Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Diarreha and Oral Hydration Therapy

Category: Child Care


Oral fluids are the best way, world-wide, to prevent complications from diarrhea. The world health organization has developed an oral rehydration solution which has the right quantities of electrolytes such as sodium potassium and glucose. This has saved numerous lives, particularly in third world countries. Surprisingly, children even in the United States are still dying annually from diarrhea and secondary dehydration. Recognizing the severity of diarrhea and starting oral rehydration therapy quickly is extremely important in preventing complications. In the United States, access to doctors, hospitals and IV rehydration is fairly available. Nevertheless, there are some areas of the country where patients have a difficult time getting care to prevent getting into a dangerous situation by starting oral rehydration therapy right away. In general, it is best to use a specific oral electrolyte solution, rich in minerals, salts and sugar such as Pedialyte, Pedialyte fruit flavored, Resol and a few other oral rehydration solutions. These are readily available at any drug store and at some regular grocery stores. Check with your doctor on his or her specific preference. This is a much better way of rehydrating a child with severe diarrhea than plain water, 7Up, apple juice or Gatorade. For mild diarrhea the regular fluids such as Gatorade, apple juice, 7Up, Coke, water, Jello, and tea can be sufficient. The key is to start oral rehydration therapy right away and to give frequent small amounts such as one-half to one cup every hour. This is particularly important if a child is small and can become dehydrated rapidly. For any child under two with diarrhea which seems significant, your doctor should be called right away.

Again it is best to avoid sugary drinks in that this may induce even more diarrhea particularly large amounts of sweet apple juice or colas. Fairly soon after starting the oral rehydration therapy you can actually start foods including most regular foods as long as they are not too heavy or greasy. Good ones to start early include things like bananas, Jello, applesauce, toast, soft boiled or microwave eggs, and popsicles. If the child is vomiting, the key is to give small amounts of the electrolyte solution at frequent intervals. If the diarrhea or vomiting gets worse and the child is more sick appearing over several hours, then your doctor should be called.

Here are a few tips on assessing your child's dehydration status. If the child is voiding well and has very moist eyes, mouth and skin he is not too dehydrated. On the other hand, if he has not voided for several hours, his skin stays pinched when you pinch it gently on the abdomen, or the back of his mouth feels dry to touch, then he may be greater than 5% dehydrated and may need medical attention including IV fluid replacement. There is a national oral rehydration therapy project ongoing throughout the country to try and prevent complication of diarrhea and Louisiana is one of the states targeted because of a higher than average rate of death from diarrhea in the past several years.

Again this is usually only in the most severe cases but still does occur in this country. Hopefully, as parents understand the importance of rehydration therapy, this can be totally eliminated.