>Date: Mon, 4 Mar 1996 16:29:36 -0600 (CST)
>From: "Maryelle G. Vonlanthen" <[log in to unmask]>
>To: Kathleen Bruce <[log in to unmask]>
>Subject: Re: Pedialyte
>
>Hi Here are a few thoughts about the use of oral rehydration solutions in
>babies with dehydration:
>
>Why is breastmilk alone not enough to treat dehydration from diarrhea??
>
>1.  Diarrhea occurs abruptly:   An infant may loose tremendous amounts of
>fluid via the stools when having diarrhea.  Breastmilk production takes a
>day or two to increase the volume and by that time the baby may/will be
>significantly dehydrated and too far behind!.
>
>2.  The composition of fluid losses varies with the type of diarrhea but
>in general the amount of sodium, potassium, chloride and bicarbonate
>exceed the amounts found in breastmilk.  Breast milk would therefore not
>provide the needed amounts of these electrolytes (salts).
>
>3.  Therefore I like to think of the treatment of diarrhea in 2 phases:
>       a.  Rehydration phase: where you are trying to catch up with the
>fluid losses.  This phase should last between 8 and 12 hours.  The fluid
>can be administered slowly by mouth (usually you calculate the amount
>needed= to losses + ongoing needs and losses for the period, add it up
>and divide it by 8.  the solution is give by spoon as opposed to bottle
>because if given too fast the baby will vomit more than he keeps in).
>During this time you may not have time to breastfeed or the baby may
>still be vomitting too much.  Ok to breastfeed if baby can handle it.
>Alternate administration route of fluids is intravenous.
>
>       b.  Maintenance Phase: By the end of the 8 hours breastfeeding is resumed
>and oral rehydration fluid is given to keep up with the ongoing losses
(vomitting
>and diarrhea).
>
>The fluids available are:
>1.  WHO solution:  designed for patients with chlolera like diarrhea,
>contains the most sodium
>
>2.  Rehydralyte: contains a little more sodium that Pedialyte and is more
>appropriate for diarrhea such as rota virus diarrhea
>
>3.  Pedialyte: good solution for maintenance but usually not enough
>sodium for rehydration phase.
>
>I hope this will help you  and the lactnet members.  Remember this is a
>brief overview of a complex topic and this discussion is by no means
>complete!.
>
>Maryelle
>
Kathleen B. Bruce, BSN, IBCLC, LLLeader, co-owner Lactnet, LLLOL, Corgi-L
LACTNET WWW site: http://www.mcs.com/~auerbach/lactation.html
Personal WWW page: http://www.together.net/~kbruce/kbbhome.html