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HOW TO DETECT AND PREVENT DEHYDRATION

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by Dr. Martin Belson

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   Keeping hydrated is always important, but as the temperature outside increases, parents should keep an even closer eye on their children’s fluid intake to prevent dehydration. Infants and children are more likely to become dehydrated than older children or adolescents because of several factors, including a smaller fluid reserve, a higher metabolic rate and dependence on others for access to fluids.



What are the signs and symptoms of dehydration in a child?

•    Urinates less frequently
•    No tears when crying
•    Dry, sticky mouth or tongue
•    Thirst
•    Headache
•    Sunken eyes
•    Sunken soft spot on the front of the head in babies (called the fontanel)
•    Lethargy (less active than normal)
•    Irritability (more crying, fussiness)
•    Dark urine (should be clear or very pale yellow)


How can I prevent dehydration in my child?

•    If a child has a sore throat, ease the pain with acetaminophen or ibuprofen. Cold drinks or popsicles can also soothe a sore throat while supplying fluids at the same time.

•    On a hot, dry day, children should start drinking before thirst develops and should rest from activity in a cool, shaded place until the lost fluid has been replaced.

•    If your child develops diarrhea, avoid drinks such as soda, tea, fruit juice (especially apple and orange), gelatin desserts, chicken broth or sports drinks. These beverages do not have the right mix of sugar and salts and can make diarrhea worse.

•    Breastfeeding should be continued for all nursing infants who have mild to moderate dehydration.


What should I do if my child shows signs of dehydration?

•    Replace lost fluids by using an oral rehydration solution, such as Pedialyte, Infalyte or Kaoelectrolyte (also available as popsicles), over the course of a few hours. These unflavored or flavored oral rehydration solutions replace water and salts lost during a bout of gastroenteritis.

•    Start the rehydration process by giving your child 1 teaspoon (5 milliliters) of an oral rehydration solution every one to two minutes. Use a spoon, oral syringe or medicine dropper. Slowly increase the amount of fluid you give every five to 10 minutes. Even children who are vomiting can usually be successfully rehydrated in this way because the small frequent sips get absorbed in between the vomiting episodes.

•    After your child keeps these small amounts of oral rehydration solution down, give 60 to 120 mL (two to four ounces) of oral rehydration solution for each episode of diarrhea or vomiting to a child weighing less than 10 kg (22 pounds), and 120 to 240 mL (four to eight ounces) to a child weighing more than 10 kg (22 pounds).

•    Breastfed infants should continue to be breastfed while receiving oral rehydration solutions.


When can my child start eating again?

•    Although oral rehydration solutions are very effective in replacing electrolyte and fluid losses, they do not shorten the duration of diarrhea or lessen the volume of stool. Early refeeding, however, can reduce stool output.

•    Therefore, once your child is rehydrated and tolerating the larger amounts of the oral rehydration solution, you should resume your child’s normal diet, which should include lots of complex carbohydrates (such as rice, potatoes and whole grain breads and cereals), lean meats, yogurt, fruits and vegetables, as well as the child’s usual milk source (breast milk or formula for infants and full-strength cow’s milk for older children).

•    Be sure to avoid fatty foods or foods/beverages high in sugars, such as juices, soft drinks and Kool-Aid.

•    Resuming an age-appropriate diet early is essential in supplying your child with necessary calories and nutrients and can even reduce the duration of gastroenteritis.


When should I call my pediatrician concerning dehydration in my child?

   Call for specific instructions when you first suspect that your child is becoming dehydrated. If your child’s dehydration does not improve – or worsens – call your doctor immediately.


DR. MARTIN BELSON, a practicing pediatrician, developed Kid Emergencies.com to provide a free resource to help parents keep their kids safe and healthy. The site is the winner of an iParenting Media Award for the Greatest Products of 2007. For more information, visit www.kidemergencies.com.


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