Juice Is Best for Treating Mild Gastroenteritis with Minimal Dehydration in Children

By John D. Cowden, MD, MPH

Dr. Cowden is an associate editor with NEJM Journal Watch Pediatrics and Adolescent Medicine, from which this story was adapted. Full coverage is available to subscribers at the link below.

For children with mild gastroenteritis and minimal dehydration, dilute apple juice for initial hydration followed by fluids of the child's choice is superior to electrolyte maintenance solution, a JAMA study finds.

Researchers randomized some 650 children (aged 6-60 months) with gastroenteritis and minimal dehydration to receive either half-strength apple juice for initial hydration followed by fluids of the child's choice, or apple-flavored electrolyte maintenance solution.

The treatment failure rate was lower in the juice group (17% vs. 25%). In addition, fewer children in the juice group received IV rehydration at the index visit (1% vs. 7%) and within 7 days (3% vs. 9%). Although effective in all age groups, juice/preferred fluids was most beneficial in children aged 24 months and older.

Comment: Use of special oral rehydration solution in cases of mild gastroenteritis may not only be unnecessary but could lead to worse outcomes than use of more readily available and cheaper fluids, such as apple juice. Evidence supporting a less restrictive approach to rehydrating mildly dehydrated children should be welcomed by clinicians and parents alike.