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ગુજરાતી: ગુજરાતી
हिंदी: बच्चों में दस्त: ORS, ज़िंक और डिहाइड्रेशन के संकेत, सुरक्षित घरेलू देखभाल और आयुर्वेदिक समझ
In the monsoon, 14-month-old Yash started having watery diarrhoea in the morning: eight times by evening, and two bouts of vomiting. His grandmother said, “Stop feeding him; if the stomach stays empty, the diarrhoea will stop.” His mother also reduced his milk. By night Yash was lethargic, cried without tears, his diaper had been dry for six hours and his eyes looked sunken. Straight to the hospital: moderate dehydration. The doctor explained ORS given little by little with a spoon, zinc for 14 days, and continuing breastfeeding and food. In two days Yash was playing again. The doctor’s words: “In diarrhoea, do not keep the child hungry and do not let water and salts run out; that is the main medicine.”
Diarrhoea in children means passing loose or watery stools three or more times a day (or clearly more often and looser than the child’s usual). Frequent soft stools in young babies who are only breastfed are not diarrhoea. Most diarrhoea is caused by infection, mainly viruses (rotavirus, norovirus), sometimes bacteria or parasites, spread through contaminated water, food and hands, and it settles on its own in 3 to 7 days. But in young children water and salts run out quickly: dehydration, which is a major cause of death in children under five worldwide, and which can be prevented almost completely with ORS and zinc. In Ayurveda, diarrhoea is called Atisara, “Ati” (excess) + “Sara” (flow), in which Agnimandya and the excessive loss of water (Ap Dhatu) with the stool are central; Kashyapa Samhita gives a special description of diarrhoea in children and during teething.
Key Takeaways
- The biggest danger in diarrhoea is dehydration; ORS is the first and most important medicine.
- Zinc for 10 to 14 days (as advised by the doctor) makes diarrhoea shorter and milder.
- Continue breastfeeding and food; do not keep the child hungry.
- Lethargy, crying without tears, less urine, bloody diarrhoea: see a doctor immediately.
- Ayurveda: peya and takra, bilva, gentle formulations like bala chaturbhadra and kutaja (in the vaidya’s child dose) and protecting agni, along with ORS and zinc, settle diarrhoea quickly, bring back digestion and prevent repeated episodes.
Types
- Acute watery diarrhoea: for hours or days; mostly viral; less than 7 days.
- Bloody diarrhoea (dysentery): blood and mucus in the stool, tummy pain, cramps, fever; bacterial (Shigella) or amoeba; needs a doctor’s treatment.
- Persistent diarrhoea: more than 14 days, risk of malnutrition; tests needed.
- Chronic or recurrent: giardia, food intolerance (lactose), celiac disease, too much juice (“toddler diarrhoea”).
Signs of Dehydration: Learn to Recognise Them
No or little dehydration: active, tears come, normal urine, moist mouth; ORS and food at home.
Some or moderate dehydration (two or more):
- Restless, irritable
- Sunken eyes
- Drinks eagerly, increased thirst
- Skin of the tummy pinched and released goes back slowly
- Few tears when crying, dry mouth and tongue
- Less urine, dark urine
→ ORS under a doctor’s supervision (a set amount, over 4 hours).
Severe dehydration (two or more), emergency:
- Lethargic, almost unconscious, difficult to wake
- Very sunken eyes
- Unable to drink or drinks very little
- Pinched skin goes back very slowly
- In young babies, a sunken fontanelle (the soft spot on the head)
- No urine for 6 to 8 hours, cold hands and feet
→ Hospital immediately, fluids through a vein.
ORS: How to Give It Correctly
- WHO-approved low-osmolarity ORS powder: free at government dispensaries and anganwadis; also from shops (check for “WHO ORS” on the packet; “energy drinks” and sugary ready-made drinks are not ORS)
- One packet in the amount of water written on the packet (usually 1 litre) of boiled and cooled clean water; not less water or more powder
- Use prepared ORS within 24 hours, then throw it away and make fresh
- Amount (after every loose stool): under 2 years, 50 to 100 ml (about a quarter to half a cup); 2 to 10 years, 100 to 200 ml; older children, as much as they will drink
- With a spoon, little by little, frequently: one spoon every 1 to 2 minutes; if the child vomits, wait 10 minutes and start again slowly
- Until the diarrhoea stops
If there is no ORS packet (immediately): rice water (with a pinch of salt), salted buttermilk, dal water, coconut water, homemade soup, clean water, and get ORS as soon as possible. Mistakes in proportion while making sugar-salt solution at home can be dangerous; use the packet wherever possible.
Avoid: cold drinks, packaged juice, glucose water, sweet tea, sports drinks; too much sugar increases diarrhoea.
