A comparison of rice-based oral rehydration solution and “early feeding” for the treatment of acute diarrhea in infants

• Published in: The Journal of pediatrics Vol. 116; no. 6; pp. 868 - 875
• Main Authors: Santosham, Mathuram, Fayad, Ibrahim M., Hashem, Mohamed, Goepp, Julius G., Refaf, Mamdouh, Sack, R. Bradley
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.06.1990
• Subjects: Acute Disease; Dehydration - therapy; Diarrhea, Infantile - blood; Diarrhea, Infantile - therapy; Enteral Nutrition; Feces; Fluid Therapy - methods; Glucose - administration & dosage; Glucose - therapeutic use; Glycine max; Humans; Infant; Infant Food; Oryza; Potassium - blood; Randomized Controlled Trials as Topic; Rehydration Solutions - therapeutic use; Sodium - blood; Time Factors; Diarrhea, Infantile; Hemic System; Sodium Ion Level > analysis; Laboratory Examinations And Diagnoses; Nutrition; Health; Diarrhea; Homeostasis; Oral Rehydration; Biology; Data Collection; Fluid Balance; Research Methodology; Examinations And Diagnoses; Potassium Ion Level > analysis; Diseases; Treatment; Data Analysis; Infant Nutrition; Physiology
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(05)80642-0

To compare the use of rice-based oral rehydration solution (R-ORS), with the introduction of food immediately after rehydration (“early feeding”), using standard glucose-based oral rehydration solution (G-ORS) in the management of acute diarrhea, we conducted a four-cell randomized, controlled trial among 200 hospitalized Egyptian infants between 3 and 18 months of age. During the rehydration phase (first 4 hours), three groups were given G-ORS and a fourth group was given R-ORS. During the subsequent maintenance phase, the control group was given a soy-based, lactose-free formula (G-ORS+SF), a second group (G-ORS+RF) was given a rice-based formula, and a third group (G-ORS+rice) was given boiled rice. The fourth group (R-ORS+SF) continued to receive R-ORS for the first 24 hours of the maintenance period, followed by a soy-based lactose-free formula. During the first and second 24 hours of the maintenance period, infants in the three treatment groups had a lower mean stool output in comparison with the control group ( p=0.006 and 0.03, respectively). The mean total stool output in the R-ORS+SF group was significantly lower than in the control group ( p=0.02). There were no statistically significant differences among the four groups in the mean duration of diarrhea. We conclude that (1) infants who were given R-ORS had reduced total stool output (by 35%) compared with the control group and (2) feeding of boiled rice or a rice-based formula immediately after rehydration therapy was as efficacious as treatment with R-ORS alone for 24 hours, followed by feeding with a soy-based, lactose-free formula.