Diarrhoea is currently the second leading cause of child deaths and kills 1.9 million young children every year, mostly from dehydration.

The latest improved ORS formula contains less glucose and sodium (245 mOsm/l compared with the previous 311 mOsm/l). The lower concentration of the new formula allows for quicker absorption of fluids, reducing the need for intravenous fluids and making it easier to treat children with acute non-cholera diarrhoea without hospitalisation.

ORS use is the simplest, most effective and cheapest way to keep children alive during severe episodes of diarrhoea. The ORS solution is absorbed in the small intestine, thus replacing the water and electrolytes lost. WHO and Unicef have jointly issued guidance for the production of the new ORS.

WHO and Unicef recommend that countries manufacture and use the new ORS in place of the previous formula.

According to Unicef and WHO, oral rehydration therapy should be combined with guidance on appropriate feeding practices. Provision of zinc supplements (20 mg of zinc per day for 10 to 14 days) and continued breastfeeding during acute episodes of diarrhoea protect against dehydration and reduces protein and calorie consumption to have the greatest impact on reducing diarrhoea and malnutrition in children.

The revised monograph for the new ORS formula will be published in the fourth edition of The International Pharmacopoeia.