Nasogastric rehydration in children

Nasogastric administration of oral rehydration solution may be required if the child refuses to drink or has frequent vomiting. It is associated with a decreased risk of electrolyte derangement and more rapid recovery from gastroenteritis than intravenous rehydrationThe Royal Children's Hospital Melbourne (RCH), February 2021.

Nasogastric rehydration is generally well tolerated in preschool-aged children; it can be considered for older children but may not be well tolerated. For the management of gastroenteritis, nasogastric rehydration is usually given as a continuous dose, because this may be associated with less vomiting than intermittent doses.

Initially, oral rehydration solution should be used for nasogastric rehydration. Once the degree of dehydration has improved:

• infants should be given their usual feed type (expressed breast milk or formula) through the nasogastric tube or orally (if tolerated)
• older children should be switched from nasogastric to oral rehydrationThe Royal Children's Hospital Melbourne (RCH), February 2021.

For more detailed guidance on nasogastric rehydration in children, see the Royal Children’s Hospital Melbourne website.

If the patient worsens or does not have a marked response to nasogastric rehydration, give intravenous rehydration and seek advice from a senior clinician.