Baby Dehydration - Preg Med

When it comes to a newborn baby, dehydration may mean something more serious than it does in adults, as their yet-to-mature systems may find it difficult to deal with the lack of fluids ^[1]. Infants may be prone to dehydration as their little bodies are more sensitive to fluid loss, even if it is just in small amounts ^[2]. For this reason, it is essential to watch out for the earliest signs of dehydration in babies and deal with the problem before it can lead to anything serious.

What causes dehydration in babies

Inability to feed properly in newborns

Studies have shown babies born to first-time mothers to be more prone to dehydration. It is believed to be linked to the mother being inexperienced at breastfeeding, as this leads to inadequate feeding, often causing the baby to get dehydrated ^[3]. In such cases, supplementary fluids and baby foods may be given to prevent any further problems.

Diarrhea

Diarrhea, one of the most common risk factor of dehydration, causes rapid loss of fluids from your baby’s little body, which may not be replaced as quickly ^[4]. A stomach infection is the most common cause of loose stools in newborns ^[5], but it may also result from a number of health problems and infectious conditions. Breast milk or formula intolerance, introducing new foods in the diet, and food allergies are other possible causes of diarrhea that is often accompanied by dehydration ^[6].

Vomiting

Another common symptom in babies occurring due to various factors, including stomach bug, Gastroesophageal Reflux Disease (GERD), food allergies, lactose intolerance and food poisoning ^{[7, 8]}, vomiting may dehydrate your baby due to excessive loss of fluids ^[9].

Having a fever or being in a hot climate may also make him dehydrated due to overheating and sweating as the body attempts to cool down ^[10]. Sometimes, teething, or an infection, some other oral condition or malformation may make it difficult for your baby to swallow, thus causing the problem ^{[11, 12]}.

How to tell if baby is dehydrated

Even though it is vital to detect dehydration in your baby at the earliest stage, it may not always be easy.

What are the early signs of dehydration in infants

Lesser number of wet diapers (dehydration often reduces the urine output) ^[13]
Darker urine ^[14]
Cracked lips and dry, pale skin ^[15]
Baby looking drowsy or lethargic, with a reduced activity level (seems unwilling to play, smiles less) ^[2]

Signs of severe dehydration in babies

No wet diaper in over 6 hours ^[15]
Sunken eyes ^[1]
Cold hands and feet
Sunken fontanels (the soft spots on the head) ^[16]
Dry lips, tongue, and mouth ^[17]
Tearless crying ^[18]
Baby being extremely fussy
Decreased skin turgor, or the skin needing a bit of time to get back to the previous state when you pinch it (this test is used by doctors to diagnose severe dehydration) ^[19]

How to prevent baby dehydration

Dehydration is associated with a number of health problems, from constipation and jaundice to even eczema and ear infections in babies. So, take measures to prevent extreme loss of fluids to reduce the risk of various other conditions as well.

In newborns

Your newborn baby cannot tell you when he is thirsty and if he has a dry mouth. So, it is up to you to make sure he is getting adequate fluids to stay hydrated, especially during the hot summer monthss and in case he is having diarrhea and vomiting ^[20]. Breastfed babies have to be nursed more often to make up for any fluid loss ^[15]. Also, make sure he gets enough foremilk (the thinner milk comes first while breastfeeding), as it has a higher water content ^[21].

Taking proper measures to prevent common cold, flu and infections in your baby, including staying up-to-date with all the vaccinations, go a long way in preventing diarrhea and vomiting, thus reducing the risks of dehydration ^[15].

It is also important to protect your child from getting exposed to extreme heat during hot weather. Keeping him out of direct sunlight and dressing him in soft, breathable clothes will help keep him cool.

In older babies

Older babies, who are already eating solid foods, can be given small amounts of water along with breast or formula milk. You may also consider diluting your child’s fruit juices (if he is having any) with water, but it is not recommended to increase the amount of juice given to him ^[1]. Carbonated drinks, sports drinks (including Gatorade ^[22]) and sugary juices should be avoided as they may be harmful ^[23].

Protecting your child from extreme heat and taking him for all the scheduled vaccinations is still as important to prevent dehydration.

What to do when your baby is dehydrated

Managing dehydration in breastfed babies

For a breastfed or formula-fed baby under 6 months of age, all you can do is to feed him more frequently, or, at least, continue his normal feeding schedule so he can get enough fluids to get rehydrated. It is never advisable to stop feeding or change the diet, even when your baby is vomiting or having diarrhea after a feed. Some experts recommend diluting the formula with water for better hydration and to make it easier to digest ^[23].

Dehydration management in babies over 6 months

Apart from giving small amounts of water to drink at regular intervals, babies over 6 months of age may also be given an oral rehydrating solution, such as Pedialyte, after consulting the doctor. The usual dosage is 0.5oz every 15-20 minutes, gradually increasing the amount according to the doctor’s instructions ^{[21, 25]}. An ORS can help to restore the reduced fluid, salt and sugar levels in your baby’s body ^[10]. A BRAT (banana, rice, applesauce, and toast) diet may be recommended for your child as the dehydration improves ^[23].

Make sure to contact your pediatrician or take your baby to the hospital as severe dehydration in newborn babies may require intravenous rehydration ^[1]. Sometimes, the doctor may also do a blood test to determine his electrolyte levels before prescribing IV fluids ^[23].

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