Apple Electrolyte

Why would an oral electrolyte solution be used as a treatment for: Food Poisoning, Rotavirus, Flu, Viral Gastroenteritis, or the Norovirus, including the Norwalk Virus?

Food Poisoning

Food poisoning occurs in situations where food may be left unrefrigerated too long causing bacterial growth or food preparation techniques are not clean. Food poisoning can also occur from consuming undercooked meats or from the improper canning of foods. A number of different organisms can cause food poisoning. These include E. coli, Staphylococcus aureus, Salmonella, and the botulism organism. Symptoms from the most common types of food poisoning usually start within 2 to 6 hours of eating the responsible food item. However, the time may be longer depending on the toxin or organism causing the poisoning. Symptoms of food poisoning can include:

• Nausea and vomiting
• Abdominal cramps
• Diarrhea
• Fever
• Chills
• Weakness
• Headache

Always check with your healthcare professional when these symptoms occur. Also, always check with your healthcare professional before using any medications. A major goal in the treatment of food poisoning is to avoid dehydration. Hold off on solid foods until the diarrhea has passed and drink lots of fluids. In infants and children, an oral electrolyte solution, such as PediaVance® Oral Electrolyte Solution, will usually be recommended to assure that the appropriate mix and balance of water, carbohydrates and minerals are taken in to the body to prevent or treat dehydration. Milk and dairy products, sodas, juices and other household beverages may worsen diarrhea.

Rotavirus

Symptoms of a rotavirus infection can include:

• Watery diarrhea
• Nausea and vomiting
• Fever
• Abdominal cramps
• Runny nose
• Cough

Rotavirus is one of the most common causes of diarrhea in infants and young children. Sometimes the diarrhea is so severe, it can quickly lead to dehydration. So always call your healthcare professional when signs of rotavirus appear. Also, your healthcare professional may recommend a rotavirus vaccine as a part of the routine immunizations given to all infants to help prevent a rotavirus infection.

For mild to moderate diarrhea with no signs of dehydration, normal food consumption should continue but more liquids should be provided. An oral electrolyte solution, such as PediaVance®, should be given in small, frequent amounts to prevent or correct dehydration. Fruit juices and sodas should always be avoided because they can make the diarrhea worse.

Always check with your healthcare professional before using any medications. Acetaminophen may be recommended to relieve any fever. Infants and children with symptoms should not take aspirin because aspirin may lead to Reye syndrome, a rare but potentially fatal liver disease.

Flu

The common symptoms of the flu may include:

• Fever
• Headache
• Muscle aches
• Chills
• Extreme tiredness
• Cough
• Runny nose
• Nausea and vomiting
• Diarrhea

Flu symptoms can be mild or severe. If they are mild, they can become severe without much notice, especially in young children. Vomiting, diarrhea and fever can dry up the body’s normal level of fluids which leads to dehydration. In infants and children, an oral electrolyte solution, such as PediaVance® Electrolyte, is usually preferred to prevent or treat dehydration. Common household beverages, such as juices and sodas or plain water, are often not recommended because they do not contain the appropriate balance of water and minerals (sodium, potassium and chloride) to maintain hydration. Treatment of the flu should also include getting plenty of rest and drinking lots of fluids to maintain hydration.

Always check with your healthcare professional before using any medications. Acetaminophen may be recommended to relieve the fever and muscle aches associated with the flu. Infants and children with flu symptoms should not take aspirin because aspirin ingestion could lead to Reye syndrome, a rare but potentially fatal liver disease.

Viral Gastroenteritis (Stomach and Intestinal Flu)

The common symptoms of viral gastroenteritis (stomach flu or intestinal flu) are similar to the flu and may include one or more of the following:

• Nausea
• Vomiting
• Stomach cramps
• Diarrhea
• Mild fever
• Extreme tiredness
• Chills
• Loss of appetite
• Muscle aches

The illness may develop over a period of hours or it may suddenly start with stomach cramps, vomiting, or diarrhea. When symptoms first appear, it is important to rest the stomach and intestines to treat this illness. Dehydration can become a serious complication of stomach flu or intestinal flu. It can occur when the body loses too much fluid because of vomiting and diarrhea.

