Oral Rehydration Therapy

Introduction

Most cases of dehydration are very minor and do not require any medical attention. They can usually be treated by drinking fluids such as water, breast milk, baby formula or diluted juices.

Oral rehydration therapy (ORT) is used for treating the more serious dehydration that is caused by viral gastroenteritis, also known as stomach flu. This virus can cause a child to vomit repeatedly or have prolonged diarrhea, which can result in loss of fluids.

Around the world, viral gastroenteritis causes about 1.5 to 2.5 million deaths a year. In the United States, the dehydration that results from gastroenteritis results in about 220,000 hospital admissions per year. Most hospitalizations occur when dehydration is not treated early.

Benefits

If your child becomes severely dehydrated, they may need to have their fluids replaced through an intravenous (IV) line. However, oral rehydration therapy is as effective as, if not better than, intravenous fluid therapy for rehydrating mild or moderately dehydrated children.

There are a number of reasons for this.

  • ORT is less traumatic for a child, as they will not need needle "pokes" for the IV or blood work.

  • ORT is easier to give in a range of settings, including at home.

Where to get ORT Fluid

Oral rehydration solution (ORS) is sold at most pharmacies in:

  • pre-mixed bottles

  • packaged powders that need to be mixed with water.

Examples of commercial brands of ORSs include Pedialyte and Enfalyte.

Whether you use a pre-mixed bottle or packaged powder, follow the dosage directions exactly to maximize the effectiveness of the ORS.

How to give ORT Fluid

Give your infant oral rehydration solution in small, frequent amounts. Use a spoon or dropper to make sure the first doses are very small. Small amounts will allow your child to better retain the ORS and reduce the chance of vomiting from the extra fluid in their system. If your toddler has been off the bottle a short time, re-introduction may help increase their intake. Pedialyte freezer pops may also help jump start the process.

Gradually increase the amount of ORS until your infant is able to drink the full dose recommended for them.

If your child refuses to drink the ORS, squirting the solution into their mouth with a syringe can be helpful.

If a breast-fed infant is dehydrated, continue breastfeeding throughout the illness. In non-breastfed infants, offer undiluted formula. The formula does not need to be lactose free.

Notes

If your child has severe viral gastroenteritis, do not provide them with water, juices, fizzy drinks, or sports drinks.

  • Drinking water alone can lead to low salt and sugar levels.

  • Juices, fizzy drinks and sports drinks contain high levels of glucose and low levels of electrolytes. They can cause diarrhea if they are given in large quantities.

As soon as your child has been rehydrated, you can start early refeeding. This involves re-introducing age-appropriate foods, which promotes better nutrition and reduces the duration of diarrhea.