Introduction to dehydration:

When children have vomiting or diarrhea, their biggest risk is often from fluid loss. The same can be true when children have fevers or respiratory infections. Dehydration is dangerous. It is the single leading cause of childhood death around the world.

What is dehydration?

Our bodies are more than half water. For babies, the proportion is even higher. More than 75 percent of their body weight is made up of water.

Each day, water is lost in the urine, the stool, from our mucus membranes, and through the skin. Each day this water must be replaced by what we drink and eat. (Food also contains a lot of water.)

Each day electrolytes, such as sodium and potassium, are lost in urine, sweat, and stool. They must be replaced by what we eat or drink.

If we don’t have enough body water, or if the concentration of electrolytes in that water gets out of balance, we are dehydrated. Our body systems begin to malfunction and shut down. Unless corrected, we can die.

How much fluid is lost each day? It varies from child to child, but on average, a healthy child who weighs

18 pounds might lose about 12 ounces of fluid over 24 hours.
13 pounds might lose about 20 ounces of fluid over 24 hours.
16 pounds might lose about 24 ounces of fluid over 24 hours.
20 pounds might lose about 30 ounces of fluid over 24 hours.
24 pounds might lose about 35 ounces of fluid over 24 hours.
32 pounds might lose about 40 ounces of fluid over 24 hours.
40 pounds might lose about 47 ounces of fluid over 24 hours.
60 pounds might lose about 55 ounces of fluid over 24 hours.
80 pounds might lose about 60 ounces of fluid over 24 hours.

Who gets dehydration?

Children with vomiting or diarrhea are most likely to become dehydrated. Both can increase the fluid losses and may decrease fluid intake.

Those with high fevers or rapid breathing are also at risk. Certain conditions, such as diabetes, can lead to dehydration.

Children become dehydrated much more rapidly than adults. Healthy babies lose (and hopefully replace) up to 20 percent of their body water each day. Healthy adults lose only about 5 percent of theirs.

Those who start out malnourished are at the highest risk from dehydration because they lack the reserves of a healthy child.

What are the symptoms of dehydration?

Children with mild to moderate dehydration may have dry mouths, fewer tears when they cry, fewer wet diapers, darker urine, and a sunken soft spot. They will likely be less active than usual.

As dehydration worsens, children usually become more irritable and then lethargic. The pulse grows faster and weaker. The eyes will be very sunken and the lips and mucus membranes very dry. The skin may wrinkle. Urine decreases even further. The hands and feet may become cold or blue.