Good hydration is crucial for babies and children. But how can we reduce the risk of dehydration in this more fragile population?

 

Why is proper hydration important for children?

An infant's body is made up of up to 75% water. Around one year old, nearly 60% of water remains. This water is a child’s engine : it regulates its temperature, transports nutrients around its body and eliminates waste.

When children lose more water than they drink, whether through lack of intake or an overly rapid loss, the body goes into crisis mode. Their cells no longer function at full capacity, digestion may slow down, and, in severe cases, their general condition may deteriorate very rapidly.

Toddlers cannot express their thirst or satisfy it for themselves. Since they have a greater body surface-to-volume ratio, they are much more vulnerable to the serious consequences of dehydration than adults. The risks are all the greater in infants less than 6 months old.

 

What are the most common risk factors for dehydration?

Gastroenteritis

During gastroenteritis, the virus or bacteria directly attacks the intestinal mucosa, causing excessive fluid secretion in the intestine. The result: rapid water and electrolyte loss, often more marked in children with limited reserves.

How long does gastroenteritis last?

Gastroenteritis in children usually resolves within 3 to 5 days, with symptoms usually disappearing within the first week. Allow up to 7 days for bowel transit time to return to its normal rhythm and consistency.

Diarrhea and vomiting

Diarrhea results in frequent evacuation of liquid stool, while vomiting expels gastric contents before absorption. In combination or not, these two phenomena drastically reduce water and electrolyte intake, exposing the child to increased dehydration.

It's often these symptoms that lead to dehydration, whatever their cause (food intolerance or intoxication, side effects of medication, digestive disorders, etc.).

Other more severe risk factors for dehydration:

• high fever
• difficulty breastfeeding, refusal to feed or malnutrition
• overexposure to heat (e.g., heat stroke)
• excessive sweating
• burns
• severe infection (e.g., pneumonia or meningitis)
• chronic illness (e.g., diabetes, kidney disease, cystic fibrosis).

How long does dehydration last in children?

• Mild case: Dehydration may subside in fewer than 24 hours as long as the child receives regular fluids (water, rehydration solutions).
• Moderate case: Allow 24–48 hours of oral or, if necessary, nasogastric rehydration to restore fluid and electrolyte balance.
• Severe case: Recovery may take several days, often with a trip to the hospital for infusion and monitoring, until symptoms completely disappear and normal weight returns.

 

What are the signs and symptoms of dehydration in babies?

Here are some examples of signs and symptoms present in dehydrated babies or children.

• Thirsty or irritable: Even if he can't yet ask for a drink, a dehydrated baby cries more easily and is often grumpy or difficult to calm.
• Sunken fontanelle: This small, soft area on the top of the skull may appear "hollow" or flatter than usual.
• Rarely or never wet diapers: If urine is infrequent (fewer than 4 to 6 wet diapers per day), or if it becomes dark and concentrated, this is a sign that your baby is eliminating less fluid.
• No tears: If he cries, and you don't see tears, this is a warning sign.
• Sunken eyes or pronounced dark circles: The eye contour appears deeper and darker.
• Dry mucous membranes: Mouth, lips and tongue are dry to the touch.
• Skin fold: If you gently pinch the skin on the stomach or thigh, and it takes longer to come back into place than before.
• Quick weight loss: The weight posted during the last weigh-in is not reached or the baby seems to be losing weight.

What are the severe symptoms of dehydration in children?

Watch for these warning signs when dehydration is advanced. The situation can evolve very quickly.

• Extreme lethargy or somnolence: The child sleeps a lot, reacts very little or responds with difficulty when called.
• Crying without tears: Even when the child is crying hard, there are no tears.
• Faint, rapid pulse: You can feel the heart beating very fast and weakly under the child’s skin.
• Fast breathing or difficulty breathing: When children are breathing faster than usual, as if struggling to fill their lungs.
• Poor skin colouration: Grey, bluish complexion, skin cold to the touch; skin may appear pale or mottled.
• Very sunken fontanelle: This small, soft, supple area on the top of a baby's skull may be deeply sunken and fail to settle back in place.
• Cold extremities: Hands and feet are cold, even bluish.

 

When should you worry about dehydration in children?

The first warning signs are:

• Dry lips
• Crying without tears
• Fewer than 4 wet diapers within 24 hours
• Irritability or unusual sleepiness.

As soon as any of these symptoms appear, it's best to consult a healthcare professional immediately.

 

When should I go to the emergency room for a dehydrated child?

Moderate to severe cases usually require more stringent care, or even hospitalization. The administration of intravenous fluids, as quickly as possible, is sometimes required. With proper care, dehydration can be resolved fairly quickly, within a few hours or days. It mainly depends on the speed and quality of the treatment. If you have the slightest doubt that your child is suffering from severe dehydration, it's best to go to hospital immediately.

In the most severe cases, the following symptoms may be seen:

• Accelerated heart rate
• Low blood pressure
• Quick breathing
• Altered state of consciousness
• Seizures
• State of shock.

 

How do I rehydrate a child quickly?

Treatment is based first and foremost on restoring the fluid balance, i.e., ensuring adequate water and electrolyte intake. In milder cases, this can be achieved by administering oral rehydration solutions at home. Contrary to popular belief, juices and soft drinks are not good choices for restoring hydration in either children or adults.

Oral rehydration solutions are sold in pharmacies and come in a variety of forms: ready-to-drink solutions, powders, effervescent tablets or popsicles. If you're a parent, it's a good idea to get some of these solutions in advance, so you're ready when you need them.

A homemade rehydration solution: the secret to good hydration

You can make your own rehydration solution at home in a jiffy: mix 1 litre of clean water, 6 teaspoons of sugar, ½ teaspoon of salt and a pinch of baking soda, and then add a drizzle of lemon juice for flavour and a natural boost of potassium.

This homemade rehydration solution (also called Pedialyte) restores your child's essential electrolytes (sodium, potassium) lost during episodes of diarrhea or vomiting, while being gentle on your child’s stomach. Economical, with no colourants or additives, it is a simple and effective alternative for maintaining good water balance and preventing dehydration.

 

How to prevent dehydration

The best way to prevent dehydration is to eliminate its causes. Here are a few tips:

• Make sure your little one is drinking enough (water or milk, depending on age and needs) and eating well.
• Focus on infection prevention, including frequent hand washing.
• Avoid exposing your child to too much heat or sunlight. Babies under 6 months of age should never be exposed to either.
• If your child vomits or has diarrhea, consult a healthcare professional as soon as possible. If you have reason to believe your child is at risk of dehydration, immediately start rehydration measures.

Dehydration in children is not inevitable. By spotting the signs early, and offering appropriate rehydration as soon as the first symptoms appear, you can help preserve energy and health. Don't hesitate to seek professional help if your little one's condition doesn't improve within 24 hours, or if severe symptoms appear.