Back to the basics – study suggests a simplified approach to treating vomiting and diarrhea

Research shows drinking diluted apple juice or a favourite beverage can be just as effective as drinking an electrolyte solution to prevent dehydration

TORONTO – In some cases even a teaspoon of sugar isn’t enough to help the medicine go down. Vomiting and diarrhea are common childhood illnesses, which are typically treated by drinking therapeutic electrolyte solution in order to prevent dehydration. The problem is some children don’t like the way these drinks taste and they often refuse to drink them.

A research team led by Dr. Stephen Freedman set out to determine whether minimally dehydrated children who were allowed to drink their preferred beverage, would do as well as kids who were told to drink electrolyte solutions. The study is published in the April 30 edition of JAMA.

Minimally dehydrated children, six months to five years old, taken to the emergency department as a result of vomiting and diarrhea were studied. Researchers found that the children who were provided with diluted apple juice in the emergency department and instructed to consume whatever fluids they wanted to at home to replace ongoing fluid losses, did better than those children who were instructed to only drink an electrolyte solution at home to replace losses. The most significant improvement in outcomes occurred with the older children in the study, those over 24 months of age.

“We believe this difference is most likely related to kids being allowed to drink liquids they actually like and thus they consumed larger amounts, felt better, and needed intravenous fluids less often” says Freedman, Adjunct Scientist at The Hospital for Sick Children (SickKids) and Associate Professor of Paediatrics, and the Alberta Children’s Hospital Foundation Professor in Child Health and Wellness at the University of Calgary Cumming School of Medicine. “Children were able to maintain their hydration level simply by being encouraged to return to a normal diet sooner and they didn’t need to see more physicians or return to the hospital more often.”  

The use of beverages with high sugar content has traditionally been discouraged due to their potential to make diarrhea worse. But current literature shows the effect is minimal. In fact this study found that the positive effect of drinking more fluids outweighs the potential negative effect of consuming sugar from juices or sports drinks.

Dr. Freedman is also a member of the University of Calgary’s Alberta Children’s Hospital Research Institute. This study was supported by a grant provided by the Physician Services Incorporated Foundation.

This paper is an example of how SickKids is contributing to making Ontario Healthier, Wealthier and Smarter.