- What is dehydration?
- Stages of dehydration
- What causes dehydration in children?
- Signs and symptoms of dehydration in children
- When to call the doctor?
- Diagnosis and assessment of dehydration in children
- Treatment for dehydration in children
- Home remedies for dehydration
- Preventing dehydration in kids
Sweat, urine, and tears. These are some of the forms in which we lose the water in our body. Typically, a child weighing 10kg loses around 1,000ml or one litre water every day (1).
The average or acceptable amount of water loss increases as the child grows. But when the amount of water lost is more than the acceptable levels, the body becomes dehydrated.
What Is Dehydration?
Dehydration is excessive loss of fluids in the body.
Over 60% of your child’s body weight is made up of water. Water flows throughout the body as a part of the blood. Some of the water you drink also goes into the kidneys and the gut, to come out in the form of urine and feces. The right amount of water in the body also enables us to maintain the standard body temperature of 98.6oF.
Dehydration is a common problem in children. In fact, young children are at a higher risk than adults because they can lose more fluid in a less time.
But the good news is that it can be adressed, or even prevented. The trick, though, is to know if and when the child is dehydrated.
Stages Of Dehydration
There are three stages of dehydration: mild, moderate and severe.
- Mild dehydration is the first stage, which can lead to 1-3% weight loss in the person. While the mouth and the lips of the person are usually moist, the skin becomes dry and the urine turns a clear yellow color in this stage.
- The second stage is moderate dehydration, which can lead to 3-6% weight loss. Lips turn dry often and the frequency of urination further decreases. Also, the urine is dark yellow in color.
- The third stage is severe dehydration, which results in over 6% weight loss and leads to chapped lips. The elasticity of the skin reduces due to lack of water in the body and urine is dark (tea) brown in color.
[ Read: How To Stop Vomiting In Children ]
What Causes Dehydration In Children?
One or more of the following reasons lead to dehydration:
1. Insufficient water intake
Not drinking enough water is perhaps the most common reason for dehydration in children. The body has a brilliant mechanism to indicate that it needs fluids – thirst. But kids may be so preoccupied with their activities that they may sometimes neglect their bodies’ needs.
This table shows the amount of water/fluids boys and girls should ideally drink (2).
|4 to 8 years||5 cups||5 cups|
|9 to 13 years||8 cups||7 cups|
|14 to 18 years||11 cups||8 cups|
The age, combined with the level of physical activity of the child, determines how much water the child should have. If your kids indulge in strenuous physical activity (sports or exercise) every day, they may need more fluids than an average kid. Also, the amount of water intake should be higher than usual during summers and in places where the temperatures are unusually high.
Diarrhea is one of the most common reasons for excessive water loss in an individual. It is perhaps the most dangerous of all and can result in rapid water loss in little time. This condition prevents absorption and retention of water from food as well, leading to severe dehydration.
Vomiting due to food poisoning or viral and bacterial infections also causes loss of fluids in the body. In the case of continuous vomiting, the body is unable to retain any water, resulting in dehydration.
4. Bacterial or viral infections
Infections also reduce the appetite and prevent the child from drinking or eating anything, thus inhibiting water intake and leading to dehydration. Some conditions like gastroenteritis, also known as stomach flu, may cause inflammation in the intestines due to a viral (such as rotavirus, Norwalk virus, and adenovirus), bacterial (Salmonella, Escherichia coli, Campylobacter, and Clostridium difficile), or parasitic infections (such as Giardia lamblia, also known as giardiasis) infection, causing dehydration from vomiting and diarrhea.
Sores in the mouth caused due to bacteria or body heat can also make it difficult for the child to eat or drink anything, resulting in dehydration.
Diabetes in children can increase the amount of fluid lost due to frequent urination. If the child does not drink enough water to make up for the fluid loss, it can lead to dehydration. Poor treatment of diabetes by not taking insulin or diabetes medication in time can also cause dehydration.
Besides diabetes, medications like diuretics make the child to urinate frequently, which means the body fluids are loss in excess. Antihistamines and antipsychotics can also cause the body to dehydrate.
Burns on the body can result in water seeping into the damaged skin cells, leading to an unwarranted fluid loss. This can also lead to dehydration in some cases.
If your child has one of these conditions, look out for the signs of dehydration.
[ Read: Home Remedies For Diarrhea In Kids ]
Signs And Symptoms Of Dehydration In Children
Is your child feeling thirsty too often? Excessive thirst, darker urine and fewer visits to the bathroom are some of the early signs of dehydration in children. In the case of mild dehydration, the following symptoms can surface within a day.
- Dry mouth
- Absence of tears when crying
If not tackled early on, mild dehydration can become severe and may even require hospitalization. Symptoms of severe dehydration in kids include:
- Dry skin
- Lack of perspiration
- Continuous vomiting
- Fever, over 103o F
- Sunken eyes (eyes seem small)
- Rapid heart beat
- Low blood pressure
When To Call The Doctor?
When your child has a dry mouth, is lethargic and refuses to do anything, has a high body temperature or complains of severe abdominal pain, consult your doctor immediately. Also, when you are unsure about the level of dehydration in the child, visit the doctor.
Diagnosis And Assessment Of Dehydration In Children
The doctor will perform a physical examination, along with a few mental tests to check for signs like disorientation, fever, lack of sweat, blood pressure, heart rate and elasticity of the skin.
A few blood tests may also be performed to check for any infections, and the levels of sodium, potassium and other electrolytes in the body. The color of the urine is the best indicator of dehydration or lack of it. So, a urinalysis could also be recommended to assess the level of dehydration in your child.
[ Read: UTI Symptoms In Children ]
Treatment For Dehydration In Children
The only way to treat dehydration in children or adults is to replenish the lost fluids in the body.
