Go to Admin » Appearance » Widgets » and move Gabfire Widget: Social into that MastheadOverlay zone
Parents should feel free to give young children with minimal dehydration apple juice or a favourite beverage instead of an electrolyte solution when they’re recovering from vomiting and diarrhea, says a Canadian doctor who put both approaches to a test.
Nearly 650 children aged six months to five years who went to the emergency department at the Hospital for Sick Children in Toronto with gastroenteritis or intestinal infection were randomly assigned to drink either diluted apple juice or a standard apple-flavoured electrolyte solution as a control.
When the children left emergency, investigators asked the parents to continue giving the diluted apple or preferred fluids or the electrolyte solution, depending on their group. A research nurse called daily until the child was free of symptoms for a day and then again after a week.
Of the 644 children who completed follow-up, those who had dilute apple juice experienced treatment failure less often (17 per cent) than those in the control group who were given electrolytes (25 per cent), Dr. Stephen Freedman, an associate professor of pediatrics at the University of Calgary and his co-authors said in Saturday’s issue of JAMA.
“I’ve bought commercially available electrolyte solutions in the past and often seen first-hand the challenges of getting a child to want to drink them,” said Freedman, who is also an adjunct scientist at Sick Kids.
Some children don’t like the way the electrolyte solution tastes. In hospital, when children refuse to drink it, staff may resort to an IV, Freedman said.
The findings challenge the recommendation to routinely give electrolyte solutions when diarrhea starts, an approach Freedman called somewhat dogmatic. It was based on evidence from developing countries where mortality and dehydration is high, but hadn’t been tested much in high-income countries where most children don’t need immediate electrolyte maintenance.
“I think this will enable physicians to take a more patient-centred approach,” Freedman said. “Sometimes it’s more important we promote the successful consumption of liquids than being rigid on what we’re allowing them to consume.”
If parents have significant concerns about a child developing dehydration, then they should be brought in for an evaluation to be reassured if they feel they can’t manage it at home, he said. In some cases, a child may need more treatment.
The Canadian Paediatric Society’s Caring for Kids website says signs of dehydration include:
The study was funded by the Physician Services Incorporated Foundation.