Is Your Baby Dehydrated? 8 Signs to Look Out ForReading Time: 5 minutes
If your baby is dehydrated, it simply means the child has lost excessive bodily fluids, mostly water. This often occurs when the quantity of water lost, is less than the quantity being taken into the body. Children and infants are at the highest risk for dehydration. When your baby loses excessive amount of water, the body is unable to carry out its normal functions. This level of dehydration requires prompt recognition and timely intervention. The amount of water contained in the adult human is about 60% of the total body weight. Infants and children have higher percentage of body water at about 65% for children and 75% for infants.
Water, salt and other electrolytes are contained in the blood and our bodies constantly work to balance the amount retained in the body with the amount lost. Water is lost from the body daily, through urine, stool, sweat, and through the lungs when we breathe.
Dehydration in children often result from conditions that make the body lose fluid faster than it can be replaced in the body. It is often caused by illnesses associated with vomiting, diarrhea, fever, and conditions that may make it difficult for your child to eat or drink. Examples of such conditions are mouth sores, sore throat, trauma to the mouth or neck.
- Diarrhea and vomiting.
- Viral gastroenteritis (stomach flu) is one of the commonest causes of dehydration in children. Viral gastroenteritis is commonly caused by rotavirus, norwalk virus and adenovirus in their order of decreasing frequency. These viruses cause acute diarrheal diseases that are often self limiting but if poorly managed may lead to death. Viral gastroenteritis commonly occur in outbreaks affecting several children in close proximity such as those living in the same household, attending same daycare centers or using the same playground. According to the Center for Diseases Control, 200,000 children die each year from viral gastroenteritis(1). Transmission is usually through ingesting food or water contaminated with the feces or vomitus of another infected child or adult, it may be airborne, or by using infected utensils, combs, toys belonging to an infected child. Rotavirus gastroenteritis which is the most common can be prevented by getting your child vaccinated.
- Bacterial gastroenteritis. Common bacteria causing gastroenteritis are Salmonella, Escherichia coli, Campylobacter jejuni, Clostridium difficile. Ingesting food or water contaminated by these bacteria cause vomiting and diarrhea that lead to dehydration if not properly managed.
- Urination: excessive urination at a rate faster than water and electrolytes are replaced may lead to dehydration. Frequent and voluminous, frothy urination may be an early sign of undiagnosed diabetes mellitus
- Fever: fever can make your child lose body water
- Conditions that do not permit food and water to be adequately absorbed such as celiac sprue or cystic fibrosis.
Signs your baby may be dehydrated
- Crying without tears
- Dry diapers or reduced urination for a period of 4-6 hours.
- Sunken eyes
- Dry mouth
- increased thirst/ reduced frequency of urination.
- Lethargy: your child is difficult to awaken or is acting drunken.
- Sunken fontanel ( soft spot on the front of the head in babies)
When to take your child to the hospital
- It is time to take your child to the hospital if he/she has any of the symptoms above and/or accompanying abdominal pain.
- Is vomiting greenish-yellow fluid, blood or pooping blood.
- If your child loses about 10-15% of their current body weight
Stages of dehydration
Home remedy. Prompt supportive care is necessary to prevent the progression of dehydration especially as a result of acute viral gastroenteritis.
- Oral rehydration therapy/solution (ORS/ORT). This is the best fluid replacement therapy as it has the right amount of electrolytes, sugar and water needed to replace the ongoing fluid loss. A setback often experienced by many mothers and caregivers administering supportive care to dehydrated children using ORS, is that, the child may vomit and be unable to retain the fluid being given. Note however, that this does not contraindicate the use of ORS therapy and should not discourage caregivers from continuing ORS therapy. One of the solutions is to give it slowly in small sips over a prolonged period. In most cases supportive therapy with adequate re-hydration is all that is required to nurse your child into complete recovery.
- Suggestive directions for ORS administration. 1-2 tablespoons of ORS every 10-15 minutes, slowly. If vomiting occurs after administering ORS, wait 20-30 minutes and then start over. Slowly increase the quantity of ORS by 1-2 spoons if there is no vomiting for at least 3-4 hours. 8 hours after your child’s last vomit, begin the BRAT/bland diet and breastfeed as normal. 24 hours after the last vomit or as 4-8 hours after initiating the BRAT/Bland diet, feed your child as you would normally.
- Breastfeeding. This is for neonates and infants still breastfeeding. Breast milk is 80-88.1% water and offers adequate hydration to breastfeeding infants especially those under 6 months. Babies being exclusively breastfed get sodium, potassium, chloride and other electrolytes alongside water from breast milk. Do not stop breastfeeding your baby because they are having diarrhea or vomiting, you should continue breastfeeding, but make the feeding time shorter and breastfeed more slowly.
- BRAT diet. Also called bland diet, include bananas, rice, applesauce, toast, cracker. These food do not irritate the stomach and help
- Antibiotics. Your child’s doctor may run some tests to determine the cause of the vomiting, diarrhea, fever or any other condition precipitation the observed symptoms. Use of antibiotics may be prescribed only when the gastroenteritis is caused by bacteria. Viral gastroenteritis usually resolve in about 3 – 5 days, however re-hydration and supportive care are essential.
- Antiemetics and antidiarrheal drugs. These drugs usually prolong the sick period, as such are not routinely given to children to stop diarrhea and vomiting.
- Zinc therapy. This is only necessary if the cause of dehydration is due to gastroenteritis. During gastroenteritis (stomach flu), the lining of the intestines become injured. Daily supplementation with zinc helps restore the injured cells, shorten the progression and duration of the stomach flu.(2)
Prevention of dehydration
- Ensure to limit the occurrence of conditions that precipitate dehydration by
- Washing your hands before feeding your baby or handling feeding utensils.
- Maintaining good hygiene and disposing of soiled diapers promptly and appropriately.
- Making sure your child is up to date with their immunizations, especially rotavirus vaccine.
- Ensure your baby has access to drinking water and good diet timely.
What Not to Give Your Child When Dehydrated
- Sugar beverages and drinks, soda, energy drinks. These drinks do not have same sugar and salt composition as the blood and will not be absorbed into the body, they worsen the ongoing vomiting and diarrhea.
- Plain water. In cases of gastroenteritis, the lining of your baby’s intestines are damaged, thus impairing absorption. Water can no longer be absorbed normally, and requires the presence of salt and sugar for proper absorption
Complications of Dehydration
Moderate to severe dehydration often lead to several complications
- Kidney failure
- Stuempfig ND, Seroy J. Gastroenteritis, Viral. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2018 Jan.
- Goldman RD. Zinc supplementation for acute gastroenteritis. Canadian Family Physician. 2013;59(4):363-364.