Dehydration in Children

A child drinking water from a yellow mug

Children are more prone to dehydration than adults since their smaller bodies have lesser reserves of water. Generally, children are also more active than adults and spend much time out playing in the sun. Children are also more susceptible to illnesses that cause dehydration like vomiting and diarrhea.

What is Dehydration?

Dehydration occurs when the body loses more water than it can retain. The body doesn’t have enough fluids to function properly. The reasons for dehydration can be many and varied and you must keep a look out for the same.

Facts about Dehydration in Kids

A little girl drinking water from a fountainDehydration among children is caused by many reasons. Some of the most common causes include vomiting, diarrhea, and not drinking enough fluids. Only in rare cases will excessive sweating or urination cause dehydration. Smaller children will lose liquids faster than older children.

Causes

The following are few of the reasons for dehydration in kids:

  • Fever
  • Vomiting
  • Diarrhea
  • Viral infections that reduces the ability to eat or drink
  • Sores in the mouth that make eating or drinking painful
  • Increased sweating due to a hot environment
  • Excessive urination
  • Diabetes
  • Conditions like cystic fibrosis that do not allow food or water to be absorbed by the body

Signs and Symptoms

There are several signs that you can look out for dehydration in your children. Here are some of the more common symptoms:

  • Not urinating for more than six hours
  • Dark colored urine
  • Dry mouth with cracked lips
  • Lethargy
  • No tears when crying
  • Cold or dry skin
  • Increased heart rate or breathing
  • Sunken eyes

Diagnosis of Dehydration

When you visit your child’s doctor, she will take a complete history and will also conduct a thorough physical exam to determine the health of your child. The doctor might also ask for certain tests. Some of them include:

  • A complete blood count to determine if there is an infection and then specific cultures to determine the cause of the infection if any.
  • Urine analysis to determine if there is a bladder infection or to identify a more serious underlying condition.

How to Measure Dehydration

The Clinical Dehydration Scale can be used to determine the severity of the dehydration your child is suffering from. It is a scale that even you can use. With the scale, you can determine if your child’s dehydration levels are increasing or decreasing. This information can help your doctor when she is treating your child.

Calculating Dehydration Status

There are several easy steps you can take to calculate the dehydration status of your child. The steps include:

  1. Make a note of your child’s symptoms
  2. Add points on the scale according to the value of the symptom on the chart
  3. Add the points and get the score

Clinical Dehydration Scale

0 1 2
General Appearance Normal Thirsty, restless, lethargic. Irritable when touched Drowsy, limp, cold, sweaty
Eyes Normal Slightly sunken Very sunken
Mucous Membranes* Moist Sticky Dry
Tears Present Decreased Absent

 

*Mucous membranes include the moist lining of the mouth and the eyes.

Score of 0 = no dehydration

Score of 1 to 4 = some dehydration

Score of 5 to 8 = moderate to severe dehydration

Treatment For Dehydration in a Child

The treatment of the dehydration is based on the severity of the dehydration that is determined using the Clinical Dehydration Scale.

  • Moderate To Severe Dehydration (a score of 5 to 8): If your child scores at this level on the scale, then you must immediately get medical attention for him. Make sure you tell your doctor of all the signs and symptoms you have taken a note of.
  • Mild Dehydration (a score of 1 to 4): Start your child on oral rehydration solution immediately. Though there are many readymade ORS solutions available in the market, it is best that you make fresh electrolyte solutions at home. In a liter of clean, fresh water, mix 6 teaspoons of sugar with half a teaspoon of salt. Give your child one or two teaspoons every five minutes. If your child refuses the ORS then make sure he gets his fluids from fresh fruit juices or even milk if he is not suffering from diarrhea.
  • No Dehydration (a score of 0): Even if your child does not show any signs of dehydration, continue giving her fluids after each episode of vomiting or diarrhea. Make sure your child eats well during this period as well.

Medication Used for Dehydration

A little boy drinking water

Your doctor will decide on a course of treatment for dehydration based on the severity of the loss of fluids.

