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WHAT  IS  DEHYDRATION?

 

Normally, the fluid taken in from food and drink is balanced by the fluid lost as urine, stools and perspiration. If your child loses more than he takes in, he will become dehydrated.

 

• A large proportion of body weight is water ­approximately 80 per cent of a newborn baby's body weight and 60 per cent of a child's body weight. 
• Dehydration involves a gradual loss of fluid from the body. In the early stages, the body is able to compensate for this loss and maintain normal functions. 
• If the process of dehydration is allowed to continue, the kidneys will stop working, shock will follow and eventual collapse. 
• Babies are at a greater risk of rapid dehydration than older children. 

Dehydration can be extremely serious in young children, so you should make sure your child has sufficient fluid intake, especially if he is unwell.

 

Causes

 

There are many possible causes of dehydration. The most common are:

 

Diarrhoea: with or without vomiting (gastroenteritis).

 

Vomiting: loss of fluids through vomiting can cause dehydration.

 

Heat exposure: a baby or child can become dehydrated outside on a hot day, even if he is kept in the shade; similarly, a very warm indoor environment can cause dehydration.

 

Strenuous activity or exercise: children will often be so absorbed in a game or activity, that they will either not notice that they are thirsty or they will choose to ignore it.

 

Fever: a child with a fever can easily become dehydrated through sweating.

 

Certain medical conditions: for example, kidney disorders and diabetes; some drugs, such as diuretics, can cause dehydration

 

Symptoms

 

Dehydration is classified into stages according to the amount of body weight lost as water at each stage.

 

Mild dehydration

• Slightly dry mouth and lips.
• Urine is concentrated - a little darker than usual and reduced in volume; a baby's nappy will be less wet than usual.
• Your child is thirsty. 

Moderate dehydration

The signs for mild dehydration, plus the following:

• Darker, more concentrated urine.
• A baby not producing a wet nappy for several hours.
• Dry, inelastic skin.
• Sunken eyes and no tears when crying.
• Sunken fontanelle - the 'soft spot' on top of your baby's head, which is usually flat.
• Your child is lethargic (drowsy) or irritable.
• Increased thirst. 

Severe dehydration

The signs for mild and moderate dehydration, plus the following:

 

• Very pale or mottled skin, cool to the touch.
• Your child is increasingly lethargic or irritable.
• Eventual collapse 

Be alert for signs of dehydration, such as the frequency of your baby's wet nappy and the colour of his urine.

 

What to do if your baby is dehydrated

 

Young babies can become dehydrated with in the space of a few hours. A baby with any signs Of dehydration, even if mild, must be taken to a GP immediately .lf there is to be delay in seeing a doctor, the baby should be take to a hospital emergency department instead. 

 

Offer a feed immediately. A breast-fed baby should be offered a breast-feed. Your doctor may recommend you continue to offer breast-feeds, but more frequently than usual, even if your baby is vomiting or has diarrhea. 

A bottle-fed baby should be offered his usual formula but, if he also has diarrhoea and/or is vomiting in smaller amounts and more frequently than usual. Alternatively, you can give oral rehydration solution (ORS) - seek advice from your health visitor or doctor about preparing these solutions correctly for your baby. 

If your baby refuses to take a bottle, try feeding with a spoon or from a small cup. 

NOTE: never give anti-diarrhoea medicine to a baby unless .instructed by your doctor.

 

What to do if your child is dehydrated

 

Mild dehydration can usually be treated at home, but if you are unsure, always call your doctor.

 

• A child should drink approximately 1.5 liters of fluid a day at least, but when dehydrated, additional fluids are needed to replace those lost. 
• The exact amount of fluid needed depends on your child's weight, but as an approximate guide, aim to give at least 60-90mls of fluid every hour. 
• The way the fluids are given depends on the cause of the dehydration, but you should aim for your child to have no remaining signs of dehydration after four hours. His urine should be straw colored and he should no longer feel thirsty. If after four hours your child's dehydration is getting worse; call a doctor. 

When to talk to the doctor

 

• A baby with any signs of dehydration must be taken to the doctor immediately. A child should be taken to a doctor if he shows signs of moderate or severe dehydration.
• A baby or child with moderate or severe dehydration will need to be admitted to hospital for treatment and is likely to need intravenous replacement of fluids to replace fluids lost. 
• A baby or child must also be seen by a doctor under the following circumstances: if he has severe watery diarrhoea for more than six hours; if he has severe vomiting for six hours or more; the is showing other signs and symptoms in addition to mild dehydration, such as blood in the stools, or fever. 

How to prevent dehydration

 

Diarrhea and vomiting:

• If bottle-fed, offer small, frequent amounts of your baby's formula milk.
• If breast-fed, continue to breast-feed as usual, offering more frequently.
• If not vomiting, a baby who has been weaned should also continue to be given his usual diet.
• If your older child is vomiting, offer small amounts of oral rehydration solutions frequently. 

Hot weather:

• Give your baby or child extra fluids.
• Bottle-fed babies can be given cool boiled water in hot weather; breast-fed babies can be offered more frequent feeds.
• If traveling, take plenty of drinks with you.
• Never leave a baby or young child unattended in a car on a hot day. 

Exercise:

• Encourage your child to take a break for a drink during strenuous exercise or very active play. 

Fever:

 

More fluid than usual is needed to replace that lost through sweating.

 

Offer small amounts of your child's usual drinks frequently, or give oral rehydration solutions; breast-feed your baby or offer him his formula milk more often than usual.

 

When your child is involved in active play, give him plenty of drinks, or fresh, juicy fruit, which provides fluids.

 

For  More  Information:  Please  consult  your  physician  on  your  next  visit.