PIP: During the 1960s-1970s, treatment of dehydration caused by diarrhea shifted from intravenous (IV) fluid replacement to use of oral rehydration salts (ORS). During diarrhea, glucose through a sodium-coupled transport mechanism and water (ORS solution) improves the ability of the small intestine to absorb fluid. Initially, the international health community ignored the potential usefulness of food, especially carbohydrates and proteins, in preventing and treating dehydration. The leading obstacle to acceptance of allowing food intake during diarrhea was variations in composition of local food staples. Food was almost always excluded during conventional clinical management of diarrhea (i.e., IV therapy). Health workers were advised to withhold food, including breast milk, during the first rehydration phase (first 24 hours). Despite the advice to withhold feeding, mothers in many developing countries continued to feed and breast feed their children during diarrhea with no ill effects. The mothers tended to use cereal-based solutions or breast feed during diarrheal episodes. In the beginning, health personnel were most concerned about access to ORS rather than acceptance. They assumed that oral rehydration therapy (ORT) was relatively easy to use. Experience showed that neither ORS nor home-prepared sugar and salt solutions (SSS) were easy to prepare correctly. In fact, mothers/caretakers often prepared SSS with unsafe high concentrations of sodium. In 1987, WHO developed a guide to help Control of Diarrheal Diseases program managers select home-based fluids that were as ORS-like as possible. Diarrhea cases in hospitals tend to be more severe than those at home. Almost all hospital cases need treatment, while those at home tend to be less severe and only need simple measures to prevent dehydration. Yet, international health specialists designed home-treatment to be like hospital-treatment. This is a restrictive approach. More rational guidelines for ORS have since emerged due to ORS failures at home.