What are the Signs of Dehydration in a Baby or Child?

There have been some scorching hot days in the past couple of weeks that have generated many online articles and discussions around keeping babies and small children cool in order to avoid dehydration.  As paramedics, we do see an increase in really sick little ones from dehydration (and oldies too, by the way) throughout the summer months.  It is not only important to understand how to prevent heat illness (more on that later), but also how to recognise it.

So what do we need to know about heat illness?

Well first let’s talk about what it is. There are a couple of different stages that can range from mild to life threatening emergencies.

Firstly, heat cramps are common amongst children that although are painful are usually fairly harmless. They often occur when kids have been running around on a hot day and haven’t consumed enough fluid. You’ll know if this happens, as they’ll let you know due to the pain! If this seems likely, take them out of the sun and offer them sips of water. You can also massage/stretch their affected muscles if they will let you.

On the other hand, heat exhaustion starts slowly and if it is not treated quickly it can progress to heatstroke. Now, heat exhaustion is bad, but heatstroke is life threatening and can be fatal.

When a baby or child is experiencing heat exhaustion they will have some of the following symptoms:

• Drowsiness, sleepy and not waking for feeds
• Dry lips and mouth
• Vomiting and nausea
• Not having wet nappies or only a small amount of very dark wee
• Increased sweating
• Sometimes dehydrated babies have cold hands and feet
• Sunken fontanelle (the soft spot on the top of your baby’s head)

When this progresses to heatstroke, they have many of the same signs but are often more severe. The one thing that is different about heatstroke is that the children I have treated in the ambulance are no longer sweating. In fact their skin is hot and dry. Sometimes they are fitting or even become unconscious.This is a medical emergency and you need to call 000 immediately. Whilst you are waiting for the ambulance to arrive get them into the shade, remove their clothing and you can place some wet cool towels on their body, particularly on their head, neck, underarms and groin. Alternatively, you can spray them with mist from a hose. If they have a decreased level of consciousness or are vomiting, please place them on their side in the recovery position. YOU MUST NOT TRY TO GIVE AN UNCONSCIOUS BABY OR CHILD ANYTHING TO DRINK!!!

As always, prevention is the best course of action— offering your children plenty of drinks/iceblocks on hot days. For babies, offer the breast or bottle more often to keep their fluids up. Make sure to dress them is cool, light clothing and keep them inside in the hottest part of the day.

Remember—if in doubt, please seek medical help! YOU KNOW YOUR BABY BETTER THAN ANYONE ELSE. If it feels like it’s not right, then it’s not right.