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Dehydration in Children

By Elizabeth J. Palumbo, MD, Private Practice, The Pediatric Group, Fairfax, VA

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Dehydration is usually caused by excess fluid loss, such as from vomiting and diarrhea, and occasionally by inadequate fluid intake, such as when an infant does not take in enough milk through breastfeeding. Children who are moderately dehydrated are less interactive or playful, cry without tears, have a dry mouth, and urinate fewer than 2 or 3 times a day. Children who are severely dehydrated become sleepy or lethargic. Sometimes dehydration causes the concentration of salt in the blood to fall or rise abnormally. Changes in salt concentration make the symptoms of dehydration worse and can worsen lethargy. In severe cases, the child can have seizures or suffer brain damage and die.

Doctors examine children and note whether they have lost body weight. A loss in body weight over only a few days is very likely caused by dehydration. The amount of weight lost helps doctors decide whether the dehydration is mild, moderate, or severe.

Dehydration is treated with fluids and electrolytes, such as sodium and chloride, given by mouth. In severe cases, fluids given by vein (intravenously) or via a thin plastic tube passed through the nose into the stomach (nasogastric tube) are needed.

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