DEHYDRATION in babies, infants and onwards

Dehydration in babies, infants and onwards

Infants are at greater risk for dehydration than older children and adults. To understand dehydration fully we need to look at the difference between dehydration and heat exhaustion.

Dehydration is when more water or fluid leaves the body than enters the body which causes an imbalance in your body. On the other hand, heat exhaustion occurs if the body is dehydrated and unable to regulate its internal temperature. Dehydration causes an electrolyte imbalance and needs to be prevented and treated. This article will mainly concentrate on babies and infants but also have some advice which can be applied for adults.

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Causes of dehydration:

• Diarrhoea

• Vomiting

• Fever

• Nausea

• Not drinking enough

• Excessive sweating

• Burns, for example, sunburn

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General Symptoms:

• Dry mouth

• Thirst

• Sunken eyes

• Low blood pressure

• Lethargy

• Bloody/greenish stools

• Shrivelled

• Wrinkled / dry skin

• Dizziness

• Flashed skin

• Fever

• Increased heart rate

• Headache

• Lack of sweating, fewer tears

• Cracked Lips

• Hands and feet unusual cold

• Decrease urine output

• Darker urine

• Extreme fussiness

• Play less than usual

Symptoms in babies:

• Sunken fontanel

• Dry tongue and mouth

• Irritability

• No tears when crying

• Sunken cheeks and or eyes

• No wet diapers for 3 or more hours, less than 4 wet diapers in 24 hours

• Refuses to drink

• Becomes inconsolable, sleepy

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PREVENTION:

• Consume plenty of fluids and foods high in water content

• Avoid doing activities during extreme heat or the hottest part of the day

• Dress appropriately to the weather

• Follow a good hygiene regime

• When playing outside, being very active or exercising one should make replenishing fluids a priority

• Avoid consuming caffeine including (infants and toddlers and older persons):

  • Coffee

  • Tea

  • Soft drinks

  • Caffeine Snacks

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TREATING DEHYDRATION:

Replace fluid that was lost by:

1. Keep on giving milk feeds (breast and formula) for the little ones but increase the frequency

2. Give oral rehydration therapy, it is as effective as intravenous fluid therapy for mild dehydration. Severe dehydration is a medical emergency and needs medical attention.

3. Let a child with mild dehydration rest for 24 hours and keep them drinking even if the symptoms are better and it might take up to a day and a half for the fluid lost to be replaced.

4. Keep on offering age-appropriate diets, including complex carbohydrates, meats, yoghurt, fruits and vegetables to the children who are eating solids

5. Avoid foods that are high in simple sugars

6. If the little one is reluctant to drink, give fluid via a spoon

7. Offer food with a high fluid content for those eating solids already

8. Water

9. Ice pops

10. Frozen water

11. Oral Rehydration solution

12. Treat the underlying medical condition

13. With persistent vomiting and diarrhoea give small amounts of fluid with regular intervals for example 1 to two teaspoons (5- 10 ml) water or oral rehydration solution every 10 minute

14. The Centers for Disease Control (CDC) recommend 60 to 120 ml oral rehydration solution for children less than 10 kg, 120 to 240 ml oral rehydration solution for those weighing more than 10kg.

15. The Rehydration Project’s guidelines of the amount of oral rehydration solution which is needed in the first 4 to 6 hours of treatment of those who experience mild dehydration are is:

    1. 4.9 kg : 200 - 400 ml

    2. 4.9 - 9.9 kg : 400 - 600 ml

    3. 9.9 - 14.9 kg : 800- 1 000 ml

    4. 14.9 - 19.9 kg : 1000 - 1 500 ml

    5. 19.9 - 29.9 kg : 1 500 - 2 000 ml

    6. 29.9 plus kg : 2 000 - 4 000 ml

16. Keep a record of the time, the volume of fluid and which fluid was given

17. If diarrhoea is the cause of dehydration you need to be cautious to give anti-diarrheal medication and those medications are not recommended for children under the age of 2 years. Speak to your doctor or pharmacist.

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HOMEMADE REHYDRATE:

This homemade oral rehydration solution is safe for use for all ages

Mixed together:

• 1 teaspoon salt

• 8 teaspoons Sugar

• 1 Litre water

• Drink small sips over time

• Banana to replace potassium

Make sure that you use clean water, boiled and cooled down.

MORE REHYDRATION OPTIONS FOR CHILDREN OVER 2 YEARS:

• Milk feedings for babies are still important due to the nutritional value of milk, more liquid feeds are needed

• 1 cup of buttermilk with ½ teaspoon of dry ginger

• Coconut water ( also for babies older than 6 months)

• Oral rehydration solution

• ⅓ cup pickle juice

• 2 Cups of Cranberry juice

• 1 Apple with ½ glass of water

• 1 to 2 glasses of orange juice

• ½ Lemon with 1 glass of water and honey

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REFERENCES:

1. Breastfeeding and human lactation: Jan Riordan and Karen Wambach

2. Caring for your baby and young child: Steven P. Shelov and Tanya R Altmann

3. https://www.jnjconsumer.co.za/our-brands/rehidrat/symptoms-to-look-out-for

4. https://www.parents.com/baby/health/sick-baby/is-your-baby-dehydrated/

5. https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086