Is rice based oral rehydration therapy effective in young infants?

• Published in: Archives of disease in childhood Vol. 71; no. 1; pp. 19 - 23
• Main Authors: Islam, A, Molla, A M, Ahmed, M A, Yameen, A, Thara, R, Molla, A, Issani, Z, Hendricks, K, Snyder, J D
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.07.1994; BMJ; BMJ Publishing Group LTD
• Subjects: Biological and medical sciences; Children; Citrates; Citric Acid; Copper Sulfate; Diarrhea; Diarrhea - metabolism; Diarrhea - therapy; Digestibility; Diseases of the digestive system; Drug Combinations; Feces - chemistry; Fluid Therapy - methods; Humans; Hydrogen-Ion Concentration; Indicators and Reagents; Infant; Infants; Male; Medical sciences; Oryza; Pediatrics; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehydration; Rehydration Solutions - therapeutic use; Rice; Sodium Bicarbonate; Young Children; Human; Treatment efficiency; Oral administration; Diarrhea; Tolerance; Infant; Glucose; Statistical study; Diet therapy; Rehydration; Digestive diseases; Intestinal disease; Clinical trial; Comparative study; Rice
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.71.1.19

Rice based oral rehydration therapy (ORT) solutions have been shown to be superior to glucose oral rehydration salts (World Health Organisation (WHO) ORS) in reducing stool volume and duration of diarrhoea in children and adults. Rice based ORT has been used only sparingly in young infants, however, because of theoretical concerns about digestibility. A randomised controlled trial of rice based ORT (50 g rice and electrolytes identical to WHO ORS) and WHO ORS was carried out in 52 male infants less than 6 months old with moderately severe acute diarrhoea to evaluate efficacy and digestibility. Nineteen (70%) of 27 children who received rice based ORT and 18 (72%) of 25 children who received WHO ORS were treated successfully. The mean (SD) diarrhoeal stool output for the first 24 hours of treatment was significantly lower in the infants receiving the rice based ORT than in those receiving WHO ORS (101.0 (60.5) v 137.1 (74.6) g/kg). The stool output was also significantly less in the rice based ORT group in the second 24 hours. Infants in the rice based ORT group drank significantly less rehydration solution than infants in the WHO ORS group (mean (SD) 165.4 (77.4) v 217.9 (86.1) during the first 24 hours of treatment. There was no difference in the duration of diarrhoea between the groups. The volume of breast and formula feeding was similar in the two groups. No difference was seen in the frequency of finding reducing substances or acid pH in the stools of either group of children. The results suggest that rice based ORT is as effective as WHO ORS in infants with moderately severe diarrhoea and that rice based ORT is as well tolerated as WHO ORS in infants.