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Date: | Sat, 9 Feb 2013 11:58:39 +0000 |
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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
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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 â‰
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
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