Zinc
Zinc, started as soon as diarrhoea begins, in the dose the doctor advises for the child’s age, for 10 to 14 days (as per doctor or government guidance), reduces the severity and duration of diarrhoea and lowers the chance of diarrhoea in the next 2 to 3 months. Complete the full course even if the diarrhoea stops. The tablet can be dissolved in water or breast milk.
Continue Food: “Keeping the Child Hungry Stops Diarrhoea” Is a Myth
- Breastfeeding: more often, never stop
- Older than 6 months: continue normal food, soft and easy to digest: khichdi, dal-rice, curd-rice, buttermilk, moong water, boiled potatoes, banana (ripe), apple, idli, roti-dal
- Little and often (5 to 6 times a day)
- A little oil or ghee in food for energy
- For 2 weeks after recovery, one extra meal a day to restore lost nutrition
- Avoid: fried, spicy food, too many sweets, juice, cold drinks, eating out
- Usually there is no need to stop milk; some children develop temporary lactose intolerance in prolonged diarrhoea, and the doctor will advise
Causes
Modern View
- Rotavirus, norovirus: the most common in young children
- Bacteria: E. coli, Shigella, Salmonella, cholera
- Parasites: giardia, amoeba
- Contaminated water and food; uncovered or stale food
- Not washing hands; unclean bottles
- Antibiotic medicines
- Too much juice and sugar
- During teething, infection from putting things in the mouth (teeth themselves do not cause diarrhoea)
- Food allergy or intolerance
- Along with other infections such as ear or urine infections
Ayurvedic View
- Agnimandya: the root cause.
- Contaminated water and food: “Dushta Ambu”.
- Overeating, indigestion, incompatible food.
- Very oily, heavy or cold food.
- Fear, grief: Charaka described Bhayaja and Shokaja Atisara.
- Krimi (worms).
- Unwholesome diet of the nursing mother or vitiated breast milk, in breastfed babies (Kashyapa).
- Dantodbheda (teething): Kashyapa described diarrhoea and fever in children at this time.
Ayurvedic Understanding
Charaka explained the pathogenesis of Atisara beautifully: the body’s water (Ap Dhatu) increases, dampens Agni, mixes with the stool, and Vata pushes it downward, so the stool becomes more liquid. There are six types according to dosha: Vataja, Pittaja, Kaphaja, Sannipataja, Bhayaja and Shokaja. In Pittaja Atisara, yellow-green, burning stools with fever and thirst; in Kaphaja, sticky, white, heavy stools; in Vataja, frothy, noisy, painful stools. When there is blood, it is Raktatisara, similar to modern dysentery.
In adults, Ayurveda advises Langhana (fasting) in early Ama Atisara, but for children Ayurveda also advises caution: tissues are delicate in children, so no prolonged fasting; continue breastfeeding and give light, easily digestible liquid food (Peya, Manda, rice water), which matches the modern principle of ORS and continued feeding. Rice water (Manda), thin, easy to digest, with a little salt, can be considered Ayurveda’s traditional “ORS”.
Samprapti (pathogenesis): contaminated water and food, infection, indigestion → Agnimandya → increase of Ap Dhatu, mixing with stool → pushed downward by Vata → Atisara → loss of water, salts and tissues (dehydration, weakness).
Samprapti Vighatana (breaking the pathogenesis): replace fluids and salts (ORS or Manda) → zinc → light, easily digestible food (Peya, khichdi, Takra) → gentle Agni-kindling and Grahi (stool-binding) substances → restore tissues → hygiene (avoiding the cause).
Classical References
- Charaka Samhita, Chikitsa Sthana, Chapter 19, Atisara Chikitsa.
- Sushruta Samhita, Uttara Tantra, Chapter 40, Atisara Pratishedha.
- Ashtanga Hridaya, Nidana Sthana, Chapter 8 and Chikitsa Sthana, Chapter 9, Atisara.
- Kashyapa Samhita, Sutra Sthana, Dantajanmika chapter (disorders during teething), chapter level.
Useful Ayurvedic Support (in the Vaidya’s child dose; not a substitute for ORS and zinc)
The right medicine, dose, vehicle (Anupana) and timing are decided by the Vaidya according to the person’s constitution, age, other illnesses and current medicines.
- Rice water (Manda/Peya): thin, with a pinch of rock salt and roasted cumin; an easily digestible fluid.
- Takra (buttermilk) with roasted cumin and rock salt: binding, kindles Agni; Charaka praised Takra in Atisara.
- Bilva (bael) fruit pulp or murabba: traditionally binding; a little in children, on the Vaidya’s advice.
