Fluid deficiency and dehydration in children

A child may have fluid deficiency when they have stomach illness or diarrhea. Give the child something to drink, preferably as soon as the child has become ill. Liquid is often enough, but sometimes the child needs fluid replacement.

Fluid deficiency occurs when the body loses more fluid than is supplied. The younger a child is, the more sensitive he is to fluid deficiency and dehydration.

symptoms

A child who has fluid deficiency or is dehydrated has one or more of the symptoms listed below. The greater the fluid deficiency the child has or the more dehydrated they are, the clearer the symptoms become.

Symptoms of fluid deficiency and dehydration are as follows:

  • The child is tired and hungry. They cannot play and you may not get the same contact with the child as you usually get.
  • The child becomes thirsty, but it may also happen that the child is not thirsty at all.
  • The child does not kiss as often as usual. The kiss can be dark yellow and smell strongly.
  • The child cannot eat.
  • The child gets dry lips. Even the inside of the cheeks can become dull and dry.
  • The child has a headache.
  • The child’s hair turns gray and they get dark circles under the eyes. The eyes may look sunken.
  • There will be no tears when the child cries.
  • The child is losing weight.

Children under one year can become more fussy and irritated than usual when they have fluid deficiency.

Symptoms of severe dehydration

One sign that the baby is very dehydrated is that the skin is not resilient. On a child under the age of three you can see it by gently pinching the skin of the baby’s stomach and pulling the skin outwards. The baby is dehydrated if the skin stays there and does not sink back quickly. Usually the skin should go back in less than two seconds.

In children who are about three years or older, you can do the same, but with the skin on your hand.

The child can become very exhausted if they have a severe dehydration. It is unusual, but the child can also become unconscious. Read more about dehydration further down in the text, in the chapter What happens in the body.

When and where should I seek care?

Most children who suffer from fluid deficiency do not need to seek care. The trouble usually goes away by itself when the child gets fluid.

Call medical help if your child appears to have fluid deficiency and you do not know if you should seek care. Then you can get help to assess symptoms or help with where you can seek care.

If the child appears to have severe fluid deficiency or dehydration, contact a health care center or an on-call reception immediately . If closed, seek care at an emergency room.

For children who are younger than two months and who have diarrhea and vomiting, you should immediately seek care at a pediatric emergency room.

What can I do for myself?

Give the child a drink often

Children need to absorb more fluid than usual if they have stomach upset or fluid deficiency for another reason. Therefore, offer the child a drink, preferably as soon as the child has become stomach-sick.

Give the child some fluid at a time, but often. The child may vomit if they drink too much fluid at once.

You can try to give fluid with a teaspoon if the child has difficulty drinking himself.

Avoid light products

Do not provide light drinks. They contain substances that can cause diarrhea.

Children up to the age of 3 can also get very low blood sugar levels if they are stomach sick and drink light drinks for a longer time. This is because the blood sugar value drops more easily in children who do not get enough nutrition, than in adults who do not get enough nutrition.

Try ice cream

The child can get an ice cream if they do not want to drink. But continue to offer the child fluid. Even if the child eats the ice cream, they still need liquid.

Continue breastfeeding or feeding with bottle

You who breastfeed or give the baby breast milk with a bottle should continue with it, but more often than usual and even if the baby vomits.

You who are breast-feeding can try to milk or pump from the breast, and give the milk with a spoon if the child does not want to take the breast.

Drop liquid in mouth

You can also use a special plastic syringe that is used to give medicines to children. Syringe or drop the liquid or breast milk to the inside of the cheek, then the fluid flows down the throat. Avoid spraying directly on the palate, as the child may have nausea. Syringes of various sizes are available at pharmacies.

Give two teaspoons of liquid every five minutes

Children who are vomiting a lot need to get two teaspoons of liquid about every five minutes. Two teaspoons is about 10 milliliters. Often children need more fluid than you think. A one-year-old may need just over a gallon of liquid for a day.

The child may need fluid replacement

Fluid replacement is best to give the child if the child is much needed or has severe diarrhea, regardless of the child’s age. The fluid replacement contains appropriate amounts of salts and sugars, which help restore the body’s fluid balance .

Children younger than one year should not receive flavored liquid substitute.

Sometimes the child may not want to drink the liquid substitute. You can then try to taste it with juice or a little concentrated juice.

Give the child fluid replacement until they become more vibrant.

Older children are not as sensitive to fluid deficiency and dehydration as younger children. Therefore, you can give an older child what they want to drink.

Liquid replacement for children is available at pharmacies. You can also mix your own liquid replacement if you do not have the opportunity to buy. 

How can I prevent fluid deficiency and dehydration?

The table shows how much fluid a child needs to receive per day. The child needs to drink more than the amounts in the table when the body gets rid of more fluid than it gets.

Here are examples of when the child needs to drink extra:

  • The child has stomach ailments .
  • The child has diarrhea .
  • The child has a fever. If the child has a high fever, even more fluid is needed.
  • The child sweats a lot.

The child may also need to drink extra if it is warm outside.

A good sign that the child does not have a fluid deficiency is that the child kisses frequently. Read more about children’s thirst and fluid needs .

Younger children are most sensitive to fluid deficiency

Children up to four years of age are more sensitive to fluid deficiency and dehydration than older children and adults.

Children younger than one year are extra sensitive. This is especially true for children younger than six months or who are premature.

Children younger than one year are also more easily affected by heat, as they find it more difficult to regulate body temperature. Therefore, give children under one year more to drink when it is warm outside.

Children who have some illness can be more sensitive

Children who have a chronic illness may be extra sensitive to fluid deficiency. Examples of such diseases are the following:

  • cystic fibrosis
  • type 1 diabetes
  • heart disease
  • liver
  • neurological disease
  • kidney
  • metabolic disease, also called metabolic disease.

Treatment

A child who has severe fluid deficiency or is dehydrated may need to receive hospital care. There, the baby gets fluid and salts through a small tube in the nose to the stomach, or sometimes directly into the blood via drip .

It is good to have information about what the child weighs and how the weight has developed in recent months. For example, you can include the child’s growth curve from bvc. Then it is possible to compare with what the child weighs during the visit.

What happens in the body during fluid deficiency and dehydration?

Fluid deficiency occurs when your body loses more fluid than it gets in you. Water and salts are essential to feel good, but they disappear from the body in case of fluid deficiency.

Shock due to low blood volume

Children under one year can quickly develop a severe fluid deficiency that develops into so-called hypovolemic shock. This means that the body is in shock due to low blood volume.

Having too little blood means that the organs do not get enough blood and energy. The organs are damaged when they receive no energy. When the brain does not get enough blood, the child becomes very fatigued and eventually the child can become unconscious.   

Younger children need a lot more fluid in relation to body weight than teenagers and adults need.

Influence and participate in the child’s care

In order to be involved in the child’s care and treatment, it is important that you understand the information you receive  from the care staff. Ask questions if you don’t understand.

Children should also be involved in their care. The older the child, the more important it is.

You have the opportunity to get help from an interpreter. You also have the opportunity to get help from an interpreter if you have a hearing loss .

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