When the first signs of gastric or intestinal flu appear, solid foods and milk or milk products should not be consumed. Clear liquids are recommended. For infants and children, an oral electrolyte solution, such as PediaVance® Electrolyte, is usually preferred over household beverages to prevent dehydration and maintain the body’s water and minerals (sodium, potassium and chloride) at appropriate levels. An oral electrolyte solution is also preferred over acidic liquids such as fruit juices and carbonated beverages which can further upset the stomach. Small, frequent sips of the oral electrolyte solution are important especially if there has been frequent vomiting. Once liquids are well tolerated, soft bland foods that are easy to digest can be given.

In severe situations, dehydration can quickly become life threatening and hospitalization may be required whereby intravenous fluids are needed to maintain hydration.

Always check with your healthcare professional before using any medications. Acetaminophen may be recommended to relieve the fever and muscle aches associated with stomach or intestinal flu. Infants and children with stomach or intestinal flu symptoms should not take aspirin because ingested aspirin could lead to Reye syndrome, a rare but potentially fatal liver disease.

If symptoms persist for more than a few days or if there is bloody vomit or bloody diarrhea or severe stomach pain, contact your healthcare provider immediately to be sure that more serious problems are not occurring and to check for dehydration.

Norovirus (Norwalk Virus)

Norwalk virus and Norwalk-like viruses (NLV) cause gastrointestinal illness. These viruses usually occur in outbreaks and are one of the leading causes of food borne diseases in the United States, usually associated with eating raw oysters or clams or swallowing stool-contaminated food or water. An infection from one of these viruses is more prevalent in adults and older children but could occur in young children. The symptoms of an infection from the Norwalk virus or from Norwalk-like viruses usually last for 2 to 3 days and may include:

• Nausea
• Vomiting
• Diarrhea
• Stomach cramps

There are presently no specific treatments to prevent an infection caused by the Norwalk virus or Norwalk-like viruses. Cleanliness and good hand washing are always recommended as preventative measures.

A complication resulting from the illness is dehydration because of fluid losses from vomiting and/or diarrhea. An oral electrolyte solution, such as PediaVance® Electrolyte Solution, may be recommended to prevent or treat dehydration associated with the symptoms of the viral infection and to help maintain the body’s water and mineral (sodium, potassium, chloride) balance. PediaVance® Electrolyte can also be used to treat children and adults. Always check with your healthcare professional before using any medications.

What are the symptoms of mild dehydration?

The symptoms of mild dehydration include: dry mouth; thirst, drinks eagerly; few or no tears when crying; fussy behavior; or fewer than four wet diapers per day or no wet diaper over 4-6 hours for infants; no urination for 6-8 hours for children; the soft spot on infant's head appears flatter than usual or somewhat sunken.

Can I dilute PediaVance®?

Do not dilute PediaVance® Electrolyte or mix it with other fluids. Children who have abnormal fluid and electrolyte losses from diarrhea and/or vomiting need to ingest a balanced oral electrolyte solution which contains the appropriate amounts of electrolytes and carbohydrates to prevent dehydration. If water or other fluids are added to PediaVance® Electrolyte, the balance of electrolytes and carbohydrates per volume is altered. This can make the solution less effective. PediaVance® Electrolyte has been formulated to contain the appropriate balance of electrolytes and carbohydrates and it should not be mixed with any additional water or other liquids unless directed by the baby’s healthcare professional.

Why is the balance of water, electrolytes, and carbohydrate important?

Sodium, potassium, and chloride are electrolytes. Sodium in combination with carbohydrate (sugar) aids the absorption of water from the intestinal tract into the body and helps to retain fluids in the body to prevent dehydration. Potassium works with sodium to help regulate fluid balance in the body. Chloride helps to maintain the acid-base balance of the body fluids and prevent acidosis. It is important that oral electrolyte solution is properly balanced with the various electrolytes to replace fluid losses and keep the body hydrated.

The carbohydrate in the solution must also be in the proper amount. The carbohydrate and sodium work together to move water out of the intestinal tract and into the body, thus promoting hydration. Too much carbohydrate can cause diarrhea to worsen by moving water from the body into the intestinal tract.

