Oral Rehydration of Neonates and Young Infants with Dehydrating Diarrhea

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Abstract
Oral rehydration among infants aged 0-3 mo. was not adequately investigated. A controlled, randomized study was thus conducted in 65 young infants hospitalized with acute noncholera dehydrating diarrhea. The study was designed to compare the efficacy and safety of the standard WHO oral glucose-electrolyte solution containing 90 mmol of Na/l (group A: 22 infants) with that of an oral glucose-electrolyte solution containing 60 mmol of Na/l (group B: 22 infants) and with standard i.v. therapy (group C: 21 infants). Among the 44 infants in groups A and B, none required i.v. therapy. Dehydration, acidosis and initial hyponatremia or hypokalemia were corrected with equal efficacy in all the 3 groups. In the critical 1st 8 h, the mean Na absorption was significantly higher (P < 0.01) in group A. This resulted in hypernatremia (50%), periorbital edema (50%), mild pedal edema (27%), excessive irritability and convulsions (4.5%). The mean serum Na levels at 8, 24 and even 48 h were significantly higher (P < 0.05) than those in groups B and C. Glucose-electrolyte oral solution containing 60 mmol of Na/l is as safe and effective as i.v. rehydration for the treatment of noncholera neonatal and early infantile diarrhea, while the standard WHO solution carries a significant risk of hypernatremia under similar conditions.