• Hyderabad pediatrician Dr. Sivaranjani Santosh resigned from the Indian Academy of Pediatrics (IAP), alleging the body did not adequately address concerns about look-alike hydration products and industry influence.
• Dr. Santosh has spent nearly eight years warning parents about products that may be mistaken for Oral Rehydration Solution (ORS), a treatment used to prevent and manage dehydration caused by diarrhoea.
• The dispute has drawn attention to ORS labeling, consumer safety, and the risk of confusing electrolyte beverages with WHO-recommended ORS formulations.
Hyderabad-based pediatrician Dr. Sivaranjani Santosh has resigned from the Indian Academy of Pediatrics (IAP) and stepped away from Instagram after an eight-year campaign against hydration products that she says could be confused with Oral Rehydration Solution (ORS).
The pediatrician told The Indian Express that she felt “tired of fighting alone” after alleging that the organization failed to adequately address concerns about industry influence and the marketing of look-alike hydration drinks.
Her resignation comes amid an ongoing debate over the branding of Kenvue's rebranded hydration product EZRL, which Dr. Santosh argues may still be mistaken for medically approved ORS despite regulatory restrictions on the use of the term for products that do not meet World Health Organization-recommended formulations.
Dr. Sivaranjani Santosh has argued that some hydration beverages may be mistaken for Oral Rehydration Solution (ORS), potentially leading consumers to use them in situations where a WHO-recommended ORS formulation is needed for diarrhoea-related dehydration.
Her concerns intensified after the Food Safety and Standards Authority of India (FSSAI) restricted the use of the term "ORS" for products that do not meet approved ORS standards. Following the change, Kenvue rebranded its hydration drink as EZRL while continuing to market ORSL as its diarrhoea-management product.
According to Dr. Santosh, the revised branding retained several visual elements associated with the earlier product, including a similar four-letter name, color scheme, typography, and fruit imagery. She filed a trademark opposition in February, arguing that these similarities could still create confusion among consumers and parents.
In its response, Kenvue maintained that EZRL complies with FSSAI requirements and stated that the product name neither contains the term "ORS" nor violates regulatory directions governing hydration beverages.
Oral Rehydration Solution (ORS) is a medically formulated treatment used to replace fluids and essential salts lost during diarrhoea and vomiting. Its composition follows World Health Organization-recommended standards designed to support the absorption of water and electrolytes in the intestine.
According to the concerns highlighted by Dr. Santosh, even small changes in the balance of sodium, potassium, glucose, and other ingredients can affect how fluids are absorbed. In some cases, an altered formulation may worsen dehydration by drawing water into the digestive tract instead of helping the body retain it.
The Indian Academy of Pediatrics (IAP), in a position statement on ORS and electrolyte beverages, advised clinicians to use only appropriately formulated ORS products for diarrhoea management. The organization also noted that "look-alike, sound-alike" products may create confusion when similar packaging or branding appears alongside medically approved ORS formulations.
The controversy has drawn attention to the importance of distinguishing medically approved Oral Rehydration Solution (ORS) from hydration beverages marketed for general fluid replacement. For children with diarrhoea, using the correct ORS formulation is critical because it is specifically designed to replace fluids and electrolytes lost during illness.
The Indian Academy of Pediatrics (IAP) has advised clinicians to recommend only appropriately formulated ORS products for diarrhoea management. The organization also supported recent Food Safety and Standards Authority of India (FSSAI) measures restricting the use of the term "ORS" to products that meet approved standards.
The case has also highlighted the role of product naming, packaging, and labeling in helping parents make informed decisions during childhood illnesses, particularly when dehydration requires prompt and appropriate treatment.
(Rh/TP)