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Ask Dr. Sue
DIARRHEA TREATMENT IN CHILDREN
Dear Dr. Sue,
My nine month old son recently had bad diarrhea. I
was giving him Pedialyte at first, and he was drinking
it fine. But then the pharmacist told me that
Gator-Ade was the same thing, only a whole lot cheaper.
Is that true? I want to give him what he needs
when he's sick, but I don't want to spend money for
nothing, either.
Mom
Dear Mom,
Gatorade and Pedialyte (or other true
oral rehydration solutions) are NOT the same thing.
Gatorade has more sugar than these drinks, which can
increase the amount of diarrhea. It also has too
little sodium (or salt), which is essential to help
correct the sodium loss that can occur with severe
diarrhea, and it is lacking the "base" which helps to
correct the acid/base mismatch
that often occurs. High levels of acidity in your
child's bloodstream contributes to vomiting, which
causes still more fluid loss.
There are several brands of true oral rehydration
solutions available; Pedialyte is only one of the
options. The others include Kaolectrolyte,
Ricelyte, and store brands which may be a dollar
per liter cheaper (check the label against regular
Pedialyte to be SURE it's the same thing, though.) The
World Health Organization makes a flavorless dry packet
that you can add to your own liter
bottle of water; it costs only about 80 cents per liter
compared to $5.00 or so for a liter of the others.
(This WHO Oral Rehydration Salts packet is currently
available at Kaiser Pharmacy, White
Cross Pharmacy, and Medical Arts Pharmacy - pharmacists,
these can be ordered from Jianas Brothers Co., 2533
Southwest Blvd., Kansas City, MO 64108, 816-421-2880).
What should you do if your baby or small child develops
diarrhea? Have one of these rehydration solutions
in your cupboard so you can start them at once. It
is much better to prevent dehydration
than to play catch-up later. If your child doesn't
like the taste of these solutions, you have two options
Using a syringe, dribble the solution into the inside of
his cheek, where he won't be able to spit it out, and he
won't choke on it.
Buy Kool-Ade powder that is sweetened with Nutrasweet
(Not Sugar!) and add it to the solution until it tastes
better to you. Then, if he still won't drink it,
use the method above and get it in anyway!
Remember, he would not like an IV any better.
Even if your child is vomiting, oral rehydration can
still work. Start out by just giving 5 cc (one
teaspoon) of solution every minute, and keep it up right
through the vomiting. Usually, as tiny bits of the
rehydration solution is absorbed, the child's acid/base
balance begins to improve and vomiting begins to
decrease, and even WITH continued vomiting, some of the
fluid is getting
through to help prevent or to fix dehydration.
Once the vomiting is improved, you can start giving
larger amounts at once, but still avoid a large amount
of fluid all at once; stretching that
irritated stomach will most likely bring on the vomiting
again.
How much to give per day depends on your baby's weight:
Consider these the MINIMUM amounts to get
into your child, for mild diarrhea. Give more if
the diarrhea is more severe. You can tell if you
are giving enough if your baby's mouth is still moist
and slippery, if he has at least six wet diapers in 24
hours, if he has tears when he cries, and if he
continues to play, at least a little, off an on
throughout the day. If any of these things aren't
true, make an appointment at once with your
pediatrician.
NOTE: If you are breastfeeding, continue to nurse as
often as possible; offer the rehydration solution
between feedings, and watch the signs above to be sure
he is getting enough.
 
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