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Chlorinated water for SAM/MAM children with rehydratation

This question was posted the Management of wasting/acute malnutrition forum area and has 2 replies.

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Alexandra Rutishauser-Perera

International Medical Corps

Normal user

23 Apr 2013, 14:08

I got a very strange question from one of our adviser and wanted to share it with you as I never heard about such an issue... She was in meeting with a WASH from an other organization who mentionned that ORS can't be given to malnourished children with Chlorinated water... She was apparently aware that ORS can't be given to SAM children but her issue was about the water being chlorinated... I never heard about such an issue before and was wondering if any of you knew about this... I honestly think that there was a confusion there but maybe something new came up that I am not familiar with... Thanks for your help

André Briend

Frequent user

23 Apr 2013, 14:42

Dear Alexandra, You are right, I am afraid there is a misunderstanding here. Years ago, it was advised not to use standard ORS for children with SAM because it had a high Na content (90 mEq Na/L). We are not sure this advice still makes sense with current ORS with lower Na levels (70 mEq/L), especially when given according to recommendations. But in any case, nothing to do with chloride, which should preferably be there to get low bacteria levels. I heard another discussion about the effect of highly chlorinated water on vitamin levels when use to make F75 or F100. Some vitamins (C and A especially) are damaged by chloride. I don’t know what is the final expert opinion on that. I guess the effect should be minimal when chloride levels are kept within the usual limits for drinking water.

Nina Chad PhD

Infant Feeding Consultant

Normal user

24 Apr 2013, 04:17

I can not speak to interactions between chlorine and vitamins in F75/100. However, it is my understanding that chlorine evaporates from drinking water quite quickly (yes, my kids keep goldfish!). To remove chlorine from drinking water, we simply leave it in an uncovered container overnight. In a situation where preventing mosquito breeding is important, I would cover the container with a small net (I have decorative lace nets that are weighted with beads that my great grandmother made for keeping insects out of water jugs). Whether or not chlorine is problematic, I could not say, but it is easy enough to remove.

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