Children with mild gastroenteritis and minimal dehydration experienced fewer treatment failures such as IV rehydration or hospitalization when offered half-strength apple juice followed by their preferred fluid choice compared with children, who received electrolyte maintenance solution to replace fluid losses, according to the study.
Researcher Stephen B. Freedman of the University of Calgary and colleagues randomly assigned children age 6 to 60 months with gastroenteritis and minimal dehydration to receive color-matched half-strength apple juice/preferred fluids or apple-flavored electrolyte maintenance solution.
Children who were administered diluted apple juice experienced treatment failure less often than those given electrolyte maintenance solution (17 percent vs 25 percent). Fewer children administered apple juice/preferred fluids received intravenous rehydration (2.5 percent vs 9 percent). Hospitalization rates and diarrhea and vomiting frequency were not significantly different between groups.
The authors write that these results challenge the recommendation to routinely administer electrolyte maintenance solution when diarrhea begins, based primarily on an unblinded study in which blocks of participants were provided instructions for use of electrolyte maintenance solution or instructions plus a prescription for electrolyte maintenance solution at no charge.
They concluded that 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.