Oral Rehydration Therapy
The goal in treating dehydration is to replace fluids in order to restore the levels of body fluids to normal.
A child who's mildly dehydrated due to overexertion will probably be thirsty and should be allowed to drink as much as he or she wants. Plain water is the best option. Also, the child should rest in a cool, shaded environment until the lost fluid has been replaced. If your child is engaged in prolonged vigorous activity, sports drinks containing sugar and electrolytes (salts) are a good option.
Children with mild to moderate dehydration due to diarrhea from an illness (such as gastroenteritis) should have their lost fluids replaced with a special liquid called an oral rehydration solution (ORS). This is available in many grocery stores and pharmacies without a prescription and is designed for kids who are dehydrated. It contains just the right combination of sugar and salts to help the intestines absorb what the body needs.
The replacement of lost fluids is known as rehydration, which is achieved by replacing the lost fluids using an ORS over the course of 3 to 4 hours. Start the rehydration process by giving your child 1 or 2 teaspoons (5 or 10 milliliters) of an ORS every few minutes. This can be done with a spoon or an oral syringe. Although this may not seem like enough fluids to rehydrate your child, these small amounts can add up to more than a cup (237 milliliters) an hour. If the child does well, you can gradually give bigger sips a little less often.
Even kids who are vomiting can usually be successfully rehydrated this way because the small frequent sips get absorbed in between the vomiting episodes. In addition, the correction of dehydration often lessens the frequency of vomiting.
In nursing infants, breastfeeding should be continued, even during the initial rehydration process unless they're vomiting repeatedly. The ORS can be given in between breastfeedings. For babies who are formula-fed, formula should be stopped during rehydration and restarted as soon as the child is able to keep fluids down and is no longer showing signs of dehydration. Changes in formula usually aren't necessary.
Other "clear liquids" often used by parents or recommended by doctors in the past are no longer considered appropriate for use in dehydrated kids. Drinks to avoid include: water, soda, ginger ale, tea, fruit juice, gelatin desserts, chicken broth, or sports drinks. These don't have the right mix of sugar and salts and can even make diarrhea worse.
Once your child is rehydrated, you can resume a normal unrestricted diet, including breast milk, formula, or milk. Resuming an age-appropriate diet early is essential in supplying your child with necessary calories and nutrients and can even reduce the duration of gastroenteritis.
Some old wives' tales about treating dehydration are not recommended. For example, the practice of withholding food for more than 24 hours is inappropriate and can be unsafe. Likewise, specific diets that have been commonly recommended in the past — such as the BRAT diet (bananas, rice, applesauce, and toast) — are unnecessarily restrictive and do not provide the best nutrition for a child's recovering intestinal tract. Also, over-the-counter medicines for diarrhea or vomiting are not recommended for kids, as they can have serious side effects. Appropriate fluids — not medicines — are the key to treatment of gastroenteritis.
Some dehydrated kids do not improve when given an ORS, especially if they have very frequent bouts of explosive diarrhea or frequent vomiting. When fluid losses can't be replaced because of ongoing vomiting, difficulty swallowing, repeated episodes of diarrhea, or other reasons, a child might need to receive intravenous (IV) fluids in the hospital.
If you're treating your child for dehydration at home and feel that there's no improvement or that the dehydration is worsening, call your doctor right away or take your child to the nearest emergency department.