Fluid and Dietary Management of Acute Infantile Diarrhoea

Oral rehydration solution is not widely used in Hong Kong for treatment of acute diarrhoea despite its well proven efficacy. Hypotonic oral rehydration solutions with osmolarity of 200 to 250 mmol/L and containing sodium of 60 mmol/L are safe in developed countries with the added effects of decreasing stool output and the duration of diarrhoea. Rice-based oral rehydration solutions are well tolerated in infants y ounger than 6 mont hs of age. M ore ev idence is re quired to justify its re placement of the glucose-based hypotonic oral rehydration solutions. Rehydration should be achieved within 4 hours. Breast feeding should be continued in acute diarrhoea. Resumption of lactose-containing normal diet immediately after rehydration does not result in worsening of diarrhoea, increased lactose intolerance and prolongation of the duration of diarrhoea but results in significantly better weight gain. Routine dilution of milk and rout ine use of lactose-free milk are unnecessary in most cases. Anti- diarrhoeal agents should not be used to treat acute diarrhoea in children.