This movement of water, electrolytes and sugar across the intestinal tract and into the body is known as osmosis. Solutions with an osmolality lower than serum make effective oral rehydration solutions. Serum has an osmolality of 310 mOsm/l. PediaVance® Electrolyte has an osmolality of 270. This is the reason why liquids such as apple juice, carbonated sodas, or sports drinks are not recommended as rehydration solutions for infants and children with diarrhea. Their osmolality is way too high and may worsen the diarrhea.

How much PediaVance® Electrolyte should I give to my child?

PediaVance® Electrolyte should be offered at the first signs of diarrhea to maintain electrolyte balance and normal hydration. It should be continued until after the last soft stool. A child should consume enough electrolyte solution to cover normal fluid intake plus replenish fluids lost during diarrhea and/or vomiting. Thus, the actual daily amount to be given will vary from child to child depending on the child’s age, weight, number of stools, and severity of the illness. Always consult with your child’s healthcare professional to determine the amount and frequency of PediaVance® Electrolyte to be given. PediaVance® can be given every 1-4 hours. A child can consume up to 64 fluid ounces per day to replenish fluids while diarrhea continues.

Should I breastfeed or use PediaVance® instead?

Breast milk is always best for a baby with any intestinal upset. Breastfeeding actually helps a baby's intestines to recuperate from viral illnesses causing diarrhea. There are very few medical reasons to stop breastfeeding.

If your baby doesn't want to nurse as frequently during an illness and is beginning to show signs of dehydration, immediately consult with your healthcare professional before using PediaVance® Electrolyte or any other liquid.

Are there organic ingredients in PediaVance®?

PediaVance® Electrolyte is currently the only oral electrolyte solution made with organic and natural ingredients; nothing is artificial. There are no genetically modified ingredients. PediaVance® Electrolyte is made with natural flavors and is free of preservatives and alcohol.

Does PediaVance® Electrolyte contain fluoridated water?

No, the purified water used in PediaVance® has not been fluoridated.

Does PediaVance® contain apple ingredients?

No, the apple flavoring in PediaVance® Electrolyte is derived from Nature’s One’s unique recipe combining organic white grape juice and a special mix of natural flavors. This proprietary combination of natural ingredients gives PediaVance® Electrolyte its pleasant apple flavor.

How long can I store an opened bottle of PediaVance®?

After opening PediaVance®, replace the cap, refrigerate and use within 72 hours. Discarding unused electrolyte solution beyond 72 hours is important due to bacterial contamination that occurs once the product is exposed to air. Since diarrhea is often caused by bacterial or viral exposure, this extra precaution may be important to a quick recovery. Please be sure the bottle is tightly resealed before storing in the refrigerator.

What are the best temperatures for consumption and storage?

Do not heat PediaVance® Electrolyte. Heating the electrolyte solution could result in the evaporation of needed water, thereby increasing the concentration of minerals and other ingredients, which could be dangerous. PediaVance® Electrolyte tastes best when chilled. You can also freeze into popsicles, ice cubes or blend into a slushy.

To ensure the highest quality over an extended period of time, PediaVance® should be stored in a cool place. Avoid extreme heat.

What type of plastic is used in PediaVance® Electrolyte?

The raw material used in PediaVance® bottles consists of only Polyethylene Terephathalate (PET) and does not contain Bisphenol-A (BPA), Phthalates nor Polyvinyl Chloride (PVC). Below is a brief explanation for each of these materials.

PET bottles are most commonly used for beverages or liquid products, such as PediaVance® Electrolyte. This bottle type is recognized as a safe material to drink from and contains no dioxins. You can identify these bottles by the small number “1” or “PETE” found on the bottom of the containers. BPA is used in the epoxy resin that coats the inside of some metal cans. BPA is not used in plastic materials like PET, nor is it used to make any of the component materials used to make PET.

PVC is a completely different plastic than PET and not a component of PET. PVC is used to soften plastics and is commonly referred to as vinyl. PVC is also used for products such as food wrap, vegetable oil bottles and blister packaging.

Phthalates are not used in PET materials. Though part of the PET chemical name contains “phthalate,” it is not the one that is of concern. The type of “phthalate” that has raised concern is used to make various plastics more flexible, and in that role is called a “plasticizer.” PET does not contain plasticizers or the type of “phthalate” that is used in plasticizers.

