Hydration in babies, children and adolescents

It is the medium in which all the chemical reactions of the body take place, it acts as a nutrient transporter and as a vehicle to eliminate waste products, lubricates and provides structural support to tissues and joints, and has a fundamental role in the regulation of temperature body, essential to avoid dehydration.

How we get dehydrated

The body loses fluids in different ways, since common functions such as breathing, sweating, urinating or defecating cause water to be lost. But, above all, what makes the difference in dehydration are environmental conditions such as temperature or humidity, in addition to the degree of physical activity. The dehydration is defined as the process of loss of body water and the most common among children is that it is produced by: frequent vomiting or diarrhea in childhood, excessive sweating or insufficient fluid intake.

It is estimated that 70% of the body weight of infants is made up of water, compared to 50% of an adult. The physiology of the baby is different from that of the adult, it has a less ability to sweat and eliminate substances in some waste lanes. We must also pay special attention to hydration of the smallest as they are not aware of being thirsty while they are entertained with pleasant activities or when they perform continuous movement, such as running, jumping, etc. where dehydration is most likely. Depending on the age, the child will need to drink more or less water.

Should Babies Drink Water?

The European Food Safety Agency (EFSA) provides guidance on water requirements for infants, since babies under six months of age obtain sufficient fluids with the water provided. This is more than 80% water, especially the first milk that the baby consumes each time he breastfeeds.

If the mother perceives that the baby is thirsty, breastfeeding will be enoughBabies do not need extra water, even in hot climates or periods of fever. Offering them water can reduce their feelings of hunger and they may not need as much milk, and this could hinder their growth. This is one of the reasons why the WHO recommends that boys and girls receive exclusive breastfeeding for the first six months of life.

After six months, when the supplementary feeding, you can start to offer water, especially in warmer times, although if breastfeeding is on demand, children will receive enough fluids and cover their daily needs, which the EFSA stipulates between 800 and 1000 ml of fluids a day. Although you should start offering water to the baby regularly several times a day, he will drink more or less depending on his thirst.

Hydration in childhood

As they grow older, it is important to insist more on drinking water, as babies are usually very willing to drink, as they can show their new skills, such as holding the adapted bottle or glass first and then the normal glass, something that works for them. very interesting and novel.

On the contrary, as they get older they show more interest in other activities and do not usually "have time" to drink. It is in this band where the EFSA stipulates drinking between 1.1 and 1.3 liters of liquids a day, and that between 800 ml and 1 liter come from water. Logically we do not have to be measuring every drop of water they drink, but we do have to offer water more often. If they drink between four and five glasses a day will be more than enough, but this is only an orientation, because if they drink water every time we offer it, they will drink the amount they need until they quench their thirst.

Hydration in adolescents

The biggest problem that we find among adolescents is not that they do not drink enough liquids, but that they substitute water for other types of drinks, usually rich in sugars. It is important to remind them that water should be the main drink and not soft drinks, juices, etc. so at home it will be the drink that we will offer both at meals and between meals.

In summer: be careful with hydration

In summer, vacations and the elderly increase the chances of possible dehydration among the little ones, because in these times sweat losses are multiplied by ten. We must pay attention to the warning signs:

• Dry mouth and lips
• That the child has not urinated for several hours
• Hollow eyes
• General weakness

On the contrary, if the child is active, has tear in the eye and urinates normally, they are usually well hydrated. But if the humidity is high and the temperature exceeds 30ºC, we will offer more liquids.

Special causes of dehydration

• Diarrhea and gastroenteritis: When you suffer from a gastric disorder, whether viral or bacterial, water losses occur that can multiply by eight, and the causes are vomiting and diarrhea. In this case, when water is not well accepted (vomiting even after drinking water), the best rehydration is with oral serum, thus recovering both mineral salts and water.
• Constipation: if constipation is part of the day-to-day life of some children, one of the first things we should pay attention to is the consumption of fruits, vegetables and vegetables, and the intake of water. All of them make the stool softer and more fluid and significantly improve constipation.
• Physical activity: o Increased physical activity in the form of games or outdoor activities increases dehydration, especially if they last one hour. Not only is water lost in the form of sweat, but in many cases it occurs as evaporation, which is less noticeable and is not associated with the need to drink fluids. Just because you don't sweat doesn't mean you don't have to drink.
• : high values ​​of glucose in the blood are partly eliminated in the urine, and this eliminated glucose is accompanied by large amounts of water to form urine. Therefore, poorly controlled and maintained glucose over time increases the risk of dehydration.

How to hydrate them correctly?

In addition to offering them water as the main drink, they should be part of the daily diet. Other valid options to hydrate is to consume broths, soups, milk if desired, but always take into account the thermal and humidity conditions by offering more water at higher figures.

• Babies under 6 months who breastfeed get enough fluids from the water provided by breast milk, they do not need additional water, even in hot climates or periods of fever.
• We must pay special attention to hydration of the smallest as they are not aware of being thirsty while they are entertained with pleasant activities or when they run, they jump ... moments when dehydration is more likely.
• During physical activity, not only is water lost in the form of sweat, but in many cases it occurs as evaporation, which is less noticeable and is not associated with the need to drink fluids.

Monica Carreira Diploma in Human Nutrition and Dietetics Master in Pediatric Nutrition