- Nutmeg (a very small amount, rubbed): traditional; larger amounts are toxic, only through the Vaidya.
- Bala Chaturbhadra, Kutaja (Kutaja Ghana Vati): classical in diarrhoea; the Vaidya decides the child dose.
To be clear: no “diarrhoea-stopping” medicine, whether a modern anti-diarrhoeal drug or a home binding remedy, should be given to young children without the doctor’s or Vaidya’s advice; keeping up fluids is more important than stopping the diarrhoea. In bloody diarrhoea, high fever or dehydration, do not waste time on home remedies. Old household “pills” containing opium-like substances are dangerous; never use them.
Gradual Ayurvedic approach: ORS and zinc are the foundation in diarrhoea, and any medicine the doctor gives must be completed; Ayurvedic treatment starts alongside it, without stopping anything. Rice water (peya), thin buttermilk (takra), bilva murabba, bala chaturbhadra or kutaja in the vaidya’s child dose, breastfeeding and khichdi continued, hygiene. When diarrhoea settles and appetite returns, medicine is no longer needed, and then protecting agni, clean water, handwashing and seasonal diet prevent repeated diarrhoea (apunarbhava). With lethargy, crying without tears, less urine or bloody diarrhoea, see a doctor at once.
Hygiene and Prevention
- Rotavirus vaccine: in the national immunisation programme (at 6, 10 and 14 weeks), protects against severe diarrhoea
- Exclusive breastfeeding for the first 6 months: the best protection
- Handwashing: before feeding the child, after changing diapers, after the toilet
- Boiled or filtered water
- Avoid bottles: bowl and spoon; if you use a bottle, boil and keep it clean
- Fresh, covered, hot food; no stale, uncovered or street food
- Wash fruits and vegetables
- Use toilets; dispose of the child’s stool in the toilet
- Toys and things chewed during teething: keep clean
- Vitamin A (as per the government programme)
Keep a “Diarrhoea Kit” Ready at Home
- 4 to 5 WHO ORS packets (check the expiry)
- Zinc tablets (according to age, as advised by the doctor)
- A measuring cup or bottle (to measure 1 litre), a spoon
- Thermometer
- A list of ORS amounts and dehydration signs, stuck on the fridge
- Phone number of the nearest paediatrician or hospital
Carry ORS and zinc while travelling too, especially in summer and monsoon.
Recovery After Diarrhoea
After diarrhoea, a child may stay weak, with poor appetite and irritability, for a few days. Agni returns slowly at this time, so no heavy or fried food immediately; move gradually to normal food through khichdi, dalia, curd-rice, buttermilk and fruit. Complete the zinc course, give one extra meal for two weeks, and check whether the weight has come back. If diarrhoea keeps recurring, review water, hygiene and food arrangements.
For Grandparents and the Family
Many traditional beliefs, “keep the child hungry in diarrhoea”, “give less water or there will be more diarrhoea”, “stop breastfeeding”, are dangerous according to today’s science. These mistakes, made out of love, push the child towards dehydration. Every family member should remember one rule: do not let water and salts run out, continue food, and do not wait if warning signs appear.
According to Season
Monsoon: contaminated water, weak Agni, the highest risk of diarrhoea; boiled water, hot fresh food, no eating out. Summer: food spoils quickly in the heat, water is lost through sweat, and dehydration sets in quickly in diarrhoea; more fluids, fresh food. Winter: rotavirus is often more common; hand hygiene.
According to Prakriti (diet in mild diarrhoea)
- Pitta: burning, yellow stools, fever; sweet buttermilk, rice water, coconut water, pomegranate; nothing spicy.
- Kapha: sticky, white stools, no appetite; light, warm food, a pinch of roasted cumin and dry ginger (in older children).
- Vata: pain, gas, froth; warm khichdi, a pinch of hing, a little ghee.
Common Myths
- “Stop food in diarrhoea”: wrong; continue food.
- “Stop breastfeeding”: wrong; breastfeed more often.
- “ORS stops diarrhoea”: ORS does not stop diarrhoea; it replaces water, and that is what saves life.
- “Antibiotics for every diarrhoea”: wrong; it is mostly viral.
- “Diarrhoea during teething is normal, do nothing”: if there is diarrhoea, ORS and care are needed; teeth themselves are not the cause.
- “Glucose or a cold drink is like ORS”: wrong; too much sugar increases diarrhoea.
Precautions
- Lethargy, crying without tears, no urine for 6 to 8 hours: emergency.
- Bloody diarrhoea: see a doctor.
- Diarrhoea in a baby under 6 months: see a doctor early.
- Repeated vomiting, unable to drink: hospital.
- No anti-diarrhoeal drugs, opium-containing pills or harsh home remedies.
