Dehydration happens when your body loses too much water and important salts. This can make you feel very weak and sick because your body cannot work properly without enough fluids.
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What Causes Dehydration?
- Vomiting or diarrhoea that makes the body lose fluids quickly
- Not drinking enough water or fluids
- Excessive loss of fluids through heavy sweating during high fever, or from burns
- In some diseases like diabetes, when the body produces too much urine
How Can You Tell If Someone is Dehydrated?
The signs of dehydration can be different depending on how much fluid has been lost. Here are some common symptoms:
- Feeling very tired or weak
- Eyes that look sunken
- In babies, the soft spot on the head (fontanel) may look sunken
- Skin that stays pinched after being gently pulled (loss of skin elasticity)
- Low blood pressure, fast heartbeat
- Breathing that is deep or fast
- Dry mouth and lips
- Little or no urine passed
Dehydration in Children Under 5 Years Old
Children lose fluids faster than adults and can become dangerously dehydrated quickly. It is important to assess the degree of dehydration in children by observing certain signs. This helps decide the right treatment.
| Signs to Look For | No Dehydration | Some Dehydration | Severe Dehydration |
|---|---|---|---|
| General Condition | Child is well and alert | Child is restless or irritable | Child is very sleepy, drowsy or unconscious |
| Eyes | Not sunken | Sunken | Sunken |
| Fontanel (soft spot) | Not sunken | Sunken | Sunken |
| Ability to Drink | Drinks normally | Drinks eagerly or thirsty | Drinks poorly or cannot drink |
| Skin Pinch | Returns quickly | Returns slowly (less than 2 seconds) | Returns very slowly (more than 2 seconds) |
How is Dehydration Treated?
Treatment depends on how severe the dehydration is. There are three main plans used by healthcare workers:
Plan A – No Dehydration or Prevention
- Give extra fluids at home such as oral rehydration salts (ORS), soup, rice water, yoghurt or clean water
- Continue breastfeeding if the child is breastfed
- Give zinc supplements to help the child recover faster
- Encourage frequent small sips of fluid, especially after vomiting
- Watch the child closely and seek medical help if the condition worsens
Plan B – Some Dehydration
- Give ORS in measured amounts over the first 4 hours (depending on the child’s age or weight)
- If the child vomits, wait 10 minutes then give the ORS more slowly
- Reassess the child regularly to check if dehydration is improving
- Start feeding the child while at the health facility
- Show the mother how to prepare and give ORS at home
Approximate ORS to give in first 4 hours:
| Age in Months | Weight (kg) | ORS Amount (ml) |
|---|---|---|
| Less than 4 | Less than 6 | 200 to 400 |
| 4 to 12 | 6 to 9.9 | 400 to 700 |
| 13 to 24 | 10 to 11.9 | 700 to 900 |
| 25 to 60 | 12 to 19 | 900 to 1400 |
Plan C – Severe Dehydration
- If intravenous (IV) fluids are not available, rehydration can be started by giving ORS through a tube into the stomach or by mouth
- ORS is given at a rate of 20 ml per kg of body weight per hour for 6 hours
- The child should be closely monitored every 1 to 2 hours for vomiting or worsening condition
- If the child does not improve quickly, urgent referral for IV treatment is necessary
- When IV fluids are available, 100 ml per kg of appropriate fluids (like Ringer’s Lactate) are given, divided over time with frequent reassessment
- Once the child can drink, ORS is continued alongside IV fluids
Important Advice for Parents and Caregivers
- Always give ORS after each episode of diarrhoea or vomiting
- Keep giving food and fluids during illness unless advised otherwise
- Zinc supplements should be given for 10 days to help recovery
- Seek medical help immediately if the child is very sleepy, cannot drink, or vomits repeatedly
- Watch the child closely during and after treatment to prevent dehydration from coming back
