Treating Dehydration

It's important for parents to learn to recognize the early signs of dehydration and to respond quickly if they develop. Younger infants and children should be watched very carefully because they're more likely to become dehydrated than older kids or adolescents.

The goal in treating dehydration is to replace fluids to restore the levels of body fluids to normal. As with prevention, strategies may differ depending on the age of the child and the condition causing the dehydration.

An older child who's mildly dehydrated due to overexertion will probably be thirsty and should be allowed to drink as much as he or she wants. Plain water is the best option for the first hour or two. After this, the child might need drinks containing sugar and electrolytes (salts) or regular food. Also, the child should rest in a cool, shaded environment until the lost fluid has been replaced.

Kids who are dehydrated due to vomiting or diarrhea from an illness (such as gastroenteritis) should have their lost fluids replaced with a special drink called an oral rehydration solution (ORS). This is available in many grocery stores and pharmacies without a prescription and is designed for children who are dehydrated. It contains just the right combination of sugar and salts to help the intestines absorb what the body needs.

The replacement of lost fluids is known as rehydration, which is achieved by quickly replacing the lost fluids using an ORS over the course of a few hours. Start the rehydration process by giving your child 1 or 2 teaspoons (5 or 10 milliliters) of an ORS every few minutes. This can be done with a spoon or an oral syringe, or even in popsicle form. Although this may not seem like enough fluids to rehydrate your child, these small amounts can add up to more than a cup (237 milliliters) an hour. Even kids who are vomiting can usually be successfully rehydrated in this way because the small frequent sips get absorbed in between the vomiting episodes. In addition, the correction of dehydration often lessens the frequency of vomiting. If the child does well, you can gradually give bigger sips a little less often.

In nursing infants, breastfeeding should be continued at all times, even during the initial rehydration process. The oral rehydration solution can be given in between breastfeedings. For kids who are normally formula-fed or who eats solids, formula and foods should be stopped during rehydration and restarted as soon as the child is no longer showing signs of dehydration several hours later. Changes in formula usually aren't necessary.

Other "clear liquids" often used by parents or recommended by doctors in the past are no longer considered appropriate for use in dehydrated kids. Drinks to avoid include: water, soda, ginger ale, tea, fruit juice, gelatin desserts, chicken broth, or sports drinks. These don't have the right mix of sugar and salts and can even make diarrhea worse.

Once your child is rehydrated, you can resume a normal diet, which should include lots of complex carbohydrates (such as rice, potatoes, and whole-grain breads and cereals), lean meats, yogurt, fruits and vegetables, as well as the child's usual milk source (breast milk or formula for infants and full-strength cow's milk for older kids). But be sure to avoid fatty foods or foods high in simple sugars, such as juices and soft drinks. Resuming an age-appropriate diet early is essential in supplying your child with necessary calories and nutrients and can even reduce the duration of gastroenteritis.

It's also important to note a number of old wives' tales about treating dehydration are not recommended. For example, the practice of withholding food for more than 24 hours is inappropriate and can be unsafe. Likewise, specific diets that have been commonly recommended in the past — such as the BRAT diet (bananas, rice, applesauce, and toast) — are unnecessarily restrictive and do not provide the best nutrition for a child's recovering intestinal tract. Also, over-the-counter medicines for diarrhea or vomiting are not recommended for children, as they can have potentially dangerous side effects. Appropriate fluids — not medicines — are the key to treatment.

A few dehydrated children do not improve when given an oral rehydration solution, especially if they have very frequent bouts of explosive diarrhea or frequent vomiting. Kids who can't replace losses because of vomiting, difficulty swallowing, massive diarrhea, or other reasons, might need to receive intravenous (IV) fluids in the hospital.

If you're treating your child for dehydration at home and feel that there's no improvement or that the dehydration is worsening, call your doctor immediately or take your child to the nearest emergency department.