Why should we monitor good hydration in babies?
The child is not a miniature adult: it is a basic concept in medicine that should not be overlooked. Indeed, a baby is still physiologically immature: its needs must therefore be taken into account in a specific way.
Hydration is an aspect in which the baby is very different from the adult, in this article we will explain why and especially how to ensure the good hydration of children in order to ensure their health and oral rehydration solutions (ORS ) available .
The baby: an organism that is still immature
A newborn is comparable to a sponge: made up of 70 to 75% water, it is therefore highly hydrated, but it also dehydrates very quickly.
This rapid dehydration is due to the fact that the skin is still an immature organ in babies, so it is more permeable than adult skin for several reasons:
è At birth, the skin smooth and without folds, of low thickness. Over the years, layers of cells will be added to thicken and protect it.
è During the first years of life, the skin is bare, it is only from the age of 2-3 years that a hydro-protective film will settle down which will make the skin a little more impermeable.
è The skin surface area/weight ratio of an infant being very high, each loss of water will have more marked consequences in these individuals than in adults.
It is therefore necessary to monitor the good hydration of a child: dehydration can appear very quickly and have serious consequences!
The main causes of infant dehydration and the effects of diarrhoea:
The two most common situations leading to severe dehydration in infants are:
· Heat : in summer during the heat, the child sweats much more than an adult and loses a very important proportion of water compared to its weight.
· Various pathologies : acute diarrhea in infants, episodes of gastroenteritis, vomiting.
These pathologies result in a very rapid loss of water in the infant and if rehydration is not done quickly, the emergency can become vital and the child can quickly find himself in the pediatric emergency department.
Rehydration is rapid in children under 2 years old and can be fatal in a few hours, which is why you must know how to recognize the signs of dehydration in order to act as quickly as possible. During diarrhea, the oral rehydration solution in the form of a sachet is the most used solution containing sugar, sodium and potassium in order to replace the lost electrolytes and facilitate the absorption of liquids thanks to an isotonic solution.
Signs of dehydration in infants
Here are some tips for spotting dehydration in infants, many of which are physiological signs that are also found in dehydrated adults (for more information on the subject, you can consult our article: what are the effects of dehydration? )
The easiest sign to spot is the production of urine :
· Healthy babies produce a wet diaper every few hours.
· A dehydrated baby will have reduced urine output and will only produce a wet diaper every 4-6 hours. You will also find that the urine has a stronger smell or a darker color than usual, due to the fact that it is less diluted because there is less water in the body.
Significant weight loss may be due to dehydration :
· In case of mild to moderate dehydration, the child's weight loss will be between 3 and 9% of body weight.
· Weight loss of more than 9% of body weight will be a sign of severe dehydration.
The appearance of the fontanels :
They are generally aligned with the rest of the scalp.
A mildly to moderately dehydrated infant will have slightly sunken or sunken fontanelles.
· Observing deeply sunken fontanelles will be a sign of severe dehydration. (it is also possible to see noticeable pulsations at the level of the fontanelles in this case)
A change in the baby's behavior can also be due to dehydration:
· In the case of mild to moderate dehydration, a child may be lethargic, apathetic, more irritable than usual.
· Severe dehydration can lead to extreme drowsiness (difficulty waking the baby) but this can go as far as loss of consciousness and coma!
Other physiological signs are linked to dehydration:
· The extremities (hands, feet) are cold;
· Very few tears are produced when the baby cries;
· His mucous membranes are dried, sticky;
· The skin may appear mottled, mottled;
You may have an increase in heart rate (tachycardia) with slowing of the pulse (because there is less volume of blood to send so the heart beats faster to send what is left throughout the body)
The fold test on the child's skin can give clues to their state of hydration :
· In a hydrated infant, after gently pinching the skin, it immediately returns to normal.
In a dehydrated infant:
o In the case of mild to moderate dehydration: the skin may take up to 2 seconds to return to normal.
o In the case of severe dehydration: the skin takes more than 2 seconds to normalize or even remain wrinkled.
How to Hydrate a Toddler
Normally breast milk or baby milk solutions are enough to keep the child hydrated, but how to compensate for water loss if there is a lack of hydration despite this?
If the mother is breastfeeding: she must increase her own water intake so that there is more in her milk.
In other cases: when the child is fed with infant formula, first age milk: if the child does not finish the bottle, we can offer a little water but the problem is that infants, very often do not like water.
A few tips to fix this :
· Before 4 months: Try to make them drink water, regularly, in small quantities. Place it in the fridge beforehand to make it cooler: it will be better accepted by the baby because the cold reduces the pain in the gums.
o Be careful not to give too cold water which could cause diarrhoea!
· We can possibly give adapted herbal teas based on fennel or chamomile.
· In extreme cases you can try giving water by syringe.
Avoid all sugary drinks before 5-6 months: especially fruit juices
· From 5-6 months you can start giving squeezed fruit juices but not nectars which are too sweet.
· It is still possible, if the child does not accept the water, to put a few drops of juice in the bottle.
What about ORS (oral rehydration solution) in case of infant diarrhea
It's something you should always have at home: these are preparations rich in bicarbonates, carbohydrates, mineral salts that quickly rehydrate the child in extreme cases.
It is to be used in case of vomiting or diarrhoea: during the first hours, according to the indications of the pediatrician, it will be the only thing to give to the child because it is the only solution that the child will not vomit (if only water is given, the child will vomit it up).
This is presented as a powder solution to be poured into the bottle of water, once mixed the mixture is colorless.
These rehydration solutions are the equivalent of our Hydratis® tablets which work on the same principle for adult hydration. We advise nursing mothers to use Hydratis® pastilles to promote their hydration after consulting a health professional (doctor or pharmacist).
As far as children's hydration is concerned, skin hydration should not be neglected: after bathing, put on body milks suitable for children. Be careful not to give baths that are too hot or too long, which could have the effect of dehydrating the child.