Dear all:
I remember reading lots of articles on oral rehydration when I was doing my MHS in 1984. It was touted as an dramatic improvement over using IVs for rehydration, especially in developing areas of the world.  YES, exclusively breastfed babies can dehydrate and die.  I've seen it up close and personal during a cholera epidemic in what is now back to Congo but was called Zaire at that time.  

Since I did not keep my collection of articles on oral rehydration because I thought it had been researched to death I cannot cite specific articles nor guarantee that there may be questions that went unanswered and assumptions made that need reexamination.

I can tell you that in the entire time I worked in developing areas of the world, the push was also to breastfeed MORE and use oral rehydration.  I can also tell you that one of my colleagues did a study on the home made solutions (which, like powdered formula, are often mixed to the wrong concentration) compared to the packaged solutions.  He did this at the Potato Institute in Peru.  What he found was that the home made solution was often used when dehydration was fairly mild when it didn't matter as much if the concentration was perfect.  The packaged solutions were used in the clinics when dehydration was more severe and it mattered more.  

Breastfed infants do get sick and do get dehydrated, just not nearly at the same rates as babies who are not breastfed or not breastfed exclusively.

Frequent breastfeeding is the first oral rehydration.  

Best, Susan Burger

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