How To Manage Dehydration In Children

 

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.