When a child starts passing watery stool, many Nigerian parents reach first for antibiotics, anti-diarrhoea tablets, or herbal mixtures. But the two things that actually save lives during childhood diarrhoea are far simpler and cheaper: oral rehydration salts (ORS) and zinc. The combination of ORS and zinc for diarrhoea in children in Nigeria is recommended by the World Health Organization and the Federal Ministry of Health precisely because it works, it is affordable, and you can start it at home in Lagos, Kano, Enugu or any village in between. This guide explains what ORS and zinc do, how to give them correctly, and the danger signs that mean you must stop self-treating and get medical help.
Why diarrhoea is so dangerous for children
Diarrhoea itself rarely kills. What kills is dehydration — the loss of water and body salts through repeated watery stools and vomiting. A small child has less fluid reserve than an adult, so a baby can become dangerously dehydrated within hours. This is especially true during the rainy season and in areas with poor water and sanitation, where rotavirus, bacteria and parasites spread easily. The goal of treatment is not to stop the stool immediately, but to keep replacing the fluid and salts the child is losing, so the body can fight off the infection safely.
What ORS does and how to mix it correctly
ORS is a precisely balanced mixture of glucose and salts. The glucose helps the gut absorb water and sodium even while the diarrhoea continues — this is why ordinary water or sugar-only drinks cannot do the same job. In Nigeria you can buy NAFDAC-registered low-osmolarity ORS sachets in any pharmacy or PHC. The most common mistake is mixing it wrongly. Always dissolve one full sachet in the exact amount of clean, safe water printed on the pack (usually 1 litre, but read your sachet — some are smaller). Do not add extra sugar, do not use half the water to make it 'stronger', and do not split a sachet across two days. A too-concentrated ORS can actually make a child sicker.
- Wash your hands with soap and clean water first.
- Pour the full sachet into the exact volume of clean water stated on the pack (boiled-and-cooled or sachet/bottled water if your tap water is not safe).
- Stir until fully dissolved — do not add sugar, salt, honey or anything else.
- Give small, frequent sips with a cup or spoon, not a rushed bottle.
- After every loose stool, give extra ORS: about a quarter to half a cup for under-2s, and half to one full cup for older children.
- Throw away any mixed ORS left after 24 hours and prepare fresh.
Why zinc matters — and how to dose it
Zinc is the quiet partner that many parents skip, but it is just as important. Zinc supplementation shortens how long the diarrhoea lasts, reduces how severe it is, and protects the child from another episode in the following months. The standard Nigerian and WHO recommendation is a 10 to 14 day course of zinc given every day — not just on the day the stool is bad. For babies under 6 months, give 10 mg (half a 20 mg tablet) once daily; for children 6 months and older, give 20 mg (one tablet) once daily. Dispersible zinc tablets dissolve in a little breast milk, ORS or clean water. Keep giving zinc for the full course even after the diarrhoea stops, because that is what builds the protective benefit.
| Child's age | ORS after each loose stool | Daily zinc dose | Zinc course length |
|---|---|---|---|
| Under 6 months | About a quarter cup (50-100 ml) | 10 mg (half a 20 mg tablet) | 10-14 days |
| 6 months to 2 years | About a quarter to half cup (50-100 ml) | 20 mg (one tablet) | 10-14 days |
| 2 years and older | Half to one full cup (100-200 ml) | 20 mg (one tablet) | 10-14 days |
Keep feeding the child throughout the illness. Breastfeeding babies should breastfeed more often, not less. Older children should keep eating soft, familiar foods — pap, mashed yam, rice, soup — in small amounts as often as they can manage. Withholding food during diarrhoea is an old habit that only weakens the child. On GoDoctor you can order a verified ORS and zinc pack for children and have it delivered, and read our fuller guide to childhood diarrhoea if you want the complete picture.
Danger signs — get help immediately
Stop home treatment and go to the nearest hospital, or call 112 or 199, if the child: is too weak to drink or breastfeed, is unusually drowsy or hard to wake, has sunken eyes or a sunken soft spot, has no urine (dry nappy) for many hours, has blood in the stool, is vomiting everything, has a high fever, or the diarrhoea is very watery and frequent (which can signal cholera). In babies, dehydration moves fast — do not wait it out. If you suspect cholera in your community, seek care urgently and read our cholera guide on what to do.
What not to give
Do not give a child anti-motility drugs like loperamide (Imodium) to 'stop' the diarrhoea — they trap the infection inside and can be harmful for children. Do not give antibiotics unless a doctor or pharmacist has prescribed them; most childhood diarrhoea is viral and antibiotics do nothing while adding side effects and resistance. Avoid unproven herbal concoctions and 'native medicine' for the runny stomach, as some can worsen dehydration or damage the liver. Soft drinks, energy drinks and very sweet juices draw more water into the gut and can make diarrhoea worse, so they are not a substitute for ORS.
When to speak to a doctor on GoDoctor
If the diarrhoea has lasted more than a few days, the child is not improving on ORS and zinc, there is recurrent fever, or you are simply unsure how dehydrated your child is, a quick consultation helps. On GoDoctor you can talk to an MDCN-verified doctor by video, audio or chat, get the right advice for your child's age and weight, arrange a home lab test if a stool sample is needed, and have any prescribed medicine delivered to your door anywhere in Nigeria. Early advice prevents a manageable case from becoming an emergency.
FAQ
Can I make ORS at home with salt and sugar instead of buying a sachet? You can use a home salt-and-sugar solution as a temporary measure if no sachet is available — six level teaspoons of sugar and half a level teaspoon of salt in one litre of clean water — but a NAFDAC-registered ORS sachet is safer and more accurately balanced, so buy one as soon as you can and never guess the proportions.
Should I keep giving zinc after the diarrhoea has stopped? Yes — complete the full 10 to 14 day zinc course even if the stool returns to normal after two or three days, because the extra days are what reduce the chance of another diarrhoea episode in the coming weeks and months.
My baby vomits the ORS back up — what should I do? Wait about ten minutes, then offer the ORS again slowly, one small spoonful every one to two minutes rather than a large amount at once; if the baby keeps vomiting everything and cannot keep any fluid down, this is a danger sign and you should seek medical care urgently or call 112 or 199.
Is ORS and zinc enough, or does my child need antibiotics? For most children, ORS plus zinc plus continued feeding is the complete treatment because diarrhoea is usually viral; antibiotics are only needed in specific cases such as confirmed cholera or dysentery with blood, and that decision should be made by a doctor — you can consult one on GoDoctor rather than buying antibiotics over the counter.