Natalie, and everyone Thank you for sending in the description of all the research you've done on RRT in breastfed children. We really need this! Years ago (it would have been >10) I came across some written information that suggested that if a baby with diarrhoea was receiving 600ml or more of breastmilk in a 24 hour period, then that was all that he would need to prevent dehydration, ie that he would not need ORS, or ORT as it was also called. Also that if a sick baby could take anything at all by mouth, it should be breastmilk. But can I find this information again??? No :-( If anyone has seen anything similar, could they pleeeeese send me the ref?? Many thanks. Pamela Morrisn IBCLC Rustington, England ------------------------------------------- Date: Fri, 8 Feb 2013 15:16:01 -0500 From: Natalie Wilson <[log in to unmask]> Subject: Oral Rehydration Therapy in breastfed children Exactly ten years ago I raised some questions about oral rehydration therapy (ORT) in breastfed children and now I am back on this issue again. I have two concrete and specific questions: 1. Is there any evidence behind use of oral rehydration salts (ORS) in breastfeeding populations? 2. Is there any research that compares the outcomes during mild to moderate dehydration in exclusively breastfed infants and children (that is children who can fall back on exclusive breastfeeding during sickness) with diarrhea and/or vomiting and breastfed infants and children who are breastfed and supplemented with ORS? I have done extensive research into the literature and did not locate one shred of evidence behind the introduction of ORS for breastfed infants. I did not locate any research that will clearly outline the exact value and concrete symptoms that will warrant introduction of ORS to breastfed children with mild to medium dehydration. WHO documents provide guidelines, but I did not see any research that would warrant these algorithms in breastfed populations of infants and children. During my research I analyzed a lot of material and detected that all the materials for diarrhea management and dehydration prevention emphasize the use of ORS as the cornerstone for dehydration prevention and treatment. Breastfeeding was introduced into the diarrhea prevention and treatment programs much later, after the use of ORS was hailed as the greatest medical discovery of the 20th century. Fasting was part of the historic development of the therapy. The only two sources that emphasize breastfeeding as the cornerstone for diarrhea treatment and dehydration prevention were Dr.Jack Newman and Kellymom. Currently, the programs that emphasize ORS as life-savers do it in such a way that successfully breastfeeding women perceive breastfeeding as secondary measure during diarrhea (ORT+BF ≠BF+ORT). This is not the issue of just healthcare providers who promote abandonment of breastfeeding following archaic fasting ORT guidelines. This is the issue of promotion materials that undermine breastfeeding in favor of ORT. Natalie Gerbeda-Wilson La Leche League of North Carolina, USA *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome