Sugary ORS-labelled drinks can worsen dehydration in children, Indian doctors warn

Post by : Saif Nasser

Physicians across India are raising the alarm that beverages promoted as ORS (Oral Rehydration Solution) but containing high sugar levels can be more harmful to children than the diarrhoeal illness they are meant to treat. These drinks, often packaged attractively and advertised as rehydration products, may actually increase fluid loss rather than restore balance.

The concern intensified after the Food Safety and Standards Authority of India (FSSAI) directed companies to stop using the term "ORS" in product names and advertising unless the formulation meets World Health Organization (WHO) standards. A company challenged the move in court, and the Delhi High Court temporarily stayed the regulator's order.

Clinicians say the mix-up endangers children

Several paediatricians have highlighted how misleading labels and marketing can put young patients at risk. Dr Sivaranjani Santosh of Hyderabad, who has campaigned against imitation ORS products for years, notes that many of these bottled drinks contain sugar concentrations far above safe levels for children.

WHO guidance recommends an ORS formula with roughly 13.5 grams of sugar per litre. In contrast, some commercial drinks marketed as ORS have been found to contain more than 110 grams per litre — a concentration that can aggravate dehydration and provoke metabolic disturbances.

Dr Santosh observed, "FSSAI's attempt to restrict misuse of the ORS label is a positive step for child safety. Products with excessive sugar are not therapeutic ORS — they are essentially sugar solutions that can do harm."

Clinical consequences of incorrect rehydration

Medical specialists report that children who consume these sugar-dense drinks may present with electrolyte imbalances and hyperglycaemia. Dr Dhanasekar Kesavelu of Apollo Hospitals said examining teams frequently note low serum sodium and elevated glucose in affected patients.

He added, "There have been instances where infants developed severe complications, including seizures and intracranial bleeding, after inappropriate rehydration."

Dr Srinivas Midivelly from Yashoda Hospital has likewise observed a rise in admissions linked to deceptive ORS substitutes. "A correctly prepared WHO-approved ORS can be lifesaving. Counterfeit or sugary imitations can produce the opposite effect," he said.

Composition of authentic ORS

True ORS delivers a precise balance of glucose and electrolytes (sodium, potassium, chloride) that facilitates intestinal absorption of fluids lost to diarrhoea or vomiting. Proper dilution and adherence to packet instructions are essential for effectiveness.

Clinicians caution that sports and energy drinks are not interchangeable with ORS; their sugar content is typically too high and electrolyte composition inadequate, which may worsen clinical status.

Dr Kesavelu advised, "Purchase WHO-approved ORS sachets from reputable pharmacies and dissolve them in the exact volume of clean water stated on the packet. Do not estimate doses."

Why imitation ORS poses particular risks to children

Dr Santosh recounted past cases where children deteriorated after consuming sugary "ORS" beverages. "While fatalities were not reported in those episodes, many children became significantly sicker. Commercial interests should not override child safety," she said.

Experts also note that marketing — bright packaging and images of healthy children — can mislead caregivers into believing these products are clinically validated rehydration therapies.

Practical advice for parents

Paediatricians offer clear guidance to reduce risk and protect children from dehydration:

Use only authentic ORS: Obtain WHO-approved ORS sachets from trusted pharmacies and follow mixing instructions precisely.

Avoid sugary substitutes: Refrain from buying beverages labelled as "energy," "electrolyte," or "ORS" unless a healthcare professional verifies their suitability.

Check labels carefully: Monitor sugar content; excessive sugar can worsen dehydration.

Offer safer fluids: When appropriate, give water, coconut water, or home-prepared solutions (salt-sugar-lemon mixtures) rather than packaged rehydration beverages of uncertain composition.

Include hydrating foods: Items such as cucumber, watermelon, and oranges help maintain fluid balance.

Seek medical help promptly: If a child has diarrhoea, vomiting, or signs of dehydration such as dry mouth, sunken eyes, reduced urine output or lethargy, consult a physician without delay.

Regulatory and public-health implications

The episode highlights broader concerns about misleading food labelling and commercial misuse of medical terminology in India. Physicians and child-health advocates are urging stricter regulation to prevent the inappropriate use of terms like "ORS" for products that do not meet established therapeutic criteria.

Parents and caregivers are advised to remain vigilant when selecting rehydration products. As Dr Santosh summarized, "A correctly formulated ORS can save lives; a misbranded, sugary drink can make a child much worse."

Summary:
Indian doctors caution that sugar-rich drinks marketed as ORS can worsen dehydration in children; they recommend WHO-approved sachets and stronger regulatory safeguards against misleading labelling.