Study Reveals IV Rehydration Safe for Severely Malnourished Children

A recent study has determined that intravenous (IV) rehydration can be safely administered to children suffering from severe acute malnutrition (SAM) and dehydration. This finding challenges decades-old treatment guidelines that discourage IV hydration due to concerns about potential heart failure. The study, conducted by researchers from Imperial College London, University College London, and Médecins Sans Frontières (Doctors Without Borders), involved nearly 300 children across Niger, Nigeria, Uganda, and Kenya. The results prompt calls for a critical reassessment of current global treatment protocols.

The traditional guidance, which emphasizes oral rehydration therapy (ORT), stems from a lack of robust scientific evidence and has been widely taught to healthcare professionals. According to Dr. Kathryn Maitland, a leading pediatrician and director at Imperial College London, “The current recommendations have always been controversial as they were based on the lowest form of evidence—expert opinion.”

The study involved 292 children aged 12 and under who were hospitalized with severe acute malnutrition and dehydration caused by diarrhea. Over a period of 96 hours, researchers observed no instances of heart failure or fluid overload, suggesting that IV rehydration does not pose the risks previously assumed. Furthermore, mortality rates were unexpectedly lower than anticipated when compared to standard control strategies, although researchers acknowledged that these rates may have been influenced by the close monitoring and care provided during the trial.

In a broader context, the Food and Agriculture Organization (FAO) reported that over 294 million people in 53 countries faced acute food insecurity in 2024, a crisis exacerbated by conflict, climate change, and economic instability. Amidst this backdrop, the need for effective treatment options for severely malnourished children has never been more urgent.

Responses to the study have varied among experts. Laura Ferguson, director of research at the University of Southern California’s Institute on Inequalities in Global Health, emphasized the need for a more substantial evidence base before changing global health guidelines. “It’s too early to suggest that global guidelines should be changed,” she stated, highlighting the necessity for sterile environments and resources that may not be available in all healthcare settings.

Dr. Maitland acknowledged the limitations of the trial but reaffirmed the importance of ensuring the safety of children undergoing treatment. “Every half an hour for the first two hours, and then every hour for up to eight hours, the nurse and doctor were at the bedside. That’s the standard of care that was required to ensure that we didn’t harm children.”

The implications of this study are significant. If global health guidelines adapt to include IV rehydration for severely malnourished children, it could potentially reduce mortality rates and improve treatment outcomes. As the scientific community continues to evaluate the findings, the hope is that this research will bridge the evidence gap and lead to improved care standards that align with those for non-malnourished children. The World Health Organization (WHO) has yet to comment on the study, but their input will be crucial in determining future guidelines for treating acute malnutrition.

In conclusion, as the crisis of malnutrition persists globally, the findings from this study underscore the urgent need to reassess established medical protocols and explore innovative solutions that prioritize the health and survival of the world’s most vulnerable children.