DEALING WITH DEHYDRATION IN SCHOOL CHILDREN

WHO defines dehydration as the condition that results from excessive loss of body water. It occurs when free water loss exceeds free water intake, most commonly due to exercise, diseases like diarrhea and vomiting or exposure to heat. The preferred method of rehydration in children is by mouth (oral). However, when dehydration is very severe and acute, nasogastric (ryles) tube inserted through the nose to the stomach or IV fluids become the first choice of treatment.

The summer season brings with it, scorching heat, followed by the months of July and August, which are humid to the core. A major health issue cropping up during this period is dehydration.

WHO defines dehydration as the condition that results from excessive loss of body water. It occurs when free water loss exceeds free water intake, most commonly due to exercise, diseases like diarrhea and vomiting or exposure to heat.

Children may present dehydration with the symptoms in varying intensities: –

  1. Dry cracked lips and tongue; Dry mouth
  2. Oliguria – a decrease in 24-hour urine output
  3. Low blood pressure and rapid but feeble radial pulse
  4. Mild fever with headache and/or nausea
  5. Muscle cramps and/or generalized body ache
  6. Lethargy and drowsiness and/or irritability
  7. Sudden unconsciousness shows severe/acute dehydration

PREVENTING DEHYDRATION IN SCHOOL CHILDREN

For Parents

  • Children should be encouraged to carry water bottles to school and sip water frequently. During extreme summers, a sipper with some lime juice or apple cider vinegar added to water may be given to the child, in addition to his usual water bottle.
  • Giving sugary snacks in tiffin should be avoided.
  • Certain vitamins like thiamin, riboflavin and niacin are essential and must be supplemented with the usual diet. Green vegetables and fruits are rich in vitamin B and C and minerals like zinc and selenium. Five portions of fruits and four portions of vegetables per day provide all vital vitamins and minerals.
  • Processed foods – trans fats or hydrogenated fats found in pastries, cakes, cookies and chips and other ready-to-cook meals must be kept to a bare minimum during summers.
  • Dairy products like milk and curd; fortified soya or coconut milk are healthy options for children. Tastier ways to encourage the child to have more of these include-milk shakes in breakfast instead of plain milk, fruit whips and flavored curd dips in lunch instead of plain curd.
  • Fizzy and aerated drinks should be discouraged. They are usually high in sugar and promote dehydration. Replace these with non-aerated drinks, fresh fruit juices etc.
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For school teachers

  • Allow the child to use washrooms every 1.5-3 hours which is normal during summers. Not permitting the child to go to the toilet leads him to suppress his natural urges and causes complications of dehydration like UTI.
  • Allowing children to have water frequently and in case of small children, encouraging them to take sips of water every 40-45 minutes keeps them hydrated.
  • Educating children and their parents on correct diet planning, healthy snacking and the importance of maintaining hydration by conducting workshops and orientation programs, helps a great deal in maintaining the health status of students at school level.

 

EFFECTIVE MANAGEMENT OF DEHYDRATION IN A CHILD AT SCHOOL

 

In order to manage dehydration, it is important to first assess the intensity of dehydration and accordingly take steps to cope with it.

Milder levels of dehydration can be managed within the school premises by giving ORS (Oral Rehydration Solution). ORS is a fluid containing salt, sugar, potassium chloride and citrate to replenish the lost water.

The preferred method of rehydration in children is by mouth (oral). However, when dehydration is very severe and acute, nasogastric (ryles) tube inserted through the nose to the stomach or IV fluids become the first choice of treatment.

The speed of rehydration varies with the age and body weight of the child and the severity and acuteness of dehydration.

Signs of successful rehydration include: –

  1. Passage of urine in relatively better volume
  2. Lack of thirst
  3. Improvement in blood pressure and radial pulse
  4. Reduction in dryness of oral mucosa- mouth and tongue regain moisture
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Fluids should continue to be administered to the child to maintain hydration until all objective and subjective symptoms of dehydration have improved.