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Hydration

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Many parents forget the importance of teaching children to drink water.  Drinking water is important because it transports the nutrients to the working muscles helping the child to develop. Also, water helps eliminate metabolic waste products from the body.

The best way to know if your child is drinking enough water or other liquids is by the color of their urine.  Every time they empty their bladder the urine should be clear.  Infrequent urge to urinate or cloudy or yellow urine are signs the child should consume more liquid.  

Preventing Dehydration on Your Child According to the Nemours Foundation

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 are unable to adequately replace the fluid that has 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 are sick or just physically active. In other words, you need to make sure that they are consuming more fluids than they are 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 is 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.  Thirst can be quenched before the necessary body fluids have been replaced.  That is why it is 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 are not dehydrated should continue to eat normally but should be encouraged to drink additional fluids 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 are 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 are not 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 are not 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 is not dehydrated, give fluids frequently, but in small amounts.

Treating Dehydration

It is important for parents to learn to recognize the early signs of dehydration and to respond quickly if they develop.  Younger infants and children should be watched especially carefully because they are more likely to become dehydrated than older children or adolescents.
The goal in treating dehydration is to replace fluids to restore the levels of body fluids to normal.  As with prevention, strategies may differ depending on the age of the child and the condition causing the dehydration.
An older child who is mildly dehydrated due to overexertion will probably be thirsty and should be allowed to drink as much as he or she wants.  Plain water is the best beverage to drink for the first hour or two. After this, the child might need drinks containing sugar and electrolytes (salts) or regular food.  Also, the child should rest from the activity in a cool, shaded environment until the lost fluid has been replaced.
Children who are dehydrated due to vomiting or diarrhea from an illness (such as gastroenteritis) should have their lost fluids replaced with a special drink called an oral rehydration solution (ORS).  This is available in many grocery stores and pharmacies without a prescription and is designed for children who are dehydrated.  It contains just the right combination of sugar and salts to help the intestines absorb what the body needs.
Other "clear liquids" often used by parents or recommended by doctors in the past are no longer considered appropriate for use in dehydrated children. Drinks to avoid include: water, soda, ginger ale, tea, fruit juice, gelatin desserts, chicken broth, or sports drinks. These beverages don't have the right mix of sugar and salts and can even make diarrhea worse.
The replacement of lost fluids is known as rehydration, which is achieved by quickly replacing the lost fluids using an oral rehydration solution over the course of a few hours. Start the rehydration process by giving your child 1 or 2 teaspoons (5 or 10 milliliters) of an oral rehydration solution every few minutes. This can be done with a spoon or an oral syringe, or even in popsicle form.  Although this may not seem like enough fluids to rehydrate your child, these small amounts can add up to more than a cup (237 milliliters) an hour.  Even children who are vomiting can usually be successfully rehydrated in this way because the small frequent sips get absorbed in between the vomiting episodes.  In addition, the correction of dehydration often lessens the frequency of vomiting. If the child does well, you can gradually give bigger sips a little less often.
In nursing infants, breastfeeding should be continued at all times, even during the initial rehydration process.  An oral rehydration solution can be given in between breastfeedings. In the child who is normally formula-fed or who eats solids, formula and foods should be stopped during rehydration and restarted as soon as the child is no longer showing signs of dehydration several hours later.  Changes in formula usually aren't necessary.
Once your child is rehydrated, you can resume your child's normal diet, which should include lots of complex carbohydrates (such as rice, potatoes, and whole-grain breads and cereals), lean meats, yogurt, fruits and vegetables, as well as the child's usual milk source (breast milk or formula for infants and full-strength cow's milk for older children). But be sure to avoid fatty foods or foods high in simple sugars, such as juices and soft drinks.  Resuming an age-appropriate diet early is essential in supplying your child with necessary calories and nutrients and can even reduce the duration of gastroenteritis.
It's also important to note that there are a number of old wives' tales about treating dehydration that are not recommended.  For example, the practice of withholding food for more than 24 hours is inappropriate and can be unsafe. Likewise, specific diets that have been commonly recommended in the past - such as the BRAT diet (bananas, rice, applesauce, and toast) - are unnecessarily restrictive and do not provide the best nutrition for the child's recovering intestinal tract.  Also, over-the-counter medicines for diarrhea or vomiting are not recommended for children.  They have potentially dangerous side effects in kids.  Appropriate fluids - not medicines - are the key to treatment.
A few dehydrated children do not improve when given an oral rehydration solution, especially if they have very frequent bouts of explosive diarrhea or frequent vomiting. Kids who cannot replace losses because of vomiting, difficulty swallowing, massive diarrhea, or other reasons, might need to receive intravenous (IV) fluids in the hospital.
If you are treating your child for dehydration at home and feel that there is no improvement or that the dehydration is getting worse, call your child's doctor immediately or take your child to the nearest emergency room.

For more information about this topic, please visit: www.kidshealth.org

 
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