Magazine article The Exceptional Parent

Don't Let the Well Run Dry: The Importance of Water to Your Child's Health. (Ask the Doctor)

Magazine article The Exceptional Parent

Don't Let the Well Run Dry: The Importance of Water to Your Child's Health. (Ask the Doctor)

Article excerpt

Dehydration, the condition that occurs when the body has lost too much water, is a far more common problem, with far more consequences, than most of us realize. All day long we lose water in our sweat, urine, breath, and feces. This water must be replaced since each of our vital organs needs water to function and survive. Although we can live about a month without food, we can survive only four days without water.

The human body has a number of very sensitive mechanisms to detect and correct dehydration. If the body has more water than it requires, it will excrete some; if it does not have enough, the kidneys will hold some back through secretion of an antidiuretic hormone (a hormone that slows water loss).

Why dehydration occurs

Many of us can be chronically mildly dehydrated and not realize it. Unfortunately, many people do not take a drink until they are thirsty, and by then they are very dehydrated. Furthermore, they may choose a drink that dehydrates them further, such as soda pop that contains caffeine. It may taste and feel good going down, but soft drinks will cause even worse dehydration because the caffeine they contain removes more water from the body. Babies and small children are more likely to become dehydrated quickly because of their high metabolisms, small size, and relatively large surface area. More severe dehydration can occur if a child has a high fever or diarrhea, is vomiting, or is physically active in hot weather. Children with disabilities may be at an even greater risk for the following reasons:

* They may not be able to access water by themselves;

* They may need more fluid due to the medications they are taking;

* They may not be able to communicate their need;

* Swallowing may be uncomfortable or painful;

* Urination is difficult;

* They may not cognitively identify thirst messages;

* They may need more fluid due to problems with constipation; or

* They may be consuming protein supplements, which require extra water for the body to process.

Children with spinal cord injuries are at high risk of dehydration and urinary infections during hot weather. Even though they do not sweat below the level of their injury, they can still lose a great deal of water through their breathing. Be sure to check with your child's doctor or dietician for a recommendation on how much water he or she should drink during hot weather. Children with spina bifida and others who have frequent urinary infections should also be encouraged to drink plenty of water during hot weather, and should be carefully monitored for signs of dehydration.

Electrolytes are ionized salts, including sodium, potassium, and chloride, that are found in blood, body tissue fluids, and cells. An electrolyte loss can occur as a result of vomiting, poor kidney function, or excessive sweating in hot weather. A sports drink can help the body replace electrolytes (see recipe page 68).

If your child is mildly dehydrated most of the time, she may have cracked lips or dehydration headaches, and be irritable, lethargic, or act "spacey." She may have no appetite, a very common effect of dehydration. She may also have bad breath and increased tooth decay, especially if she is a mouth breather. Or she may just not feel good most of the time!

Preventing dehydration

If you suspect your child is not getting enough water, try keeping track for a week of all fluids he or she is consuming, including formula, juices, pop, broth, milk, tea, and water. Then consult with your doctor about exactly how much water your child needs, based on his or her body weight and particular situation. Check if any medications he or she is taking can lead to dehydration. If your child has heart, lung, liver, or kidney problems, this needs to be taken into account as well. If your doctor does not know the exact amount your child needs, consult a pediatric dietician. …

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