  • If the dehydration is mild, around 3 to 5% loss of total body weight, then your doctor will most likely prescribe the oral rehydration method discussed above. You will be able to administer this at your home.
  • In case of moderate dehydration, around 5 to 10% of loss of body weight, then your child’s doctor will administer fluids intravenously or IV. This is to ensure quick replacement of fluids. After a round of IV, if the fluid retention is good, your doctor will send you home to continue oral rehydration.
  • Severe dehydration or a loss of 10 to 15% of body weight will require your child to be admitted in the hospital with IV fluids. Further tests will be required to determine the cause of infection. For bacterial infections, a round of antibiotics will be administered. No medicines will be administered for viral infections as they tend to run their course. Specific medicines to stop vomiting will be avoided in children as it tends to prolong the illness.

Treatment after Rehydration

Once your child is better rehydrated, the next step is to ease her back into eating what she normally eats. About 4 to 6 hours after the last episode of vomiting or diarrhea, you can give your child the food she enjoys eating. While you do not have to restrict her food to bananas, rice, toast, and apple sauce, it is best to avoid highly processed foods that have a high content of sugar and salt. High fat foods that are spicy are also best avoided.

If episodes of vomiting and diarrhea continue, you should give your child a few teaspoons of oral rehydration solution for babies after each episode.

Home Remedies

There are some natural remedies for dehydration that you can try for the management of dehydration in children. Some of them are:

  • The main method of managing dehydration in children is through oral rehydration. You should make the oral rehydration solution fresh at your home and administer it every few minutes if the dehydration is severe.
  • For breast feeding infants, you must reduce the amount per feeding. If your infant has vomited twice, then feed your child every one to two hours. If your infant has vomited more than two times then you should nurse her for 5 minutes every 30 to 60 minutes. If the vomiting continues, then switch to oral rehydration for a stretch of 4 hours.
  • Children older than one year can be given fluids like flat soda, Gatorade, clear soups, popsicles and oral rehydration. For cases of only vomiting you can also give your child water and ice chips.
  • Limit food to bland complex carbohydrates for a period of 24 hours.
  • Feed your child bread, saltine crackers, rice, and cereals
  • Give your child tender coconut water as it is an excellent source of fluids.
  • Yoghurt
  • Bananas
  • Watery fruits like watermelon
  • Buttermilk

How to Prevent Dehydration

Some of the precautions of dehydration in children include:

  • While it is impossible to protect your child from infections that could cause dehydration, you can stay vigilant for any of the signs of dehydration.
  • On especially hot days, ensure that your child is receiving adequate amounts of fluids.
  • Do not give your child carbonated drinks. They contain high levels of sugar that could cause dehydration.
  • Dilute the juices your child prefers to drink with water to ensure adequate fluid replacement.
  • If the environment your child plays in is very humid, then it is best that you prevent him from doing so. High relative humidity will cause excessive sweating.
  • Ensure that your child wears the appropriate clothing for play. Light colored clothes with ventilation as the best option to dissipate heat to prevent excessive heat build up.

When to Seek Doctors Help

You must immediately seek medical help in the following conditions:

  • Your child’s signs of dehydration do not seem to improve with time or are getting worse.
  • There is blood in the stool or if the vomit is green.
  • Your child is unable to ingest enough fluids for adequate replacement.
  • Persistent vomiting or diarrhea that hampers your child’s ability to consume fluids.
  • Diarrhea that lasts for more than ten days.

Things to Remember

When it comes to dehydration in children, you will do well to keep these points in mind:

  • Infants and younger children are more susceptible to getting dehydrated.
  • Early detection and treatment is the best line of defense.
  • Mild dehydration in children can be managed at home.
  • Children with severe dehydration must be given immediate medical attention.

Dehydration in children can be both frequent and dangerous. It is best to keep track of all symptoms and administer fluid levels at the earliest. With dehydration in children, it is better to be cautious and seek medical assistance for your child.

Also Read: Anorexia in Children