Dealing with dehydration in Children

Water is vital for life. In fact 75 % of our body consists of water. There is no doubt why it is very important to drink water (and even other fluids) as the body constantly needs to stay hydrated. However, it is quite easy to lose fluids from the body. Sri Lanka, being a tropical island with sunny warm weather through the year, doesn’t help matters because those living here tend to lose more fluids from the body. This week’s edition of Health Capsule focuses on dehydration. Dr. Kosala Karunaratna, Consultant Paediatrician of the Lady Ridgeway Hospital, Colombo, elucidates our readers on how to keep children hydrated despite encountering obstacles like warm weather and disease.  

“Dehydration occurs as a result of the loss of fluids from the body. This can occur in a child when inflicted by conditions like diarrhoea, vomiting or gastroenteritis which is an inflammation in the stomach and intestines caused by microbial infections which leads to diarrhoea and vomiting,” explained Dr. Karunaratna. He further added that another way of the body losing its water is due to the extreme hot weather conditions which causes sweating. “Exposure to vigorous sports and playing a lot under the sun, without proper means of constant hydration, can lead to dehydration. When children suffer from fever they are more prone to losing fluids from their bodies. When a child suffers from fever he or she becomes reluctant to drink water and other fluids. In these situations the body can get easily dehydrated,” the Paediatrician mentioned.  

Signs  
According to Dr. Karunaratna, there is both a severe and mild form of dehydration that children have to be guarded against. However the mild form doesn’t cause that much of an issue. “Symptoms of the mild form of dehydration includes thirst. Usually urination takes place 6-7 times a day in children. The urine output decreases in children when they become dehydrated,” he added. Signs of severe dehydration include drowsiness, irritability, lethargy, dizziness, and headaches. It could even cause the loss of consciousness. Dry lips and skin along with sunken eyes should be enough of a sign to indicate that your child is dehydrated.  

ORS vs. Water?  
The problem of dehydration can be solved by constantly hydrating the body through liquids and fluids. This must be done whether the source of dehydration is due to a condition like diarrhoea or whether it’s due to a hot climate. “Hydration is important. While drinking lots of water is important for the body, when a child suffers from dehydration, just drinking a lot of pure water is not always the answer. In fact when a child is dehydrated the ideal fluid to give the child is the Oral Rehydration Solution (ORS) which is referred to as ‘Jeewani’. This is the best option as treatment,” the Paediatrician stressed. Why is ORS more ideal than water? Dr. Karunaratna explained that dehydration is not relieved by just pure water as it does not contain the useful electrolytes that enhance absorption in the body that contributes to better hydration. It is important that a rich content of electrolyte minerals such as sodium and potassium, glucose is given with the fluids.  

“Losing fluids is dangerous. This could directly affect the brain cells. Substances are absorbed by the small and large intestines of the body. The electrolytes coupled with the fluids given will enhance the absorption of water, increasing the efficiency of absorption of nutrients in the body,” he explicated. ‘Since the time of the cholera epidemic, ORS has come under the spotlight for proving itself as an efficient method of treating dehydration. “Water is lost from the gut, which releases excreta like water from a tap, when one contracts the disease. ORS proved a worthy medication during such an epidemic. It is still the best cure for dehydration. ORS contains sodium minerals and glucose in equal amounts. This facilitates water absorption in the body. If electrolytes were not provided with pure water, the water would not be absorbed fast enough,” added the doctor. “ORS is not very tasty. Children may refuse to consume ORS due to its taste. If the dehydration is not very severe, alternatives like soup with added salt and fruit juices can be given along with water. Pure water on its own will not be sufficient,” Dr. Karunaratna advised.  

ORS can be given in a volume to the volume of fluids lost by the child when dehydrated. If diarrhea and severe symptoms of dehydration are displayed, then a volume of 100 ml or so should be given. Saline would be provided as well in some cases depending on the severity.If it just a mild case of dehydration, 50ml of ORS would help hydrate the body back to health.   

How dangerous is dehydration?  
“While mild cases of dehydration do not impose huge threats to the health, the more severe levels of dehydration could affect the brain. Such conditions could become seriously dangerous. Not just the brain, but other organs would be affected too. This condition could even lead up to kidney failure,” he warned.   

If dehydration occurs solely due to hot weather, it is advised not to be exposed out in the sun for long periods of time and if so sufficient nourishment has to be given for the patient to stay hydrated. Water and fluids should be taken. If a child is sick and suffers from conditions like fever, there is a higher risk of getting dehydrated. ORS would be a good choice of fluid to provide during these circumstances. Sri Lanka being a warm country is enough of a reason to stay alert on how much water your body loses as it is easy to get dehydrated during warm weather.   

“ORS is a wonder to prevent or treat dehydration. King coconut water is a natural alternative to ORS and is said to be quite comparable to ORS. It is quite a refreshing drink as well. In Sri Lanka this is a drink which is rightly quite famous among the citizens. Sophisticated medicine is not always the answer,” the doctor concluded.