed
- Drowsiness, floppiness, or difficulty waking
- Unable to drink or breastfeed, or vomiting everything
- No urine for 6 or more hours in an infant, 8 or more in an older child
- Blood in the stool
- High fever with listlessness
- Fast breathing or fits
Any diarrhoea in a baby under 2 months old is itself a reason to see a doctor immediately.
How doctors assess it
Most childhood diarrhoea needs no tests at all — doctors assess dehydration by examining the child, following the WHO classification of no, some, or severe dehydration. Tests are reserved for specific situations: stool tests when there is blood or prolonged diarrhoea, and blood tests (like CBC and electrolytes) for very sick or admitted children. If a doctor treats your child without ordering tests, that is usually correct practice, not neglect.
Treatment: the WHO-proven pair — ORS and zinc
The World Health Organization and UNICEF recommend the same simple treatment worldwide, and it has saved millions of lives:
- ORS (Oral Rehydration Salts) — Nimkol and other ORS sachets are available at every pharmacy and store in Pakistan for a few rupees. Mix one full sachet in the exact amount of clean (boiled and cooled) water written on the packet — never half sachets or guessed amounts, as wrong concentration can be harmful. Give small, frequent sips — a spoonful every minute or two — especially after each loose motion. If the child vomits, wait ten minutes and restart more slowly.
- Zinc — WHO recommends zinc syrup or tablets daily for 10 to 14 days for children with diarrhoea; it shortens the illness and prevents the next episode. Ask your doctor or pharmacist for the child-appropriate preparation.
- Keep feeding — continue breastfeeding on demand throughout, and offer normal soft foods to older children: khichdi, banana, yoghurt, rice. Starving a child with diarrhoea is an old myth that delays recovery.
What NOT to give without a doctor:
- Antibiotics — most diarrhoea is viral; unnecessary antibiotics do harm and fuel resistance. Doctors prescribe them for specific cases such as bloody diarrhoea or cholera.
- Anti-motility medicines (the loperamide family) — dangerous in young children and not recommended.
- Ghutti, unprescribed syrups and opioid-containing remedies — some traditional preparations can sedate a child and mask danger signs. Our elders mean well, but ORS is the proven lifesaver.
Prevention
- Exclusive breastfeeding for the first 6 months — breastfed babies suffer far less diarrhoea
- Rotavirus vaccine — given free in Pakistan's EPI schedule; make sure your child has it
- Boil or filter drinking water; wash hands with soap after the toilet, after cleaning a baby, and before preparing food
- Wash fruits and vegetables; keep flies off food
- Safe disposal of children's stools — they are as infectious as adult stools
Age-specific notes
- Under 6 months: dehydration develops fastest here; any diarrhoea with reduced feeding deserves same-day medical review.
- 6 months to 5 years: the classic ORS-and-zinc age group; most episodes can be managed at home with vigilant watching.
- School-age children: usually tolerate illness better, but bloody stools, high fever or diarrhoea beyond a week still need a doctor.
- All ages: a child who seems better but then becomes drowsy or stops urinating has slipped into dehydration — return to care immediately.
Frequently asked questions
Bachon mein dast ka gharelu ilaj kya hai?
The proven home treatment is ORS after every loose motion, zinc for 10 to 14 days, continued breastfeeding and soft food. Home fluids like lassi, chawal ka paani and yakhni can supplement, but ORS is the essential one because it replaces salts in the right balance.
ORS kaise banate hain?
Mix one complete sachet in the exact volume of boiled-and-cooled water printed on the packet — usually one glass or one litre depending on the brand. Use the whole sachet, stir well, use within 24 hours, and give small frequent sips rather than large gulps.
Bache ko ulti aur dast ho to kya karein?
Give ORS in tiny sips — a teaspoon every one to two minutes — so the stomach keeps it down, and continue feeding. If the child vomits everything, cannot drink, becomes drowsy or stops urinating, go to hospital immediately.
Kya dast mein antibiotic dena chahiye?
Usually no. Most childhood diarrhoea is viral and antibiotics do not help. Doctors prescribe them only in specific cases such as blood in stool, suspected cholera, or a very young or very sick child. Never start antibiotics on your own.
When should I take my child to the hospital for diarrhoea?
Immediately, if you see sunken eyes, drowsiness, refusal to drink, vomiting everything, no urine for 6 to 8 hours, blood in stool, or fits. For diarrhoea lasting beyond a week, or any diarrhoea in a baby under 2 months, see a doctor even without danger signs.
Unsure how serious your child's symptoms are right now? Our free symptom check walks you through it in minutes. This article is general health education, not a diagnosis. Always consult a doctor about your own health.