Oral rehydration solution safely used in breast-fed children without additional water

Abstract

Abstract

Sixty-four children of age 3 months to 2 years were treated for diarrhoea in a rural treatment centre with oral rehydration solution (90 mmol/l Na+); plain water was not supplied during rehydration. All children continued breast-feeding during the therapy. Serum sodium levels after 24 h of intake indicated that 61 children had serum sodium level below 148 mmol/l and three were above (range 150-151). None of the children developed clinical signs or symptoms of hypernatremia. The use of additional water may not be necessary during rehydration therapy of breast-fed children.

PIP: The findings of a clinical trial involving 64 children ages 3 months-2 years suggest that the use of additional water may not be necessary during rehydration therapy of breastfed children with diarrhea. The children had a history of watery diarrhea of less than a week's duration, mild to moderate dehydration, and had received no prior treatment. They were rehydrated and maintained by oral rehydration solution alone. Breastfeeding was encouraged after the 1st 4-hour rehydration period. This regimen successfully rehydrated all the children. After 2 hours of ad-libitum oral rehydration solution and breast milk intake, 61 of the 64 subjects had serum sodium levels in the range of 128-148 mmol/liter. Sodium levels in the 3 remaining children were 150-151 mmol/liter, but there were no clinical signs of symptoms of hypernatremia. It is concluded that it is unnecessary to instruct mothers to provide a volume of water in areas where breastfeeding is widespread. The use of oral rehydration solution therapy should be modified on the basis of the specific feeding practices prevalent in different geographic or cultural settings