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If you've got a vomiting kid, you don't need to rush out to the drugstore and buy those oral rehydration solutions. Just add some water to the juice you have in the refrigerator, and you're all set.
That's the bottom line of a study published in JAMA (The Journal of the American Medical Association). Researchers studied about 600 children who came to the emergency room with stomach flu and minimal dehydration. Half of them were given dilute apple juice, and half were given an oral rehydration electrolyte solution (like Pedialyte), colored to look like apple juice and sweetened to make it taste better. The families whose children got the apple juice were told to give them whatever fluids they would take once they got home, while the ones who got the electrolyte solution were told to continue giving the solution at home.
The children that got apple juice were less likely to need intravenous fluids or end up back in the emergency room.
There are a few reasons why doctors have recommended the special solutions. The major reason is that they worry that fluids that have a lot of sugar in them, like juice or Gatorade, can worsen diarrhea. The other reason is that when you have a lot of vomiting or diarrhea, you can lose electrolytes like sodium that are crucial for your body's function. And certainly, in children with severe dehydration or in very small infants, these are real worries.
But for the average child sick with stomach flu who has only mild dehydration, these aren't big worries. Those kids generally do just fine as long as they get fluids into them — pretty much any fluids. And as any parent knows, kids are most likely to drink fluids that are familiar to them, and that taste good. Solutions like Pedialyte are not familiar to most children — and while they don't taste bad, they can have an odd taste that many children don't like.
Here are some important tips when giving fluids to children with vomiting and diarrhea:
- Start with clear fluids, like the diluted apple juice used in the study. Once they are keeping that down well, you can try milk or other fluids.
- The "dilute" part is also a good place to start. A little extra water, and a little less sugar, is easier on the stomach. Once they are keeping fluids down, it's less important to add the water.
- When children are vomiting, give them little bits at a time (an ounce or two) to be sure it stays down. Sometimes kids will be thirsty and want to take more — but their stomach can't handle it yet. Keep giving the small amounts until they are keeping fluids down.
If your child can't keep anything down or is having repeated diarrhea, goes more than 6 hours without urinating, seems excessively tired to you, has a high fever, or has really bad pain of any kind, call your doctor. You should also call for advice if your child is less than 6 months old or has any ongoing medical problems.
This study underlines what our grandmothers knew instinctively: when it comes to caring for sick children, most of the time, simple is best.