Child under 5 with diarrhoea or vomiting. Action: assess severity (WHO Plans A/B/C), rehydrate orally with oral rehydration salts (ORS) in frequent small volumes, maintain breastfeeding and refer if danger signs are present.
Lethargy, sunken eyes, skin pinch returning very slowly, no tears, dry mouth and tongue, inability to drink → severe dehydration (Plan C): refer immediately for IV rehydration.
Assess: general state, sunken eyes, skin pinch, tears, mouth/tongue and thirst. Plan A (no dehydration), Plan B (mild to moderate), Plan C (severe).
Give ORS 75 mL/kg in frequent small volumes over 4 hours (spoon/cup, every 5–10 minutes). Reassess the child during rehydration and teach the mother/father to continue at home.
Maintain breastfeeding and restart the usual diet as soon as possible. Zinc 10–20 mg/day for 10–14 days reduces the duration and severity of diarrhoea.
A child who cannot drink, is lethargic or has a skin pinch returning very slowly: immediate referral for IV rehydration. Reassess in the community after discharge.
Use ORS (hypo-osmolar) and never plain water or soft drinks. Offer frequent small volumes with a spoon/cup. Do not stop breastfeeding. Zinc 10–20 mg/day for 10–14 days shortens diarrhoea duration (if locally recommended).