dehydration

Dehydration in children almost always happens as a complication of diarrhea and vomiting, especially if combined with fever - most commonly a viral gastroenteritis.

Diarrheal water loss from the child's system can be very rapid, because the infecting germs (bacteria) may either secrete a toxin that irritates the bowel and stimulates fluid loss into the stool or it may directly disrupt the machinery of the cell and cause active secretion of body fluids into the stool that way (viruses). Because of the rapidity with which the very young child can get into trouble, we are especially vigilant during a gastroenteritis infection.

Signs of dehydration which deserve an immediate call to your doctor include:

Direct signs of loss of body fluid:
- decreased urination - fewer than 6 wet diapers a day
- decreased tears
- decreased saliva - dry mouth or lips
Less direct signs:
- weight loss
- irritability
- sunken eyes
- "doughy" skin
- extreme thirst

Also call ASAP if there is blood in the stool, fever 102F or greater, or abdominal pain.

Dangerous dehydration is usually preventable if oral electrolyte solutions (Pedialyte®, Infalyte®, Ricelyte® and others) are started promptly and continued even in the face of vomiting. Start with oral electrolyte solution when the illness first begins, and check with your doctor or the office nurse for specific instructions for fluid use and resumption of solids early on in the illness so that they know what is going on and you have a plan of action. This is a good topic to discuss with the doctor or nurse at an early well baby visit.

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