- The doctor would most likely recommend oral rehydration, like ORS or electrolytes. They may tell you to give small doses of water mixed with electrolyte powder to increase the fluid content and improve fluid retention.
- If you have a bottle-fed child who has vomited for two times or more, offer ORS to them for at least eight hours.
- Sometimes, kids may not recover even after giving ORS, especially if they are vomiting frequently or having diarrhea. In such cases, they may be given IV fluid for supplying fluids directly to the vein.
- The child may be given medication for any underlying medical conditions such as bacterial or viral infections that have caused the dehydration. They may have to stay in the hospital for observation and treatment of these infections.
A proper nursing care plan is important to keep the child healthy and hydrated after the treatment as well.
Home Remedies For Dehydration
Drinking plenty of water is one of the best ways to replenish the body fluids lost due to dehydration. In addition to that and any medicine that the doctor has prescribed, you can try these home and herbal remedies for re-hydrating the child.
1. Homemade oral rehydration solution
If ORS is not handy, you can make your own oral fluid replacement solution. Here is how:
- Mix a half teaspoon salt in four cups of water.
- Add six teaspoons of sugar in the salt solution.
- Mix the liquid until both the salt and the sugar dissolve.
Give a small glass of this solution to the child once every hour or two until he recovers.
2. Fruits and vegetables with high water content
One way to give the body the necessary water as well as energy is to eat a lot of watery fruits and vegetables like cucumbers, strawberries, papaya, spinach, zucchini, watermelon, oranges, cantaloupe, grapefruit, tomatoes, celery and grapes.
According to a study by the University of Aberdeen Medical School, fruits and veggies with high water content are twice as effective as a glass of water, in replenishing lost fluids in the body.
3. Coconut water
Coconut water is a natural hydration agent in tropical regions such as India and Sri Lanka. Coconut water contains a high amount of electrolytes that can restore the water levels in the body quickly. A glass of coconut water is as powerful as sports drinks (3).
Fruits and veggies with high water content are twice as effective as a glass of water, in replenishing lost fluids in the body.
4. Yogurt and buttermilk
Yogurt contains good bacteria that can help fight the diarrhea causing bacteria in the body. It is also a great source of electrolytes that the body needs to stay hydrated.
You can give your child a small cup of plain yogurt after a meal. If rice is your staple food, eat rice with curd and a pinch of salt.
5. Barley water
Barley water can help retain the water and also keep the body cool, which makes it a great option if your kid has fever due to dehydration.
- Soak barley seeds overnight.
- Add the soaked barley seeds to a bowl with four cups of water. Let it boil.
- Simmer it for around 45 to 60 minutes and take it off the stove.
- Once the liquid is cooled, strain it.
- Add a spoon of lemon juice and some honey.
Give small quantities of this solution to the child regularly.
[ Read: Bacterial And Fungal Infections In Kids ]
Lemons are rich in vitamin C and excellent for fighting the symptoms of dehydration.
- Add half a slice lemon juice to one glass of water.
- Add a pinch of salt, black pepper powder, and one teaspoon honey to the lemon water.
- Mix it well and give it to the child to drink every three to four hours (in addition to other re-hydrating solutions)
7. Watery soups or broths
Vegetable soups and broths can replace the lost fluids in the body. Make sure you add water rich vegetables in the broth and avoid making them too thick.
8. Epsom baths
A bath with Epsom salts in the water is an effective home remedy for dehydration. The salts are rich in magnesium, which can help fight the negative symptoms of dehydration.
A 15-minute bath with Epsom salts can be relaxing, and also eliminates lethargy and muscle weakness that the child has.
Salt can help is stabilizing the level of water and electrolytes in the body. That is why eating salty foods such as biscuits, salted nuts and salads after vigorous exercise is recommended. Besides some salty food, make sure that the kid also has plenty of water.
The effects of dehydration in children can be severe, considering their vulnerability to illnesses and their underdeveloped immune systems. Extra care must be taken to make sure that children are hydrated properly, in all seasons, at all times.
If your kid is suffering from dehydration while still breastfeeding, continue that. Keep giving him/her ORS in between.
11. Replacement Drinks
For treating dehydration, you may replace fluids with Pedialyte, and Pedialyte popsicle.
Preventing Dehydration In Children
Dehydration can be avoided in most cases unless it is induced due to a medical condition like a viral or a bacterial infection. In fact, you cannot prevent a viral or bacterial infection. What you can do is keep an eye on the signs that indicate dehydration, and act accordingly. Some of the things you can do to prevent dehydration in children are:
- Make sure that your child drinks adequate water every day.
- Avoid playing or doing strenuous activities outdoors when the weather is extremely hot.
- Make sure that your child drinks plenty of water after playing or a vigorous activity like exercising, playing a sport or dancing.
- Try and avoid eating street foods that can increase the chances of a viral or bacterial infection.
- Include foods such as cucumbers, watermelons, zucchini, etc. that have a lot of water in the diet. Also avoid high-protein diets for kids. Carbohydrate is a must.
- If your child has diarrhea or has vomited more than five times in 24 hours, start using electrolyte powders immediately to replenish the lost fluids.
- If you are unsure about the severity of the condition, don’t just rely on oral rehydration. Contact your doctor.
- [ Read: Why Do Headaches Occur In Children ]
Dehydration can go from mild to moderate to severe in a short time. Your goal must be to deal with it early on. It is also one the common causes of fatality in children aged five or less, resulting in over two million deaths worldwide. The good news, however, is that you can protect your children from dehydration with proper care at home and medical treatment.
Have any tips to prevent dehydration in children? Tell us about them here.
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