Further, such solutions decreased stool output, and promoted greater absorption and retention of fluid and electrolytes than did a glucose-based solution. Along with improved oral rehydration solutions have come advances in the field of early refeeding. Fasting has been shown to prolong diarrhea. This may be due to undernutrition of the bowel mucosa which delays the replacement of mucosal cells destroyed by the infection. 15 Early refeeding should commence 6-12 hours into therapy.
Fluid therapy is based on an assessment of the degree of dehydration present.
If diarrhea is present, but urinary output is normal, the normal diet and breast-feeding may continue at home with fluid intake dictated by thirst. Mild - If symptoms and signs are limited to decreased urinary output and increased thirst, mild dehydration is suspected. Assessment and treatment under close supervision are indicated. Early refeeding with the child's customary formula at the usual concentration is recommended. If dehydration is corrected, therapy for ongoing losses and maintenance are continued as outlined above.