- Make ORS exactly as per the packet; concentrated ORS is dangerous.
Do’s and Don’ts
Do: ORS after every loose stool, zinc for 10 to 14 days, continue breastfeeding and food, watch for signs of dehydration, wash hands, boiled water, rotavirus vaccine.
Don’t: keep the child hungry, stop milk or breastfeeding, give juice, cold drinks or glucose, give antibiotics or anti-diarrhoeal medicine on your own, wait when warning signs appear.
Case Studies
Case 1: The mistake of keeping the child hungry
14 months; watery diarrhoea and vomiting in the monsoon, food and milk reduced; moderate dehydration at night. ORS by spoon and zinc were started in hospital. After coming home the vaidya gave rice water, thin buttermilk, bilva murabba, bala chaturbhadra in a child dose, and breastfeeding and khichdi continued. The next day diarrhoea was much less, on the third day appetite returned; an extra meal for two weeks and hygiene kept the rest of the monsoon free of diarrhoea. (Results may vary from person to person.)
Case 2: Bloody diarrhoea
4 years; fever, cramps and mucus with blood in the stool after roadside pani puri. Straight to the pediatrician, stool test, bacterial dysentery, antibiotic and ORS-zinc. Alongside, the vaidya gave rice water, buttermilk and khichdi, kutaja in a child dose and pomegranate juice. Improvement in three days, the antibiotic completed on time, and then bala chaturbhadra for agni removed the weakness quickly. This case shows why a doctor is needed in bloody diarrhoea. (Results may vary from person to person.)
Case 3: Juice and frequent loose stools
2 years; for months 3–4 loose stools a day, but good weight and playful; three glasses of packaged juice daily, stool test normal. The vaidya stopped the juice, gave whole fruits, balanced ghee and fibre in meals, bala chaturbhadra in a child dose and dry ginger and cumin in food. Within two weeks stools were normal, and with this diet the loose stools did not return. (Results may vary from person to person.)
When to See a Doctor Immediately (Red Flags)
- Lethargy, difficulty waking
- Crying without tears, dry mouth, no urine for 6 to 8 hours
- Sunken eyes or fontanelle
- Repeated vomiting, unable to drink
- Bloody diarrhoea
- High fever, convulsions
- A baby under 6 months
- Diarrhoea for more than 14 days
About Dr. Nikul Patel
Dr. Nikul Patel (BAMS) is an Ayurvedic physician at LifeCare Ayurveda and has been practising since 1999, that is, for 27 years. In childhood diarrhoea, he gives first priority to ORS, zinc and recognising dehydration, works in coordination with the paediatrician, and guides parents on easily digestible food, hygiene and gentle Ayurvedic support in child doses.
Frequently Asked Questions
What should I do first if my child has diarrhoea?
ORS after every loose stool, continue breastfeeding and food, and zinc as advised by the doctor.
How much ORS should I give?
After every loose stool: under 2 years 50 to 100 ml, 2 to 10 years 100 to 200 ml; little by little with a spoon.
What should I feed in diarrhoea?
Khichdi, curd-rice, buttermilk, ripe banana, boiled potatoes, idli: soft and easy to digest.
How do I recognise dehydration?
Lethargy, few tears, dry mouth, sunken eyes, less urine.
Does Ayurveda help in children’s diarrhoea?
Through easily digestible food like rice water and buttermilk and gentle medicines in the Vaidya’s child dose, along with ORS and zinc.
People Also Ask
Why zinc in diarrhoea?
It reduces the severity and duration of diarrhoea and lowers the chance of future diarrhoea.
What is the rotavirus vaccine?
A vaccine that protects young children against severe diarrhoea, in the government programme.
Why does diarrhoea happen during teething?
Infection from putting things in the mouth; if there is diarrhoea, normal care is needed.
What is Atisara?
In Ayurveda, frequent loose stools, diarrhoea.
How long does prepared ORS last?
24 hours; then throw it away and make fresh.
Conclusion
Diarrhoea is common in children, but dehydration should never be taken lightly. ORS, zinc, continuing breastfeeding and food, and timely recognition of warning signs are essential, and Ayurveda is a strong companion here: peya and takra, bilva, bala chaturbhadra and kutaja in child doses, protecting agni and hygiene settle diarrhoea quickly, bring back appetite and prevent repeated episodes. Every child’s results may differ.
Dr. Nikul Patel (B.A.M.S.)
307, 3rd Floor, Shalin Complex, Above Farki Lassi, Krishnabaug Char Rasta, Maninagar, Ahmedabad – 380008
Timings: 10:00 AM to 1:00 PM and 3:00 PM to 6:30 PM | Saturday–Sunday: Closed
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