Step 3: Advise the mother what else to do

In Step 2, you learned how to find out what the mother was doing that was correct, and to praise and encourage her for it. But it is unlikely that the mother has done everything exactly as she should have done, and she will need to be advised about what else she should do. For example, to the mother who gives her child food, but who does not mash it you may say, "He will probably find it easier to eat if you try giving him soft, mashed foods. He may also be more willing to eat small amounts at a time, but several times a day".

The mother may even be doing some things that are harmful. In this case, you must carefully advise against this behaviour, and suggest something else in its place. For example, a mother may be giving the child some antibiotics she bought in the market-place. You could tell her, "Your child does not need these medicines right now, and they will not help him. The kind of diarrhoea he has will stop in just a few days. The most important thing is to keep helping him to eat and drink so he will stay strong."

It is important that this step be carried out carefully, that is, in a way that shows respect for the mother rather than making her feel that she has done something very wrong.

In the previous exercise you were asked to find out what a mother did correctly in each of four common situations. In the following exercise, look at the same situations, and:

Listen to the mother's answer.

Decide if she has done something harmful (or not helpful);

Say how you would carefully advise her against that;

Say what else you need to advise her. (Limit your answer to drinking, eating, or medication, according to each situation).

Remember to use simple language.

Exercise

For this exercise, work in a pair with another person in your group. Discuss and write answers to the questions for all four of the situations. When everyone has completed the exercise, each pair of volunteers will present to the group their suggestion of how these situations may be carried out. Each pair should demonstrate one situation.

As in the previous exercise, each child is about 8 months old and has no signs of dehydration.

1. The mother says, "Yes, my child is drinking. I give him two spoonfuls of ORS, three times each day."

(a) Has the mother done anything that is harmful, or not helpful? What?
(b) How would you advise this mother on what she is doing?
(c) What else do you need to advise her about giving fluids?

2. The mother says, "I offer my child food, but she doesn't want anything but breastmilk."

(a) Has the mother done anything that is harmful, or not helpful? What?
(b) How would you advise this mother on what she is doing?
(c) What else do you need to advise her about giving her child food?

3. The mother says, "I have given my child two of the pills that the pharmacist sold to me."

(a) Has the mother done anything that is harmful, or not helpful? What?
(b) How would you advise this mother on what she has done?
(c) What else do you need to advise her about using medication?

4. The mother says, "My child hasn't taken any medication or other treatment."

(a) Has the mother done anything that is harmful, or not helpful? What?
(b) How would you advise this mother on what she has done?
(c) What else do you need to advise her about using medication?

Advising about danger signs

Mothers need to know what signs to watch for in their children, to decide whether the child needs medical care. Since understanding and recognizing dehydration may be difficult, the CDD programme suggests a few simple signs that most mothers can recognize easily. These are:

If the child cannot eat or drink;
If the child is very thirsty;
If the child passes many watery stools;
If the child is vomiting;
If the child has a fever;
If there is blood in the child's stools;
If the child is not getting better.

It will be very important to make sure that the mother understands these signs and can remember them. The Mother's Card that you will learn to use later in this session will help both you and the mother to remember the essential signs.