Related topics: •  Constipation in Children

Dehydration means that the body is losing too much fluid or not taking enough in, usually because of fever , overheating, or diarrhea. It's both preventable and easily treatable, but you need to address the problem right away or it may become life-threatening.

These are the most common signs:

•Decreased energy or playfulness

•A sunken fontanel (soft spot) on a baby

•A dry sticky mouth

•No tears while crying

•An elevated heart rate when there's no fever

•Decreased urine output

•Dark yellow urine

•For a child in diapers, failing to wet every two to three hours

•For an older child, not urinating about once every four hours (during waking hours)

If you notice any of these symptoms, call your child's doctor right away.

If your child continues to lose fluid, symptoms of serious dehydration may appear. If you see any of the following danger signs, get your child to an urgent care center immediately:

•Sunken eyes

•Cool, mottled hands and feet

•Light-headedness

•Lethargy, confusion, dizziness, or delirium

Kids have plenty of opportunity to get dehydrated, from playing outside on a scorching day to getting one of the many childhood illnesses. Here are some common culprits:

•Fever and overheating. These are among the most frequent causes of dehydration. When your child has a fever, she sweats and water evaporates from her skin as her body tries to cool down. It's surprising how much fluid children lose when they have a fever: For every degree her temperature rises above 100.4 F, your child loses 12.5 percent of her body fluid.

The air we breathe is humidified in the respiratory tract, which gives fluid another escape route. When children have fever or lung infections, they breathe fast and blow off extra fluid. Like fever, exercising on a hot day or just sitting in a stuffy, sweltering room can lead to sweating and fluid loss.

•Diarrhea and vomiting. If your child has an intestinal illness, especially one known as acute gastroenteritis (AGE), she may lose fluid in the form of diarrhea. If she's vomiting too, even more fluid is lost. If she has trouble keeping down liquids to replace these losses, the risk of dehydration rises.

•Excess urination. More rarely, diseases like diabetes, kidney disease, and certain conditions affecting hormones and the nervous system can lead to increased fluid loss.

•Decreased fluid intake. Sore throats and other ailments, such as hand, foot, and mouth disease, can cause so much pain that children sometimes stop drinking.

Infants with diarrhea need special care, because they can become severely dehydrated in less than 24 hours. Call your child's doctor immediately if you see signs of dehydration such as sticky saliva, dark yellow urine, weakness, dry diapers, or cool, mottled hands or feet.

If you have a toddler or young child, give her a tablespoon of a clear liquid such as broth every 10 minutes. (Children over the age of 6 should have an ounce every 10 minutes.) Avoid very sweet liquids, and sodas are best diluted with 50 percent water; don't give her fruit juice, milk, or sports drinks, and avoid over-the-counter antidiarrhea medicines. If your child is older, you can increase her intake of liquids by giving her frozen fruit bars and ice chips.

If your child has severe diarrhea, she needs an electrolyte solution like Pedialyte, Infalyte, or Kaolectrolyte. Give her a few sips every few minutes. Call your doctor immediately if you see the signs of dehydration listed above.

If your child has a fever, offer plenty of liquids -- some kids do better with ice-cold drinks, while others may find warm liquids more soothing. Avoid citrus drinks like orange juice and grapefruit juice; they'll sting and burn the irritated tissue of a sore throat. If she's having trouble swallowing, you can use a pain medication like acetaminophen. (To guard against Reye's syndrome, a rare but potentially life-threatening disorder, never give aspirin to children or teenagers.)

If a child is vomiting, give her small amounts of fluid frequently. For children between the ages of 1 and 6, start with one tablespoon every 10 minutes. (If you're watching TV, this works out to one sip every commercial break.) Children over 6 can try an ounce every 10 minutes. Double this amount when your child has gone four hours without vomiting. If vomiting continues, withhold all fluids for an hour and start again with a smaller amount. Ice chips and Popsicles can work well, too.

During hot weather and exercise, of course, your child needs more fluids than usual. Kids generally need 44 to 88 ounces of fluid per day; for every half hour of heavy activity, add another 8 to 12 ounces of water. Have your child load up on fluids two hours before exercising, and then offer her liquids every 10 to 20 minutes whether she's thirsty or not. Again, avoid sports drinks: The relatively high sugar content of some of these beverages can cause cramping, nausea, and diarrhea.

If your child shows symptoms of dehydration -- dark urine, tearless crying, sticky mouth, lethargy, and mottled hands and feet -- and is getting worse despite your care, contact your pediatrician. Severely ill children may need intravenous fluids.

--Lisa Asta, MD, is a writer and pediatrician practicing in the San Francisco Bay Area. She has written for the Annals of Internal Medicine, the Journal of the American Medical Association, and Hippocrates.

Further Resources

National Institute of Child Health &Human Development

http://www.nichd.nih.gov/default.htm

Robert H. Pantell M.D., James F. Fries M.D., Donald M. Vickery M.D., Taking Care of Your Child: A Parent's Illustrated Guide to Complete Medical Care. Perseus Books Publishing, L.L.C.: 1999.

References

First published August 18, 1999
Last updated June 21, 2007
Copyright © 1999 Consumer Health Interactive

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