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Drinking Apple Juice, Other Fluids OK To Treat Vomiting, Mild Diarrhea In Kids

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It's okay for parents to give children apple juice or their favorite beverage for mild cases of dehydration, says a new Canadian study.

Gut-related conditions like gastroenteritis are not uncommon among children, but while they are easily cared for in developed countries, at least 2 percent of them may have to be hospitalized because of the severity of the condition and serious dehydration.

Dehydration, which is usually caused by diarrhea, can lead to severe water loss and electrolyte imbalance with a wide range of symptoms such as decreased output of urine, dizziness, low blood pressure and rapid breathing.

One of the first steps of treatment for gastroenteritis is dehydration recovery. Some health experts, however, frown upon certain drinks like apple juice due to their high sugar content that, they contend, may exacerbate water loss.

The new Canadian study suggests that apple juice may turn out to be beneficial for children experiencing vomiting and mild dehydration.

In the single-blind randomized trial, the researchers worked with 647 children between the ages of 6 months to 5 years old admitted in a tertiary pediatric hospital in Canada from October to April from 2010 to 2015.

Following the standard protocol on oral rehydration, the researchers gave 323 of these children the drink of their choice or half-strength apple juice while the rest received the conventional apple-flavored electrolyte maintenance solution. The researchers then instructed the parents to continue with what the children were drinking upon discharge until vomiting and diarrhea had subsided.

During the follow-up on 644 children, the team found that there was no significant difference between the frequency of diarrhea and vomiting, as well as rate of hospitalization between the two groups.

However, at 17 percent, the incidence of treatment failure among children who drank apple juice or their preferred beverage was less, compared to 25 percent of kids who had the electrolyte solution.

Further, only 2.5 percent of apple juice drinkers required intravenous rehydration as opposed to the 9 percent who drank the electrolyte solution.

Although the study didn't fully explain these statistical differences, it could be because not all children like the taste of electrolyte solution.

"I've bought commercially available electrolyte solutions in the past and often seen first-hand the challenges of getting a child to want to drink them," said Dr. Stephan Freedman, University of Calgary pediatrics associate professor and one of the co-authors.

If the child continues to avoid these electrolyte solutions, the emergency department may be left with no choice but to use IV treatment.

Nevertheless, parents should take note that these data were conducted on children with mild dehydration. If the problem is more severe, it's best to have the child evaluated by a health care provider. This may also be necessary if the parent doesn't know how to effectively handle gastroenteritis and its symptoms.

Based on the study however, the researchers hope doctors will become more "patient-centered" in treating those with mild diarrhea.

"Sometimes it's more important we promote the successful consumption of liquids than being rigid on what we're allowing them to consume," Freedman said.

The study was published in JAMA on April 30.

Photo: Geoff Peters | Flickr

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