Dehydration

What is dehydration?

When gastroenteritis or other illnesses causes a child to vomit or have diarrhea, he will lose fluids and salts from his body.

If a child has too little fluid in his body, we say that the child is dehydrated. Ths condition can be very serious if the dehydration is severe. Children with diarrhea or vomiting can easily become dehydrated because they may lose more fluid than they are able to take in by drinking. Babies under 1 year of age normally need approximately 1 quart of fluid per day, and children over 1 year need 1-2 quarts of fluid per day, depending on their size. That amount increases when body fluid is lost through vomiting or diarrhea.

Children are not as tolerant of fluid loss as adults are. For those under 3 years of age, dehydration can develop within a few hours, especially if the child is already vomiting and having diarrhea. Having a fever alone will increase the loss of fluid through the skin and also raises the risk of dehydration.

Home treatment

1. Give your child plenty to drink, but in small amounts. If your child is vomiting, give him a teaspoonful of fluid or a little sip every 2 -3 minutes. Wait 30-60 minutes after an episode of vomiting before giving your child anything to drink. 
2. Children who are being breast-fed can continue to take breast milk. However, your child should be breast fed more often than normal (every 1-2 hours), and given smaller amounts (breast feed for 5-10 minutes at a time). If the child will not take the breast, the mother can pump and give the child the milk by spoon, cup or bottle.
3. Infants who are on formula can continue taking a regular, full-strength formula. 
4. In addition to breast milk and formula, you can give your infant one of several specially prepared oral rehydration solutions (i.e. Pedialyte, Ricelyte or Kao Lectrolyte). These oral rehydration solutions (ORS) help to quickly replace the fluids and salts lost through diarrhea and vomiting, and can be bought in a variety of flavors at your local drugstore or supermarket. Older children can be given frozen popsicles made from these solutions. If your child is over 6 months old and does not like the taste of plain (unflavored) Pedialyte, you can add half a teaspoonful of apple juice to each dose. 
5. Be careful when giving plain water or watered down juice, breastmilk, formula or electrolyte solution to a baby less than 1 year old because this could create sale imbalances that may be dangerous for your child. Talk to your doctor about the best way to treat your baby. 
6. Older children can be given other fluids in addition to oral rehydration solutions. Children with diarrhea should avoid fruit juices and soft drinks because they have high sugar content which can make the diarrhea worse. If the child is vomiting, but doesn't have diarrhea, he may drink small amounts of clear fluids. 
7. Monitor your child's urine output carefully. 
8. Always ask your child's physician for advice, especially if you have any questions about dehydration.

When to seek medical advice

See the doctor immediately or call 911 if:

• Your child is showing signs of dehydration. These signs include: listlessness, lethargy, dry lips or mouth, or lack of urination for more than 4 to 6 hours in a baby or more than 6 to 8 hours in an older child. 
• Be aware that young children, especially infants less than 6 months old, will become dehydrated much more quickly than older children. 
• Dehydrated infants less than 1 year old will have a sunken fontanel (the soft spot on top of the head). 

Make an appointment with your doctor if:

• You are concerned that your child may be becoming dehydrated. For example, if your child cannot hold down any fluids, is not urinating as much as he normally does, or seems more tired than usual, he may be becoming dehydrating. 
• You are not sure of your child's condition.