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Subject:
From:
Karleen Gribble <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 9 Feb 2013 08:56:43 +1100
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Hi Natalie,
I wonder whether Marko Kerac might have some information that might assist? Marko has been working on a project looking at how to manage malnutrition in infants under 6 mo (MAMI project). Google will find him.
Karleen Gribble
Australia
On 09/02/2013, at 7:16 AM, Natalie Wilson wrote:

> 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
> 
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