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11. Zinc supplementation

Last update: 2023-03-31


Zinc is a mineral that is important for children’s healthy growth and development. Foods such as meat, fish, dairy products, beans and nuts contain zinc. Sometimes children do not have enough zinc, and as a result they may have longer, more severe bouts of diarrhoea, and may become very sick.

If children between six months and five years of age who have diarrhoea are given extra zinc together with ORS, they are less likely to get very sick and will recover faster.

Please note: even though zinc is a naturally occurring mineral and is recommended to minimize the effects of diarrhoea, taking too much zinc can cause problems such as stomach ache, headache, chills or feeling tired. It is important to give only the recommended amount.

During an outbreak of diarrhoeal disease (including cholera), children between six months and five years of age with diarrhoea should be given a zinc supplement together with oral rehydration solution (ORS). ** Caution is required towards people who show signs of malnutrition. A child or adult that has a red or yellow mid upper arm circumference (MUAC) measure should be referred immediately to a health facility for treatment or prevention of dehydration. ** (see Action Tools, Measuring acute malnutrition in emergencies and Measuring mid upper arm circumference for further information on MUAC and on malnutrition).

What to do and how to do it

Preparing for zinc supplementation

  • Do not give zinc without the supervision and advice of health professionals. This type of intervention will be managed by a supervisor with a health background (like a doctor or a nurse), or by a coordinator who works closely with the health authorities who will advise on the correct dose and method of administering zinc.
  • If possible, make sure you know your National Society’s policy on when volunteers can give zinc to children; follow it. If your National Society does not have a policy, take the advice of your supervisor about if and when to administer zinc.
  • Make sure you understand the correct way to prepare and use zinc supplements.

Administering zinc

  • Make sure all children from the ages of six months to five years with diarrhoea are given zinc correctly, together with ORS. (See Action tool Giving oral rehydration solution (ORS)). Follow the advice of health care professionals for the amount of zinc (number of sachets) to give to each child. The health provider will determine this based on the age of the child.
    • Use treated or boiled water to make the zinc solution.
    • Make sure that the cups and utensils used to make the solution are clean, and that water containers are clean and covered.
    • Hands should be washed with soap before making zinc or ORS solution.

Social mobilization around zinc supplementation

  • Social mobilization and behaviour change communication are important supporting activities. (See the points above and Action tool Social mobilization and behaviour change)
    • Make sure caregivers of children are preparing and using zinc supplements correctly.  
    • Demonstrate how to correctly prepare and give zinc supplements. Conduct follow-up visits to make sure caregivers are preparing and using zinc correctly.