Year: 2026 | Month: July-September | Volume: 11 | Issue: 3 | Pages: 97-104
DOI: https://doi.org/10.52403/ijshr.20260312
Role of Low-Osmolar Oral Rehydration Solution in Managing Intractable Diarrhoea and Dehydration in Early Infancy: A Case Series
Aravind Swaminathan
Department of Paediatrics, St Peter’s Medical College Hospital and Research Institute
Corresponding Author: Dr. Aravind Swaminathan
ABSTRACT
Background: Pathologies causing excessive stool output and dehydration in young infants frequently prompt prolonged intravenous rehydration, which carries clinical risk. Although low-osmolar oral rehydration solution (ORS) is effective, it remains underutilized in neonates and early infancy due to safety concerns.
Methods: This case series evaluated three infants (aged 18 days to 4.5 months) with dehydration driven by distinct pathologies: an ex-preterm infant with bowel resection and a high-output stoma; a 6-week-old infant with severe cow’s milk protein allergy; and an 18-day-old infant with parenteral diarrhoea from a urinary tract infection and secondary lactose intolerance. Fluid deficits were managed using the World Health Organization low-osmolar ORS (245 mOsm/l) alongside amino-acid-based or lactose-free formulas.
Results: Enteral low-osmolar ORS successfully corrected dehydration and fluid loss in all cases. The stoma output in case 1 decreased with weight gain within 2 days. Dehydration in case 2 resolved within 2 days, allowing for ORS discontinuation by day 6. Stool patterns in case 3 normalized within three days. Regular serum sodium monitoring revealed no adverse effects or dyselectrolytemia, enabling successful nutritional rehabilitation and weight gain.
Conclusions: Low-osmolar ORS appears to be a safe, effective, and sustainable enteral alternative to prolonged intravenous hydration for managing fluid loss and correcting dehydration in neonates and young infants. However, large-scale studies are needed to validate this recommendation.
Keywords: Infantile diarrhoea, Low-osmolar ORS, High-output stoma, Malabsorption, Dehydration