ORS Dosing for an 8.8kg Child
For an 8.8kg child, administer 60-120 mL of ORS for each diarrheal stool or vomiting episode, with a maximum of approximately 500 mL per day during the maintenance phase. 1, 2
Initial Rehydration Phase (If Dehydrated)
If the child presents with mild to moderate dehydration, the initial rehydration dose is calculated as:
- 50-100 mL/kg over 3-4 hours 1, 2
- For an 8.8kg child: 440-880 mL total over 3-4 hours 1
- This should be administered in small, frequent volumes 2
Reassess hydration status after 3-4 hours by checking skin turgor, mucous membranes, urine output, and mental status to determine if additional rehydration is needed. 2, 3
Ongoing Loss Replacement (Per Purge)
Once initial rehydration is complete, replace each subsequent loss:
- 60-120 mL ORS for each diarrheal stool 1, 2, 3
- 60-120 mL ORS for each vomiting episode 1, 2
- Alternative calculation method: 10 mL/kg (88 mL) per watery stool and 2 mL/kg (18 mL) per vomiting episode 3, 4
- Maximum daily amount: ~500 mL/day for children <10kg 1, 2
Practical Administration Strategy
Start with small volumes if vomiting is present:
- Begin with 5 mL every 5 minutes for the first 30 minutes 2, 4
- Gradually increase to 10-15 mL every 10-15 minutes as tolerated 4
- Continue replacing each stool/vomit with 60-120 mL 2, 4
Type of ORS to Use
Use low-osmolarity ORS (such as Pedialyte, CeraLyte, or WHO-ORS) for all age groups. 1, 2, 5
Critical Pitfalls to Avoid
- Never use apple juice, Gatorade, sports drinks, or soft drinks for rehydration—these have inappropriate electrolyte content and high osmolality that can worsen diarrhea 1, 2, 3, 4
- Do not use anti-diarrheal medications in children with acute diarrhea 2, 3, 4
- Do not restrict fluids or delay feeding—continue age-appropriate nutrition throughout the illness 1, 2
- Do not "rest the bowel" through fasting—resume feeding as soon as appetite returns 1
When to Escalate Care
Severe dehydration requires immediate IV rehydration with 20 mL/kg boluses of isotonic crystalloid until vital signs normalize, then transition to ORS. 1, 2, 3 Signs of severe dehydration include altered mental status, prolonged skin tenting >2 seconds, poor perfusion, or inability to tolerate oral intake. 1, 3
Consider nasogastric administration at 15 mL/kg/hour (132 mL/hour for 8.8kg) if the child cannot tolerate oral intake but is not in shock. 1, 2, 4