Infantile diarrhea; tolerance to solutions of electrolytes by mouth

Since Darrow's recommendation of electrolyte administration by mouth to infants with diarrhea, the constituting of a palatable liquid has been in the minds of all persons concerned with the treatment of diarrhea. Owing to the frequent association of gastric distress with oral administration of electrolyte solution, presumably because of increased osmolarity, a study was made at Kern County General Hospital to determine what osmolarity of solution was tolerated by most infants. For this purpose a commercially prepared oral electrolyte solution was used. When this new solution was given undiluted-that is, at an osmolarity of 20 times that of physiologic solution-only one of 29 patients, who were acutely ill and dehydrated, refused it or vomited it, probably due to irritation of the gastric mucosa. However, at a dilution of 1:3 with 5 per cent glucose and an osmolarity of six times physiological, only one of the 29 infants vomited and two others occasionally refused it. The length of hospital stay was not shortened by the substitution of the commercial preparation in either dilution. However, since the babies readily drank this electrolyte solution, it was possible to stop parenteral administration of electrolytes once fluid replacement had been carried out when the patient was first admitted.