Apple juice best to treat dehydration in kids: study

Children suffering from mild gastroenteritis and dehydration should be given diluted apple juice instead of electrolyte drinks to replace fluid losses, scientists say.
Researchers found that children with mild gastroenteritis and minimal dehydration experienced fewer treatment failures such as Intravenous (IV) rehydration or hospitalisation when offered half-strength apple juice followed by their preferred fluid choice compared with children who received electrolyte maintenance solution to replace fluid losses.
Gastroenteritis is a common paediatric illness. Electrolyte maintenance solution is recommended to treat and prevent dehydration, although it is relatively expensive and its taste can limit use. Its advantage in minimally dehydrated children is not proven, researchers said.

For the study, researchers from the University of Calgary in Canada randomly assigned 647 children aged 6 to 60 months with gastroenteritis and minimal dehydration to receive colour-matched half-strength apple juice/preferred fluids or apple-flavoured electrolyte maintenance solution.
After discharge, the half-strength apple juice/preferred fluids group was administered fluids as desired; the electrolyte maintenance solution group replaced losses with electrolyte maintenance solution, researchers said.
The outcome for the study was a composite of treatment failure defined by any of the following occurring within 7 days of enrollment - intravenous rehydration, hospitalisation, subsequent unscheduled physician encounter, protracted symptoms, crossover, and 3 per cent or more weight loss or significant dehydration at in-person follow-up, they said.

Among the randomised children (average age, 28 months; 68 per cent without evidence of dehydration), 644 completed follow-up, researchers said.

Children who were administered diluted apple juice experienced treatment failure less often than those given electrolyte maintenance solution (17 per cent vs 25 per cent), they said.
Fewer children administered apple juice/preferred fluids received intravenous rehydration (2.5 per cent vs 9 per cent), researchers said.
Hospitalisation rates and diarrhoea and vomiting frequency
were not significantly different between groups, they said.
"In many high-income countries, the use of dilute apple juice and preferred fluids as desired may be an appropriate alternative to electrolyte maintenance fluids in children with mild gastroenteritis and minimal dehydration," researchers said.

The findings were published in the journal JAMA.