How to prepare Oral Rehydration Solution (ORS) at home?

From the Guidelines

To prepare Oral Rehydration Solution (ORS) at home, mix 6 level teaspoons of sugar and 1/2 level teaspoon of salt in 1 liter of clean drinking water, as recommended by the most recent guidelines 1. This homemade solution should be used within 24 hours if kept at room temperature or 48 hours if refrigerated.

Key Components of ORS

• 6 level teaspoons of sugar
• 1/2 level teaspoon of salt
• 1 liter of clean drinking water ORS works by replacing essential electrolytes and fluids lost during diarrhea or vomiting.

Administration Guidelines

• For children under 2 years, give 50-100ml after each loose stool;
• for older children and adults, offer frequent small sips as tolerated 1. If symptoms persist beyond 48 hours, if there's blood in stool, or if dehydration worsens (signs include decreased urination, dry mouth, sunken eyes), seek medical attention immediately.

Importance of ORS

The safety and efficacy of ORS, in comparison to intravenous rehydration therapy (IVT), was evaluated in a meta-analysis of 17 RCTs involving 1811 patients aged <18 years from high-income and low-income countries 1. Low-osmolarity ORS can be given to all age groups, with any cause of diarrhea, and is safe in the presence of hypernatremia as well as hyponatremia (except when edema is present) 1. Some key points to consider when preparing ORS at home include:

• Using clean drinking water to minimize the risk of infection
• Stirring the solution until the sugar and salt are completely dissolved
• Adding 1/2 cup of orange juice or a mashed banana for potassium and to improve taste, if desired
• Discarding any unused solution after 24 hours at room temperature or 48 hours if refrigerated
• Monitoring the patient's condition and seeking medical attention if symptoms worsen or persist.

From the Research

Preparation of Oral Rehydration Solution (ORS) at Home

To prepare an Oral Rehydration Solution (ORS) at home, the following ingredients and methods can be used:

• Half a teaspoon of salt in 1 liter of water is recommended for preparing an ORS, as it achieves the most acceptable sodium level 2
• A domestic teaspoon and a standard 750 ml bottle can be used for the preparation of home-based oral rehydration solutions 3
• The use of level teaspoons of sugar and half a level teaspoon of salt in a 750 ml bottle of water is a reliable method for preparing an ORS 3

Important Considerations

• The finger-pinch-and-cup method for measuring salt can produce sodium values that are too high and too variable, and is not recommended 2
• Adding flavorings such as apple juice, orange juice, or orangeade to an ORS can decrease the sodium and chloride content, and increase the osmolality, making it less effective for rehydration 4
• Commercially flavored ORS is recommended, as it fulfills ESPGAN criteria for ORS and is preferred by most subjects 4

Electrolyte Content and Osmolality

• The preferred ORS is one similar to the glucose-containing reduced osmolarity World Health Organization ORS, which typically contains specific amounts of sodium, potassium, chloride, and glucose 5
• The use of other liquids, such as sport drinks, juice, soft drinks, and chicken broth, is not recommended for preparing an ORS, as they do not contain the correct balance of electrolytes and osmolality 5