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After rehydration: what happens to the child?
S Riyad1, M el Moughi, A A Wahsh
1National Control of Diarrheal Disease Project (NCDDP), Dokki, Giza, Egypt.
Insights
Home-based oral rehydration solution (ORS) effectively managed diarrhea in young children. Continued feeding, particularly breast milk, aided recovery and reduced illness duration.
Area of Science:
- Pediatrics
- Gastroenterology
- Infectious Diseases
Background:
- Diarrhea remains a leading cause of mortality in infants and toddlers globally.
- Effective rehydration strategies are crucial for managing diarrheal diseases in young children.
- Oral rehydration solution (ORS) is a cornerstone of diarrheal disease management.
Purpose of the Study:
- To evaluate the efficacy of home-based oral rehydration solution (ORS) administration in infants and toddlers with diarrhea.
- To assess the impact of continued feeding on the duration of diarrheal illness and associated symptoms.
- To identify factors influencing treatment outcomes in young children with diarrhea.
Main Methods:
- A prospective study followed 300 infants and toddlers with diarrhea for 5 days post-initial rehydration.
- Home-based ORS administration was guided by specific volume recommendations based on stool consistency.
- Clinical outcomes, including re-hospitalization rates and symptom duration, were monitored.
Main Results:
- Only two of 300 children required re-hospitalization when managed with home-based ORS.
- One fatality occurred in a child with voluminous losses inappropriately managed at home.
- Fifteen percent of children experienced persistent watery diarrhea and vomiting by day five, potentially linked to polypharmacy.
Conclusions:
- Home-based ORS administration is a safe and effective strategy for managing most cases of diarrhea in infants and toddlers.
- Continued feeding, especially breast milk and cereal grains, is recommended to shorten illness duration.
- Maternal time and effort in administering ORS are critical determinants of treatment success.
Abstract:
Three-hundred infants and toddlers with diarrhoea were followed up for 5 days after initial rehydration with oral rehydration solution (ORS). When an average of 300-340 ml per day was given at home (520 ml if the diarrhoea was watery), only two children required re-hospitalization; one other child died whose voluminous losses should not have been treated at home. Fifteen per cent of the children still had watery diarrhoea and vomiting by the fifth day, perhaps as a result of multiple drug therapy. Continued feeding, especially breast milk and cereal grains, should reduce the duration of diarrhoea and vomiting (and perhaps the number of drugs). The amount of time a mother can spend giving ORS ultimately limits the amount a child receives.