Complete resumption of normal feeding after 4 hrs of rehydration with glucose ORS led to higher weight gain without adverse effects

A multicenter study on behalf of the European society of paediatric gastroenterology and nutrition working group on acute diarrhoea. Early feeding in childhood gastroenteritis
Sandhu BK et al
Journal of Paediatric Gastroentrology & Nutrition 1997; 24:522-7

Three-part Clinical Question
In children with gastro-enteritis is gradual introduction of feeding better than immediate normal feeding with regards to symptom control and time to resolution?

Search Terms
Medline 1966-09/01 using ovid interface( exp gastro-enteritis) AND ( exp bottle feeding OR breast feeding OR exp feeding methods OR "feeding".mp) LIMIT to human AND (newborn infant OR infant OR preschool child OR child).

The Study
Non-blinded randomised controlled trial with intention-to-treat.

The Study Patients
230 weaned European children under the age of three admitted to hospital with acute diarrhoea

Control group
(N = 96; 88 analysed): rehydration with ORS over 24 hrs then normal diet, breast fed children were fed throughout

Experimental group
(N = 134; 134 analysed): rehydration with ORS over 4 hrs then immediate normal diet

The Evidence

Non-Event Outcomes

Time to outcome/s

Control group

Experimental group


Weight gain 

After rehydration

2 gram 
<100g No difference

95 gram


No severely dehydrated children

Appraised by
Nico Grunenberg, Ravenswood surgery , New Road , Forfar, DD8 2AE; 20 November 2002