For more information on the safety of PET bottles, please visit: http://www.napcor.com/faqs.htm

Can the Electrolyte Solution withstand weather conditions during delivery?

Please be assured that PediaVance® Electrolyte can easily withstand the exposure to hot or cold weather conditions during the delivery period.

While the leading and store brands use artificial sweeteners, colors and flavors, PediaVance® only uses organic and natural ingredients when available. PediaVance® is manufactured in the U.S.A.

Ingredients: Filtered Water, Organic Dextrose, Organic White Grape Juice Concentrate, Natural Flavors, Malic Acid, Potassium Citrate, Sodium Chloride, Sodium Citrate, Ascorbic Acid (Vitamin C), Colored with Elderberry.

PediaVance® is made without GMO ingredients. This product does not contain corn, preservatives or alcohol.

Oral electrolyte solutions are specifically designed to help the body maintain its water and mineral composition in the correct proportions. An oral electrolyte solution consists of specific amounts of water, certain types of carbohydrates, and the electrolytes (minerals) sodium, potassium and chloride needed to maintain hydration status or to treat dehydration.

The links below provide information about how the ingredients used in PediaVance® Electrolyte support your baby's health:

Carbohydrates:

Carbohydrates are commonly referred to as sugars or starches; however, they are classified scientifically as monosaccharides, disaccharides, or polysaccharides. The carbohydrates used in PediaVance® Electrolyte are monosaccharides, which is a one molecule sugar. Examples are glucose (also sometimes called dextrose), fructose (sometimes called fruit sugar), and galactose. Glucose is the major fuel needed by the body for energy. It does not need to be broken down like more complex sugars. This is why intravenous fluids (IVs) used in medical situations contain glucose (dextrose). Dextrose can be injected directly into the bloodstream without the need for further digestion by the body and is a ready source of energy for the body’s cells.

Glucose is also used in oral electrolyte maintenance solutions, such as PediaVance® Electrolyte. A combination of sodium with glucose in the small intestine of the body promotes the absorption of water into the bloodstream, thus helping to keep the body hydrated. This physiological system in the body is referred to as the glucose-sodium cotransport system. So in diarrhea management, glucose is very important!

The balance of carbohydrates in a solution is also important in preventing or treating dehydration. Too much carbohydrate can cause the diarrhea to worsen by moving water from the body into the intestinal tract. PediaVance® Electrolyte is specifically designed to meet all of the requirements needed to maintain hydration in infants and children. An appropriate combination in the proper amounts of organic dextrose, derived from organic tapioca, and organic white grape juice is used to meet carbohydrate requirements. The organic dextrose is used by the body as a ready source of glucose for the glucose-sodium cotransport system. Fructose has not been added to the formulation of PediaVance®. Instead, the organic white grape juice contains naturally occurring amounts of fructose and glucose.

Organic Dextrose:

PediaVance® organic dextrose is used by the body as a ready source of glucose that is derived from organic tapioca. Organic dextrose is a simple sugar that is quickly digested and absorbed into the bloodstream to provide a quick supply of energy. PediaVance® Electrolyte uses organic dextrose in combination with sodium to promote water absorption into the bloodstream to help keep the body hydrated.

Organic White Grape Juice:

The organic white grape juice provides a secondary source of carbohydrates and these are readily broken down by the body into glucose. White grape juice has been recommended as the first fruit juice to introduce to an infant or toddler.¹ Research reveals that white grape juice is an appropriate juice for infants and toddlers because it does not contain sorbitol and it has an appropriate balance of fructose and glucose, making it easier to digest than apple and pear juice.² Furthermore, white grape juice has been found to be well tolerated in children recovering from diarrhea because it holds the right combination of carbohydrates without the presence of sorbitol.³ Organic white grape juice also provides some natural flavoring to the solution.

1. Nobigrot, T. et al, “Carbohydrate absorption from one serving of fruit juice in young children: age and carbohydrate effects,” Journal of the American College of Nutrition (2) 16: 152-148, April, 1997.
2. Moukarzel, A. A. et al, “Irritable bowel syndrome and nonspecific diarrhea in infancy and childhood relationship with juice malabsorption,” Clinical Pediatrics, (2) 41: 145-150, April, 2002.
3. Ribeiro, R. et al, “Incomplete carbohydrate absorption from fruit juice consumption after acute diarrhea,” Journal of Pediatrics (2) 139: 325-327, August, 2001.

