International guidelines have long discouraged intravenous rehydration in children with severe acute malnutrition because of concerns about fluid overload, but there was a lack of evidence to support this concern[1]. The GASTROSAM study compared three rehydration strategies in 272 children with severe acute malnutrition and gastroenteritis: standard oral rehydration (138 children), rapid intravenous strategy (67 children), and slow intravenous strategy (67 children)[1]. After 28 days, 12% of children in the oral group and 10% of children in the intravenous group died, with no significant difference in mortality[1]. Serious adverse events occurred in 23% of children in the oral group, 21% in the rapid intravenous group, and 15% in the slow intravenous group[1]. The study reported no signs of pulmonary edema, heart failure, or fluid overload in either group[1]. The results show that intravenous rehydration is safe and not less effective than oral rehydration, which could lead to a reconsideration of global recommendations[4].