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

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