What are the symptoms of dehydration?

Dehydration is caused by a loss of body fluids, which are made up of water and salts. When sick children have diarrhea or are vomiting, 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.

What are the signs of dehydration?

• decreased urination (fewer than four wet diapers in 24 h)
• increased thirst
• no tears
• dry skin, mouth and tongue
• faster heart beat
• sunken eyes
• grayish skin
• sunken soft spot (fontanelle) on baby’s head

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

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, after going to the toilet, and before preparing and eating food.

What causes diarrhea?

Many different germs cause diarrhea. Usually, it is caused by a virus (such as rotavirus), so it cannot be cured with antibiotics. Occasionally, bacteria can cause diarrhea. Some examples of these bacteria include Campylobacter, Salmonella, Shigella and Escherichia coli. Some bacterial diarrhea can be treated with antibiotics, but children usually start 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 your child. If these fluids are not replaced quickly, then your child may become dehydrated and may need to be hospitalized. Children with diarrhea need to keep drinking the right amount of fluids to avoid dehydration.

What are oral rehydration solutions?

An oral rehydration solution (ORS) is an exact mixture of water, salts and sugar. These solutions can be absorbed even when your child is vomiting. The key is to give small amounts of ORS often, gradually increasing the amount until your child can drink normally. They come in different flavours to make them more appealing to children.

How can you treat diarrhea?

Children with diarrhea lose fluids quickly. An ORS can be used:

• to help keep children well hydrated when their diarrhea is serious.
• to help put back fluids when children show signs of mild dehydration.
• If you are breastfeeding, then keep breastfeeding on demand, and offer the ORS according to the schedule
• If a child vomits, you may need to stop giving him or her food and drink. But continue to give the ORS using a spoon. Give 15 mL (one tablespoon) every 10 min to 15 min until the vomiting stops and your child is able to drink. Then, give the regular amount of the ORS. If vomiting does not stop after 4 h to 6 h, take your child to the hospital.

The number of stools may increase at first (one or two more each day). It may take 7 to 10 days or longer for stools to become completely formed. This is part of the bowel-healing process.

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

Do not give your child sugary drinks, such as fruit juice or sweetened fruit drinks, carbonated drinks, sweetened tea, or animal milk.These have the wrong amounts of water, salts and sugar. They can also make your child’s diarrhea worse.
Talk to your doctor before giving over-the-counter medications to stop diarrhea. If your child’s diarrhea is very serious, do not offer plain water. Drinking only water may lead to low blood sugar or low sodium levels in your child’s blood.

When should parents call their child’s doctor?

Visit your child’s doctor if:

• your child has diarrhea and is younger than 6 months of age.
• your child has bloody or black stools.
• your child is still vomiting after 4 h to 6 h.
• your child has a fever with a temperature higher than 38.5°C (101.5°F).
• your child has signs of dehydration (as listed above).

If diarrhea or cramping continues after 5 to 7 days, your doctor may suggest a lactose-free formula or lactose- free milk until the diarrhea improves. Your doctor may also suggest other medications or treatments. Careful hand washing after going to the bathroom or changing diapers will prevent the spread of infection to others.