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Baby Medical Q&A, Issue #090 Dehydration Update
April 01, 2014
Hi

Welcome to another edition of Baby Medical Q&A News.

This month I am focusing on Dehydration in children and babies.

I have recently had a child in hospital because of dehydration and she required intravenous fluids for treatment. This is the treatment for dehydration at the severe end of the spectrum and I think it is worthwhile looking at how you detect dehydration early in your child and treat it so she doesn't end up in hospital requiring an intravenous infusion.

Another reason that I thought this would be a good topic is the recent research findings that coffee drinking does not cause dehydration. There had been speculation that because coffee (caffeine actually) is a mild diuretic (so makes you pee a lot) that it might cause dehydration. The recent study shows this is not the case.

What causes dehydration in babies and toddlers?

There are several conditions that may cause dehydration, such as:
  • diarrhea
  • vomiting
  • poor fluid intake for any reason

Basically, dehydration occurs when there is a mismatch of fluid going into the body and fluid coming out. So any condition that causes more fluid loss, such as diarrhea or vomiting, or not taking enough fluid in, such as in illness, can cause dehyration.

How can I tell if my child is dehydrated?

There are a number of signs you can look for but one of the easiest signs is the color of the urine. When your child is well hydrated, the urine looks a pale colour. Once the urine is starting to look yellow or darker than that, then your child is probably a bit dehydrated. The first morning urine is always a bit darker and that's ok as it shows the kidneys are working overnight.

Looking at the color of the urine is an easy way of knowing whether your child is drinking enough. Clear to pale lemon is fine. Yellow means drink more.

Other signs and symptoms include:
  • feeling thirsty - this is not an early sign of dehydration, so when your child feels thirsty, give them some water
  • having a dry tongue or lips - give your child something to drink if you see this
  • having sunken eyes - this is a relatively late sign of dehydration so don't delay giving your child a drink if you notice this
  • being listless and lethargic - again this is a late sign, so don't hesitate in acting

What is the best fluid to give if my child is dehydrated?

Early on, giving water is fine. So, if you notice the urine is a bit darker than usual, just give more water. This also applies to when your child feels thirsty.

Don't give juice or soda for thirst or dehydration. Given the recent research, it is unlikely that caffeine in soda (such as cola) actually causes dehydration, but it is not a healthy drink for your child for other reasons. Juices and soda have high sugar loads and have long term adverse effects mainly on weight but also behavior.

Once you get to the later stages, so once your child is listless with sunken eyes, then it's better to give an oral rehydration solution (ORS). You can make your own.
Click here to read more on making your own oral rehydration solution and for guideline on how much to give.

What if my child is vomiting and can't keep fluid down?

This often happens especially if you child has gastroenteritis (Click here to read more).
The trick is to give very small amounts very frequently. This may be 15 ml every 5 minutes in a 3 to 4 year old, (click here to read more on how much to give depending on age).

If your child is still vomiting even small amounts, a special anti-sickness medication can often help. There is an anti-sickness medication that comes like a wafer and dissolves on the tongue which is very helpful in these situations -it's called Ondansetron. Your doctor can prescribe it.

If your child continues to get dehydrated despite these measures, then she probably needs further medical assessment and may need fluids given either via a nasogastric tube (into the stomach) or an intravenous line (into the bloodstream).

Reference:

"No evidence of dehydration with moderate daily coffee intake: a counterbalanced cross-over study in a free-living population," by Sophie C. Killer, Andrew K. Blannin and Asker E. Jeukendrup - in PLOS ONE.


Please feel free to share this ezine with family and friends.

Till next time,

Dr Maud

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