Mothers don’t know how to make and feed saline to children properly

Majority of the mothers in the country either cannot or do not read what’s written on the saline packets. Many don’t know how to prepare and feed saline to children in the proper way. The fact that preparing saline in the wrong method and feeding that to children without following the rule can be harmful is unknown to mothers.

This information came up in a research conducted by the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) recently. The research was carried out on the mothers of the children aged below five, who had been admitted with diarrhoea in the icddr,b hospital in Mohakhali of Dhaka. Data were collected from 350 mothers through survey in this research. Plus, in-depth interview were taken from 31 of those mothers.

ORS (Oral Rehydration Salts) packets produced by Essential Drugs Company Limited, Social Marketing Company or any other pharmaceutical company approved by the government come with instructions on preparing, feeding and preserving the saline on the package. The instruction says that the entire contents of the ORS packet should be mixed well in half a liter of uncontaminated water.

Newborns (till 28 days from birth) have to be fed half a litre of saline within 12 hours. Children based on their age have to be given half a litre of saline within 8 to 12 hours. Adults have to drink it according to their needs. The solution cannot be prepared with hot water or the solution cannot be heated. The solution has to be thrown out after 12 hours.

After years of experiments, researchers and scientists have determined the quantity of ORS ingredients (sodium chloride, potassium chloride, sodium citrate, and anhydrous glucose) and the method for preparing the solution to treat diarrhoea. The use of ORS has increased in Bangladesh, but it is not being used properly when it comes to feeding it to children. And, that’s a matter of concern.

It’s a concern because when there’s sudden spike of salinity in children’s blood it can be harmful to them, cause seizures, cause kidney failure, and damage the nervous system. If the salinity level in the blood remains high for a long time, the child can also die from that. Even if they do survive, there is a risk of disability. The symptom of having too much salinity in the blood is called ‘hypernatremia’ in medical science.

This additional salt or sodium dissolves in children’s blood from the saline. Many mothers prepare saline in less than half a liter of water. They prepare a thicker solution that contains extra salt. Some mothers, even if they make the solution properly, feed the child more saline than required. Some others feed the saline after 12 hours of preparing that.

The icddr,b research showed that 88 per cent of the mothers do not have the proper idea about ORS. Meanwhile, 72 per cent of the mothers feed saline to children in the wrong way.

About 68 per cent of the mothers do know that ORS is the primary treatment for diarrhoea while, almost 24 per cent of the mothers believe, antibiotic medicines are more effective than saline in treating diarrhoea.

Similarly, 97 per cent of the mothers think they know how to prepare ORS. However, only 65 per cent of these mothers follow the steps of preparing oral saline. And, just 23 per cent of the mothers actually read the instructions written on the saline sachet.

During the in-depth interview majority of the mothers told the researchers that they usually do not use the entire powder contents of the saline packet at once. In many cases, they do not follow the instructions written on the sachet and do not use the said amount of pure water.

The research revealed a misconception among mothers that may be responsible for the misuse of saline. Most mothers believe that if the child is breastfed, the saline consumed by the mother will reach the child through breast milk. This misconception can have a harmful impact on the health of both the mother and the child.

This winter, many children are being admitted to the icddr,b hospital with diarrhoea caused from rotavirus. Many of them have to be kept in the ICU because they were either fed saline that was prepared improperly or was not fed the saline as instructed at home.