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Abstract The investigators conducted a randomized, double-blind study to evaluate the safety and efficacy of rice-based solutions in the management of mild to moderate dehydration in infants with acute diarrhea. They studied 86 infant boys, 3-18 months of age, in Costa Rica. They did not study girls because separate collection of urine and stool from infant girls is difficult unless catheters are used. The infants were randomly assigned to one of three treatment groups: group A received a rice based electrolyte solution containing 30 grams of rice-syrup solids and 50 mmol of sodium per liter (Ricelyte), group B received the same solution with the addition of 5 grams of casein hydrolysate per liter, and group C received a commercial oral rehydration solution containing 75 mmol of sodium and 25 grams of glucose per liter (Rehydralyte). The randomly assigned solutions were administered in volumes twice as great as the estimated fluid deficit over 4-6 hours. If the infant refused to drink or vomited frequently, the solution was administered by nasogastric tube at 15 ml per kilogram of body weight per hour. The investigators found that the solutions containing rice-syrup solids were superior to a glucose based solution in decreasing stool output and that there was no advantage in adding casein hydrolysate to one of the rice solutions. However, because of the potential hyponatremia, the authors did not recommend the rehydration solution containing 50 mmol of sodium for children with cholera. Only one child in the entire group (with a high stool output and persistent hyponatremia) required intravenous therapy. Comment: From an historical point of view, it is important to give credit to the millions of Asian mothers who knew, centuries ago, that rice water mixed with a little salt was useful treatment for diarrhea. [ABSTRACT FROM AUTHOR]