The most common emergencies children with CSID face are:

1. Dehydration Although all phenotypes are suceptable to dehydration, the children in phenotypes B and C, depending on the amount of sucrose ingested, have lost 5% to 20% of their total body weight in less than 4 hours from vomiting and diarrhea.  This has required emergency room intravenous re-hydration followed by extra liquids orally for two to three days.  Physicians and dieticians have also used regular sugar-free popsicles sweetened with aspartame or 100% grape juice; pediatric electrolyte oral solutions and popsicles made with dextrose and fructose when children refused the extra fluids, or were too weak to drink from a cup.  Popsicle ingredients need to be carefully checked for sweeteners and correct labeling.  In hospitals especially, the regular and sugar-free popsicles are both stored in the same freezer, are poorly marked, and easily come out of their original bags. 

2. Viral Infection Children with CSID are prone to frequent viral and upper respiratory infections with a faster onset and more severe symptoms than normal children.

3.  Vaccinations Many oral vaccinations are prepared with sucrose in the syrup base.  Alternative dosing for the oral measles vaccination for example should be considered by the attending physician.

4.  Childhood Illnesses Simple childhood illnesses are usually treated with over the counter or prescriptions drugs.  Children's oral and chewable medications usually contain sucrose which can cause severe dehydration, vomiting, and diarrhea.  If no alternative dosing can be found in oral or chewable antibiotics the primary care physician may choose to use an intravenous administration of antibiotics and other medications.  We have compiled a list of over the counter sucrose-free drugs and some prescription drugs which the manufacturer or pharmacist has indicated as of the posted date were sucrose-free.  Before administering any of these medications your physician or pharmacist will want to double check their ingredients for sucrose, lactose, and starch. In some cases the drug manufacturer may need to be contacted directly for an ingredient list of a particular medication.

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