New Oral Rehydration Solution is More Effective for Treating Children with Diarrhea

World Health Organization Plans to Make Changes Based on New Research Findings

Children who receive a less concentrated (reduced osmolarity) oral rehydration solution for the treatment of dehydration and diarrhea are significantly less likely to need costly intravenous (IV) fluid treatment compared to children treated with the current solution used by the World Health Organization (WHO), according to a new study conducted by the Johns Hopkins School of Public Health and five other institutions around the world. Based on the latest research findings, the WHO plans to conduct a meeting of experts to revise its recommendations on oral rehydration solution formulation for treatment of children with diarrhea. The study is published in April 2001 edition of Pediatrics .

"More than 200,000 children are hospitalized and nearly 300 die from severe diarrhea in the U.S. each year and the problem is worse in other countries. The reduced osmolarity, or less concentrated, oral rehydration solution is a very effective treatment and it will be extremely beneficial to children in developing countries who might not have access to IV's and advanced medical care," says co-author, Mathuram Santosham, MD, MPH, professor of international health at the Johns Hopkins School of Public Health .

Since its development in the 1960s, oral rehydration solution has been credited with saving the lives of millions of children throughout the world who suffer from dehydration caused by severe diarrhea. The solution is a mixture of water, glucose, sodium, potassium, and electrolytes, which help children recover and retain vital fluids and nutrients. The United Nations Children's Fund (UNICEF) distributes oral rehydration solution worldwide. Similar solutions are sold in U.S. supermarkets under different brand names such as Pedialyte, CeraLyte, and Infalyte.

The new reduced osmolarity solution is a less concentrated formula and contains less sodium than the current WHO solution. The lower osmolarity helps the body absorb water more quickly and reduces the risk of hypernatraemia, which is a rare but deadly disorder caused by too much salt in the body.

For the double-blind study, researchers randomly selected 675 children from health centers in five developing countries who suffered from diarrhea. All of the children selected for the study were between one and 24 months of age. Half of the group was treated with the current rehydration solution while the other half was treated with the new reduced osmolarity solution.

"We found that the children who received the reduced osmolarity solution were 33 percent less likely to need IV treatment when compared to the children treated with the current WHO formula. Also, the new formula was equally effective at reducing diarrhea and vomiting," explains Dr. Santosham.

The study was funded by grants from the World Health Organization (WHO), Division of Child Health and Development, Applied Research on Child Health Project of the Harvard Institute for International Development, and the United Nations Children’s Fund (UNICEF).

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