Re: how can one tell when a child is dehyrated

That's a very interesting and important question.
Dehydratation (i.e.fluid loss via diarrhea or vomiting)is a leading cause 
of death among children in third-world contries. And diagnosis of 
dehydratation in children remains rather difficult, and needs good 
medical skills.

In order to highlight the problem, let's consider that during the first 
year of life, an infant ingests or eliminates a much higher amount of 
fluids, when plotted against his wight, than an adult.

Diagnosis may be difficult. The younger the child, the more difficult the 
situation. Symptoms are different from adults. Thirst is not a symptom. 
Body weight is a key symptom, and especially its variation. The more 
critical the dehydratation, the more important the amount and speed of 
body weight loss. An other symptom is a delayed recoloration time: when 
you press with your thumb (gently!) on a baby's leg or forearm, the skin 
will become white and return pink in les than three seconds. Should this 
duration increase, this mean poor circulation, due to various conditions 
such as infection or dehydratation. ultimately, the child will become 
comatose, and eventually die.

In summary, dehydration is a "subtropical killer", mainly a consequence 
of infectious diseases (diarrhea, otitis, etc). Awareness of such a 
dangerous condition may prove to be difficult among babies or children. 
That's a challenge in sanitary education in the world.

Hope this helps.


Luc Ronchi, MD
Pediatric Anesthesia
General Hospital
Saint Nazaire (France)