BY CHIOMA UMEHA
Dehydration occurs when a child's body is deficient in
fluid. Dehydration can be caused by a lack of fluid intake, vomiting,
diarrhoea, or a combination of these factors. Dehydration can occur when you
sweat excessively or urinate excessively. Since infants and small children lose
fluid more quickly than older children or adults, they are considerably more
likely to get dehydrated.
Why A Child May Become Dehydrated
1. Dehydration is often caused by a
viral infection, which causes fever, diarrhea, vomiting, and a diminished
capacity to drink or eat. Example of these viral infections are Rotavirus, Norwalk virus, and Adenovirus.
2. Sometimes wounds in a kid's mouth
(produced by a virus) make eating or drinking uncomfortable, which contributes
to or worsens dehydration. Other severe bacterial infections may make a child
less likely to eat and may induce vomiting and diarrhoea. Common bacterial
infections include Salmonella, Escherichia coli, Campylobacter, and Clostridium difficile.
3. Sweating excessively in a hot
environment can lead to dehydration.
4. Other causes include undiagnosed or
poorly controlled diabetes mellitus or diabetes insipidus.
5. Health conditions such as
cystic fibrosis and celiac sprue prevent food absorption and can lead to
dehydration.
Symptoms of Dehydration in Children
Be alert to when your child vomits or
experience severe diarrhoea, or if the child becomes reluctant to eat or
drink. Sunken eyes, decreased frequency of urination or dry diapers, a sunken
soft spot on the front of the baby's head (called the fontanel), no tears when
the child cries, dry or sticky mucous membranes (the lining of the mouth or
tongue), lethargy (less than normal activity), and irritability are all signs
of dehydration.
In order to assess the degree and cause of the
dehydration, the doctor will do a complete history and physical exam. This may
involve the carrying out of specific lab tests on the child.
- A
complete blood count may reveal the presence of an infection.
- Blood
cultures can help identify the type of infection.
- Blood
chemistries can detect electrolyte imbalances caused by vomiting and
diarrhoea.
- Urinalysis
can detect bladder infection, determine the severity of dehydration, and
detect sugar and ketones in urine (evidence of uncontrolled diabetes).In
some cases, the doctor may order other tests, such as a chest x-ray, a test to check for
rotavirus, stool cultures, or lumbar puncture (a spinal tap).
How To Treat Dehydration in Children
Self-Care at Home
i. To help a dehydrated child, provide
plenty of fluids while the child is unwell. This is known as fluid replacement.
ii. Suitable fluid replacement for
children under the age of two includes Pedialyte, Rehydralyte, Pedialyte
freezer pops, or any similar product designed to replace fluids, sugar,
and electrolytes (dissolved minerals such
as sodium, potassium, and chloride). You can buy these products at
most large grocery and drug stores.
iii. You can make your own oral rehydration fluid by following this
recipe:
1/2 teaspoon table salt
1/2 teaspoon potassium chloride (lite salt)
1/2 teaspoon baking soda
4 tablespoons sugar
Dissolved in 1 liter (a little over a quart) of water
iv. Children above the age of two years may be given flat
soda (soft drinks that have been opened and shaken to lose their fizz),
Gatorade, or water-based soups.
v. Give a few sips every several
minutes.
vi. Although it may appear that your child is vomiting
everything given to him or her, an acceptable amount of fluid is usually held
down.
vii. In children who have been weaned from formula or
breast milk, a BRAT diet (bananas, rice, apples, toast, and other basic
carbohydrates such as noodles or potatoes) can be started four hours after the
vomiting ends.
viii. After one to two days on the BRAT diet, gradually
transition to a normal diet. If you are breastfeeding, you may continue to do
so during your sickness.
ix. If you are bottle-feeding, you should resume
half-strength formula feedings after one to two days on Pedialyte, and then
return to full-strength formula feedings within another day.
Medical Treatment
1. If the dehydration is light (three
to five percent total body weight loss), the doctor may instruct you to
administer small sips of Pedialyte or other oral rehydration fluids to the
child. If your kid can drink fluids (and there is no hazardous underlying
sickness or infection), you will be sent home with instructions on oral
rehydration, advice on items to be worried about, and reasons to return or
phone again.
2. If your child is significantly
dehydrated (five to ten percent loss in total body weight), the health
practitioner may insert a tube into a vein (intravenous line or
"IV") to administer fluids. You may be sent home if your child is
able to take fluid by mouth after IV fluid replacement, improves following IV
fluid replacement, and has no obvious serious underlying sickness or infection.
When you are discharged home, you will be given instructions on oral
rehydration, close follow-up with your family doctor (most likely the next
day), and information on items to be concerned about and reasons to return or
call back.
3. If your child is seriously
dehydrated (weight loss of more than 10% to 15%), he or she will most likely be
brought to the hospital for continuing IV fluid replacement, observation, and
often additional tests to discover what is causing the dehydration. Medicines
will be given to children with bacterial infections, but antibiotics will not
be given to children with viral infections. Antiemetics and anti-diarrhoea
medicines are nearly never used to treat vomiting and diarrhoea in children.
Typically, such medication would prolong the diarrhoea.
