Dehydration and diarrhea

What are the symptoms of dehydration?

Dehydration is a loss of body fluids, which are made up of water and salts. When sick children vomit or have diarrhea, they can lose large amounts of salts and water from their bodies, and can become dehydrated very quickly.

Dehydration can be very dangerous, especially for babies and toddlers. Children can even die if they are not treated.

What are the signs of dehydration?

• decreased urination (less than four wet diapers in 24 h)

• no tears

• dry skin, mouth and tongue

• sunken eyes

• grayish skin

• sunken soft spot (fontanel) on infant’s head

Healthy children can spit up, vomit or have a loose stool once in a while without being in danger of dehydrating.

What are the symptoms of diarrhea?

Diarrhea is a very common problem in childhood. Usually, it’s mild and brief. Sometimes, it can be severe, especially in infants.

A child has diarrhea if there are more bowel movements than usual, and if the stools are less formed and more watery than usual. A child with diarrhea may also have fever, loss of appetite, nausea, vomiting, stomach pains, cramps, and blood and/or mucous in the bowel movement.

How is it transmitted?

Diarrhea germs are easily spread from person to person, and especially from child to child. They usually spread readily among children who have not learned to use the toilet. The spread of the infection can be reduced if adults and children wash their hands carefully after every diaper change or toilet visit, and before preparing and eating food.

What causes diarrhea?

Many different germs cause diarrhea. Most commonly, it’s caused by a virus (such as Rotavirus) and so can’t be cured with antibiotics. Occasionally bacteria causes diarrhea. Examples include Campylobacter, Salmonella, Shigella and E coli. Some bacterial diarrhea can be treated with antibiotics, but the child usually starts to get better before the bacteria are identified.

What can happen if diarrhea is not treated properly?

Diarrhea can be dangerous if not treated properly because it drains water and salts from the child. If these are not put back quickly, dehydration can occur and hospitalization may be necessary. It is most important that the child with diarrhea continues to drink an appropriate quantity of fluids to avoid dehydration.

What are oral rehydration solutions?

They are exact mixtures of water, salts, and sugar. These solutions can be absorbed by the body, even when infection is causing the child to vomit.

They are available at drugstores in ready-to-serve preparations, frozen pops and powders.

How can you treat diarrhea?

At the start of illness:

If breastfeeding, it’s important to continue to breastfeed on demand and offer oral rehydration solution (ORS), according to the schedule below.

If not breastfeeding, continue to offer food and drink and give ORS as follows:

First six hours

• Six months and under 30 mL to 90 mL (1 oz to 3 oz) every hour.

• Six to 24 months 90 mL to 125 mL (3 oz to 4 oz) every hour.

• Over two years 125 mL to 250 mL (4 oz to 8 oz) every hour

• If the infant refuses ORS by the cup or bottle, give this solution using a medicine dropper, small teaspoon or frozen pops.

• If the child vomits, you may need to stop food and drink. But continue to give ORS using a spoon. Give 15 mL (1 tablespoon) every 10 min to 15 min until vomiting stops, then give regular amounts.

If vomiting does not stop after four to six hours, call your doctor or take your child to the hospital.

Six to 24 h: recovery stage

• Keep giving the oral rehydration solution until diarrhea is less frequent.

• When vomiting decreases, it’s important to have your child drink the usual formula or whole milk and regular food in small frequent feedings.

• After 24 h to 48 h, most children can resume their normal diet.

• Stools may increase at first (one or two more each day). It may take seven to 10 days or longer for stools to become completely formed. This is part of healing the bowel.

What should parents avoid giving their children if they have diarrhea or are vomiting?

DO NOT give sugary drinks such as: Kool-Aid, fruit juice/drinks, pop, Jell-O, sweetened tea, broth or rice water. These have the wrong amounts of water, salts and sugar. These can also make your child’s diarrhea worse.

DO NOT give over-the-counter medications to stop diarrhea. Some of these will prevent the body from getting rid of infection.

When should parents call their child’s doctor?

• your child has diarrhea and is less than six months of age

• your child has bloody or black stools

• your child is still vomiting after four to six hours

• your child has a fever: temperature greater than 38.5°C (101.5°F)

• your child has signs of dehydration:

  • decreased urination (less than four wet diapers in 24 h)
  • no tears
  • dry skin, mouth and tongue
  • sunken eyes
  • grayish skin
  • sunken soft spot (fontanel) on infant’s head

If diarrhea or cramping continues after five to seven days, your doctor may suggest a lactose-free formula or lactose-free milk until diarrhea improves.

Your doctor may suggest other medications or treatments.

Careful handwashing after going to the bathroom or changing diapers will prevent the spread of infection to others.