Electrolytes:

Sodium, potassium and chloride are called electrolytes. Electrolytes are mineral substances that become chemical ions in a solution and acquire the capacity to conduct electricity. The balance of the electrolytes in our bodies is essential for the normal functioning of body cells and organs. Electrolytes are needed to prevent dehydration that may be caused by diarrhea or vomiting from illnesses such as the flu, rotavirus, Norwalk virus or food poisoning. Giving pure water is not the best way to restore body fluid levels because it dilutes the minerals inside the body’s cells and interferes with their chemical and electrical functions.

The sources of electrolytes in PediaVance® Oral Electrolyte Solution are sodium chloride (to meet sodium and chloride needs), potassium citrate (to meet potassium needs), and sodium citrate (to also help meet sodium needs). Sodium chloride is salt. Sodium citrate and potassium citrate are rapidly absorbed when given orally and help to make the urine less acidic preventing metabolic acidosis. The use of potassium citrate as a good source of potassium in oral rehydration solutions has been well documented.¹

1. Islam, M.R., “Can potassium citrate replace sodium bicarbonate and potassium chloride of oral rehydration solutions,” Archives of Diseases in Childhood, 60: 852-855, 1985.

Potassium: This is an electrolyte and works with sodium to regulate the body’s waste balance, transmit nerve impulses, and regulate muscle contraction including the heart muscles. It is essential for metabolism and the release of insulin.

PediaVance® Electrolyte: 4.7 mEq Potassium per 8 fluid ounces
Sodium: The primary role of sodium in the body is to maintain fluid balance. Sodium works with potassium and chloride to conduct electrical currents in the body and keep tissue fluids in balance. Sodium in combination with glucose aids the absorption of water from the intestinal tract into the bloodstream and from the bloodstream into body cells. This helps to retain fluids in the body and prevent dehydration.

PediaVance® Electrolyte: 10.6 mEq Sodium per 8 fluid ounces

Chloride: This electrolyte helps to maintain fluid balance in the body and also is a component of the stomach juices (hydrochloric acid) needed for digestion of foods.

PediaVance® Electrolyte: 8.3 mEq Chloride per 8 fluid ounces

Osmolality:

The movement of water and electrolytes and glucose across the intestinal tract and into the bloodstream is known as osmosis. Solutions with an osmolality lower than blood serum make effective oral electrolyte solutions. Blood serum has an osmolality of 310 mOsm/liter. PediaVance® Oral Electrolyte Solution has an osmolality of 270 and is most appropriate for rehydration. Liquids such as apple juice, pear juice, carbonated sodas, and sports drinks are not recommended as rehydration solutions for infants and children because their osmolality is too high and this may worsen the diarrhea. Also, these drinks do not contain the appropriate balance of electrolytes and carbohydrates needed by infants and children to prevent or treat dehydration.

PediaVance® Electrolyte: 270 mOsm/kg H2O per 8 fluid ounces

Vitamin C:

Vitamin C is also known as ascorbic acid. PediaVance® Electrolyte contains a small amount of ascorbic acid to help the body heal. The ascorbic acid also contributes to the pleasant tart taste of the solution.

Vitamin C has received a lot of attention because of its major role in the body as an antioxidant, a substance that prevents damage to cells from free radicals and pollutants, and as a protector against infections, particularly the common cold. Vitamin C plays a role in nerve transmission, tissue repair, the conversion of cholesterol to bile acids, and the enhancement of iron absorption. Vitamin C is used by the body to make collagen, the connective tissue in skin, ligaments and bones.

Malic Acid:

Malic acid is sometimes referred to as a fruit acid or apple acid because it is naturally found in apples and other fruits. The malic acid in PediaVance® is added to adjust the pH (a measure of acidity or alkalinity) required to delicately process the ingredients.

Natural Caramel Color:

PediaVance® apple flavored Electrolyte Solution is colored with natural Caramel or Caramel color. The natural Caramel coloring is processed by heating brown sugar. Nature's One® formulation includes diluting the concentrated Caramel to create the apple-like color. There is no dairy in the caramel coloring. PediaVance® Electrolyte is the only electrolyte solution that does not contain artificial colors.