What’s the best treatment for a stomach infection and dehydration from diarrhea and poor eating? Most infections in children are viral, not bacterial. The majority are mild and do not require any antibiotics or hospitalization. Conversely, babies and toddlers can get dehydrated after a couple of days of severe diarrhea and inadequate fluid and food intake.
The basics of hydration include continuing to breastfeed your child during an infection and having them eat normal foods (if possible). Many parents think that their child automatically needs intravenous hydration at the hospital, but in reality, the majority of cases can be treated orally and at home.
The American Academy of Pediatrics’ official position paper on gastroenteritis (tinyurl.com/ly5wo76) states that “oral rehydration was found to be as effective as intravenous therapy in rehydrating children with mild to moderate dehydration.” A 2006 meta-analysis (tinyurl.com/m3rkjcp) by the Cochrane Collaboration, which collected data from the best studies, concluded “no clinically important differences between oral rehydration therapy and intravenous therapy.”
What is the best way to ensure proper rehydration at home? The WHO-approved Oral Rehydration Salts (WHO-ORS), which are sold over the counter in pharmacies worldwide, including China. WHO-ORS have been exhaustively studied worldwide and provide the right balance of water, sugar and salts. Pure water is not the best treatment, as it contains none of the sodium salts and sugars needed to replenish cells.
Sports drinks and sodas are also not ideal. They usually contain a lot of sugar and other ingredients that make their osmolarity much higher than what the body can handle. This actually pulls more liquid from your cells, worsening diarrhea and dehydration. Coke’s osmolarity is very high and in some sports drinks, it’s even higher. The Japanese drink Pocari Sweat is closer in composition to ORS, but still contains more glucose and – critically – less sodium. Sodium is the single most important mineral for hydration; a major imbalance, whether too high or too low, can cause great harm.
At home, many parents resort to clear liquids like chicken soup or juices. However, chicken soup often contains an enormous amount of sodium and the osmolarity of apple juice and ginger ale is so high that consumption can significantly worsen diarrhea.
Parents should always resort to WHO-ORS first for diarrhea and vomiting – not water, sports drinks, teas, or juices. The Academy of Family Practice (AFP) has more specific advice in their article on managing acute gastroenteritis in children (tinyurl.com/m8c75jn).
Need more info? Dr.Richard Saint Cyr is a family doctor at Beijing United Family Hospital, and the director of clinical marketing and communications. He runs the blog www.myhealthbeijing.com.
photo from wikimedia commons.
This article originally appeared on p27 of the beijingkids August 2013 issue.
Check out the PDF version online at Issuu.com