Children who participate in the School Breakfast Program show significant improvement in academic performance and tardiness rates, and a trend toward improvement in absenteeism. The School Breakfast Program was created by Congress in 1966 to provide a breakfast on school days for low income children who would otherwise have none. Children (N=1,023) in grades 3, 4, 5, and 6 in six elementary schools in Lawrence, Massachusetts, were chosen for a one-year study on the effects of Breakfast Program participation. Rates of change were calculated for test scores on the Comprehensive Test of Basic Skills (CBTS)-, absence, and tardiness for Program participant and non-participant groups before and after implementation. Participant and non-participant groups were compared with regard to demographic variables from school records, and on their CBTS score, tardiness, and absence rates of change. Results were the following: (1) participants and non-participants did not differ with respect to sex, ethnicity, or number of children per family; (2) participants improved their CBTS score; (3) absenteeism of both participants and non-participants increased, but there was less increase for participants; and (4) tardiness decreased for participants and increased for non-participants. Limitations of the study include the following: (1) access to data was limited to those available from school records; and (2) not knowing which of the study subjects habitually did not eat breakfast prior to the implementation of the Program. Sixteen pages duplicating accompanying explanatory slides are included. (FMW)

ABSTRACT. Objectives. Parents may be deterred from obtaining commercial oral rehydration solutions (ORS) for their young children with acute diarrheal disease because of its availability and/or cost, especially if they are poor. We conducted a randomized clinical trial to determine 1) whether low-income parents could safely mix and administer cereal-based ORS (CBORS) both from ingredients commonly found in the home and from a premixed packet; 2) whether these CBORS were as effective in maintaining hydration as commercial glucose-based ORS; and 3) whether CBORS were more effective in reducing severity and duration of illness.Methods. Children 4 to 36 months of age discharged from emergency departments and health centers with acute diarrheal disease were randomized to receive either homemade CBORS, reconstituted packet CBORS, or Pedialyte. A study nurse saw the child at home each day until the illness resolved, and obtained capillary blood for serum sodium at enrollment and at 24 to 48 hours; a sample of CBORS for sodium concentration; stool for pathogen analysis; and daily fluid intake, stool frequency, and weight.Results. A total of 232 children were enrolled, of whom 203 (88%) completed the study. Two parents (3%) in the homemade CBORS group and one parent (1%) in the packet CBORS group made mixing errors resulting in a high sodium concentration (>100 mEq/L); their children refused the solution and had normal serum sodium values. Mean CBORS sodium concentration for the remainder of the homemade CBORS group was 60 ؎ 10 mEq/L, and for the packet CBORS group, 54 ؎ 13. Eighteen children (11%) had abnormal serum sodium values at presentation, which returned to normal in all groups in most cases. Three children (4.5%) in the homemade CBORS group, 4 (6%) in the packet CBORS group, and 1 child (1.4%) in the Pedialyte group failed therapy.Children refused to take homemade CBORS and packet CBORS (43% and 32%, respectively) more often than Pedialyte (9%), and those in the CBORS groups tended to take less ORS and total fluids. There were no significant differences among the three groups in incidence of daily vomiting or stooling, duration of diarrhea, or weight gain.Conclusions. CBORS do not offer a clinically significant advantage over glucose-based ORS. Homemade CBORS represent a treatment option in carefully selected cases, but it is not the safest alternative for regular clinical use. Pediatrics 1997;100(5). URL: http://www. pediatrics.org/cgi/content/full/100/5/e3; diarrhea, dehydration, oral rehydration, cereal.

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