Treatment of Moderate Dehydration

Clinical Assessment and Rehydration Protocol

The American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend administering oral rehydration solution (ORS) at 100 mL/kg over 2-4 hours as first-line therapy for moderate dehydration (6%-9% fluid deficit) 1, 2
Moderate dehydration presents with specific physical findings, including loss of skin turgor with tenting when pinched, dry mucous membranes, decreased capillary refill time, and rapid, deep breathing, which guide treatment intensity 3
The World Health Organization recommends administering reduced osmolarity ORS containing 50-90 mEq/L sodium at 100 mL/kg over 2-4 hours, representing strong evidence with moderate quality for all age groups 1, 2

The Centers for Disease Control and Prevention recommend continuously replacing ongoing losses with ORS, including 10 mL/kg for each watery or loose stool and 2 mL/kg for each episode of vomiting 2
The American Academy of Pediatrics recommends using ORS containing 40-90 mEq/L sodium for ongoing loss replacement 2

The Infectious Diseases Society of America recommends administering maintenance fluids and replacing ongoing losses with ORS until diarrhea and vomiting resolve, carrying strong evidence despite low quality 1, 4
The American Academy of Pediatrics recommends resuming age-appropriate diet immediately after or during rehydration completion, as continuing nutrition during illness improves outcomes 1, 4
The Centers for Disease Control and Prevention recommend avoiding antimotility drugs (loperamide) in children <18 years with acute diarrhea, as this carries strong evidence with moderate quality 1, 4