Dehydration

From: kidshealth.org

Under normal conditions, we all lose some body water every day in our sweat, tears, urine, and stools. Water also evaporates from our skin and leaves the body as vapor when we breathe. We usually replace this body fluid and the salts it contains with the water and salts in our regular diet.

Sometimes, however, children lose abnormally large amounts of water and salts through fever (more water evaporates from the body when body temperature is increased), diarrhea, vomiting, or long periods of exercise with excessive sweating. Some illnesses might also prevent children from taking fluids by mouth. If they're unable to adequately replace the fluid that's been lost, kids can become dehydrated.

Recognizing Dehydration

If your child has fever, diarrhea, or vomiting, or is sweating a lot on a hot day or during intense physical activity, you should watch for signs of dehydration, which can include:

• dry or sticky mouth
• few or no tears when crying
• eyes that look sunken into the head
• soft spot (fontanelle) on top of baby's head that looks sunken
• lack of urine or wet diapers for 6 to 8 hours in an infant (or only a very small amount of dark yellow urine)
• lack of urine for 12 hours in an older child (or only a very small amount of dark yellow urine)
• dry, cool skin
• lethargy or irritability
• fatigue or dizziness in an older child

Preventing Dehydration

The best way to prevent dehydration is to make sure kids gets plenty of fluids, whether they're sick or just physically active. In other words, you need to make sure that they're consuming more fluids than they're losing (from vomiting, diarrhea, or sweating).

The way you should keep a child adequately hydrated will differ depending on the circumstances. For example, a child with a sore throat may become dehydrated due to difficulty drinking or eating. Easing the pain with acetaminophen or ibuprofen may help. Cold drinks or popsicles can also soothe a burning throat while supplying fluids at the same time.

Infants with blocked noses who have trouble feeding can be helped by flushing their nostrils with saltwater, or saline, nose drops and suctioning out the mucus with a bulb syringe.

Fever, which can be a factor in dehydration in any infectious disease, can be controlled with medications or room-temperature sponge baths and dressing the child in light clothing.

On hot, dry, and windy days, it's important that children drink often. Those who participate in sports or strenuous activities should also drink some extra fluid before the activity begins. They should also drink at regular intervals (every 20 minutes) during the course of the activity and after the activity ends.

Thirst is not a good early indicator of dehydration. By the time a child feels thirsty, he or she may already be dehydrated. And thirst can be quenched before the necessary body fluids have been replaced. That's why it's recommended to start drinking before thirst develops and to drink some additional fluid even after thirst is quenched. Sports practices and competitions should be scheduled in the early morning or late afternoon to avoid the hottest part of the day.

Children with mild gastroenteritis (an infection, sometimes called the "stomach flu," that can cause nausea, vomiting, and diarrhea) who aren't dehydrated should continue to eat normally but should be encouraged to drink additional fluid to replace fluid losses. According to the American Academy of Pediatrics, recent studies have shown that most children with gastroenteritis can safely eat a regular age-appropriate diet while they're sick. In fact, feeding a regular diet to children who have diarrhea may even reduce the duration of diarrhea, while offering proper nutrition at the same time. Infants with mild gastroenteritis who aren't dehydrated should continue to drink breast milk or regular-strength formula. Older children may continue to drink full-strength milk.

Foods that are usually well tolerated by children with gastroenteritis who aren't dehydrated include: complex carbohydrates (such as rice, wheat, potatoes, bread, and cereals), lean meats, yogurt, fruits, and vegetables. Avoid fatty foods or foods high in simple sugars (including juices and soft drinks). If the child is vomiting and isn't dehydrated, give fluids frequently, but in small amounts.