Definition: what is dehydration?
The dehydration corresponds to a consequent loss of water and of mineral salts of the organism. This one is often consecutive to an episode of acute diarrhea during an infection viral gastrointestinal. “You should know that the dehydration can have serious and life-threatening consequences, especially in babies under six months old, warns Dr. Jean-Louis Chabernaud. Moreover, she is at the origin of a fifty deaths each year in France and one frequent reason for going to the emergency room and hospitalization. »
Dehydration: what are the causes?
Dehydration and gastroenteritis: what are the symptoms?
At the tinythe dehydration often follows a episode of acute diarrhea. “The viral infection will lead to a water hypersecretion and electrolytes by the cells of the intestine (enterocytes), explains Dr. Chabernaud. This hypersecretion will cause a profound disturbance in the absorption of water: this is the acute diarrhea. »
In young children, gastroenteritis is manifested by:
- a acute diarrhea,
- of the nausea or some vomiting,
- a asthenia (fatigue) and a loss of appetite,
- of the stomach aches,
- of the fever but it is not systematic.
In infants and young children, the dehydration characterized by :
- a weightloss,
- unusual behavior, lethargy,
- a apathythe child is no longer in the exchange with others,
- a depressed fontanel which forms a hollow,
- of the dark circles under eyes,
- a lack of tears,
- a tachycardia i.e. an increase in heart rate,
- of the marbling on the skin,
- a persistent skin pinch,
- a rarefaction of urine : the child no longer wets his diaper,
- a dry mucous membranes : dry mouth,
- a skin pallor.
” The weightloss is one of first signs to watch out for, insists Dr. Jean-Louis Chabernaud. You should know that the amount of water in the body of a young child is 70% to 75% against 50 to 60% in adults. A baby is considered dehydrated from 5% weight loss. When she reaches 10% it can be serious. This is why children are always weighed to estimate their water loss. »
When to worry? What are the risks ?
The water and the mineral salts are essential to our body. These are involved in biochemical reactions, the proper functioning of our organs, the regulation of temperature, etc. In case of severe dehydration – i.e. if the weight loss is greater than 10% – the proper functioning of vital organs (heart, vessels, liver, brain, etc.) may be compromise.
“In the context, for example, of an infection with the rotavirus (note: one of the viruses causing gastroenteritis), it is possible that the dehydration occurs within hours. Dehydration can lead to tachycardia – that is to say an acceleration of the beating of the heart – then a drop in blood pressureand at worst disturbances of consciousness or even a coma. »
When to consult a doctor ?
He is important to consult his doctor or his pediatrician when the baby or young child throws up, suffers from severe diarrheahas fever, refuses to drink, rarely urinates or if his general condition deteriorates. “In infants, severe dehydration, that is to say reaching more than 10% of the weight, quickly arrived during a rotavirus infection, recalls the intensive care pediatrician. Also, it is necessary to watch your child carefully and if necessary to call the regulating doctor of 15 in order to get a medical opinion. »
In case of dehydrationit is essential assess the severity of symptoms.
- When this is moderate (i.e. less than 5% by weight), in first intention the child will be rehydrated with oral rehydration solutions (ORS).
- On the contrary, if the dehydration seems serious and if the baby’s condition deterioratese, you must quickly consult your doctor or call 15.
All other drinks or preparations (pure or sweetened water, sodas including Coke, carrot soup, rice water, etc.) are unsuitable at this age to prevent dehydration, reminds the specialist.
In case of moderate dehydration
The first step is to compensate for the loss of water and mineral salts giving the child a drink oral rehydration solution (ORS). “These sweet and salty drinks, whose composition is high in sodium, are readily accepted by infants up to two years of age. On the other hand, slightly older children appreciate their taste less”, specifies the Améli site.
At the same time, it is important to:
- weigh your child to monitor his weight,
- note the number of vomiting and stools in the context of gastroenteritis,
- count the number of bus bottles and the volume of liquid absorbed,
- closely monitor the baby’s behavior : if his condition deteriorates, consult without delay.
“Sometimes, alongside the oral rehydration solutionthe doctor can prescribe racecadotril (Tiorfan®), a antidiarrheal which will reduce intestinal hypersecretion and limit water loss, says Dr. Jean-Louis Chabernaud. But the most important thing is rehydration with ORS. »
How to use an oral rehydration solution?
Oral rehydration solutions come in the form of powdered sachets to be diluted in water. When prescribed by the doctor, they are covered by health insurance for infants and children under 5 years of age with acute diarrhea. Know that in an emergency, you can also be obtained from the pharmacy without a prescription.
Dilute the sachet in water then give rehydration solution to your child several times per hourin small quantitiesgradually increasing the doses.
If your baby is drinking mother’s milk (powdered milk), replace the bottle of milk with the rehydration solution. Then, reintroduce the usual milk and alternate with ORS as long as the risk of dehydration persists.
What if baby is breastfed?
If you are breastfeeding, it is advisable to continue breastfeeding as usual and to give your baby oral rehydration solution between feedings.
In case of severe dehydration
A significant dehydration (10% of the child’s weight) requires urgent hospitalization of the child in order to rehydrate intravenously (infusion).
What are the right steps to take?
Dr. Jean-Louis Chabernaud recalls that a vaccine against rotavirus exists. “In toddlers, dehydration is mainly caused by diarrhea and vomiting. However, the rotavirus vaccine is efficient, well tolerated and reduces cases of gastroenteritis. This vaccination is however not recommended in the French vaccination schedule. It is up to the attending physician to suggest it, depending on the infant’s risk factors.
Among the good reflexes to adopt from the outset, the intensive care pediatrician advises to always have in your first aid kit rehydration solution so that it can be administered quickly if necessary. “And above all, don’t forget about yourself wash hands frequently with soap, concludes Dr. Jean-Louis Chabernaud. Rotavirus is extremely contagious and you can be a healthy carrier. Hence the importance of respecting the barrier gestures ! “.