Fluid replacement is indispensable when children are sick, especially in the case of stomach ailments. Fluid replacement prevents dehydration and fluid deficiency in children. You can make your own liquid replacement according to the children's ER recipe, or buy Semper's fluid replacement at a pharmacy. Avoid Resorb for young children.
When does a child have fluid deficiency?
- At least on and off during the day, when a fever is low, they should be alert and happy and want to play. Sleeping more than usual is perfectly ok, but the child will sometimes wake up by himself.
- Pee. It can be difficult to judge based on nappy contents with lots of diarrhea, but you have to try as best you can.
- Have warm, dry skin with normal color for the baby. A little paler may be ok, but greyish-green pale and clammy - this is not ok!
- Has saliva in the mouth and if the baby cries tears should come.
Do not wait until the child has become dehydrated (ie becomes numb, stops peeing and has cold and sticky skin and no saliva in the mouth) before you start giving fluid replacement. Fluid replacement should be given from the first vomiting or diarrhea incident.
You can buy liquid replacement in powder form at the pharmacy. It is very important to mix in as much water as is necessary for it to be the right strength (measure!).
Recipe for own liquid replacement
- 1 liter of pure water (tap water in Sweden)
- 0.5 teaspoon salt (sodium chloride, common saline, no seltin or other salt variants, no flaked salt, this would be the wrong amount)
- 2 tablespoons powdered sugar
Then stir in the salt and the sugar dissolves. Taste! It should taste slightly salty and a little more sweet, but fully drinkable. You can mix in a little concentrated juice (2 tsp in the whole liter) for a better taste, but I'm not sure if I believe it will be better. Taste and decide what is easiest to get in your child.
Återigen: det är JÄTTEVIKTIGT att mäta så att det blir rätt koncentration av socker och salt i lösningen. Höfta inte! En lösning med för mycket socker eller salt kan förvärra situationen snarare än hjälpa den. En rätt blandad vätskeersättning är en livräddande och fantastisk medicin!
Liquid replacement from the pharmacy
Semper's liquid replacement from the pharmacy is well balanced and works well. It is just as important to mix it with the right amount of water as it is to mix the homemade liquid substitute properly.
Resorb is not recommended for children, and especially children under three years of age. It contains more sugar and less salt per litre than the recommended solutions which can interfere with the salt balance in the body.
How much fluid replacement does a child require to prevent dehydration?
If the baby vomits, start giving liquid replacement with a syringe without needle tip, five millilitres every five minutes. If you give too quickly the child may vomit because of it. After half an hour without vomiting, you can give ten millilitres every ten minutes and after an hour without vomiting you can give the baby fluid replacement in the baby bottle in small sips. If the baby is sick again: go back to five millilitres every five minutes.
If the child only has diarrhea, you can administer fluid replacement quicker from the start. Provide fifty millilitres of fluid replacement for each diarrhea incident the child has.
If the child only gets fluid replacement as a fluid, you need to provide the child's entire basic fluid requirement (that is, all the fluid the child would usually get via food and drink) plus you need to replace all the losses (diarrhea and vomiting) with the same amount of fluid replacement.
So there is a lot of fluid you have to administer! But if you do and the child is well-nourished, is peeing and has warm skin, you can feel like a wonderfully talented, wise and life-saving parent!
When should the child receive anything other than fluid replacement?
When the child is not vomiting and does not have very intensive diarrhea (ie has less than 8 diarrhea incidents / day), you can give fluid other than fluid replacement. Start giving liquids with sugar in, which gives the child some energy. Frozen liquid such as ice cream is also good. Pouches with fruit puree or porridge also work well.
Food can wait until the baby wants it. Liquids can't wait.
What to do if the child does not want anything?
Forcing the child. It's true. Forcing the child. We are not used to forcing our children into things in Sweden today, which is good. But when it comes to fluid intake in the case of stomach ailments, we need to. Let the child sit on your lap, hold in caring arms and insert the syringe (without needle tip), far into the mouth (it goes well behind the teeth row) and inject the liquid on the inside of the cheek. A little may be spit out, but most of it goes in. If you feel like the world's worst parent forcing your child, I just want to say: it's the opposite. You give the child what it needs even if the child does not understand this.
When should I go to the hospital?
- If a child under the age of two has very frequent diarrhea, 10-15 incidents / day or more, you should come to the hospital after a few days, even if you manage to give enough fluid replacement, this is to check that the salt balance in the blood is ok. In most cases it is and you can go home and continue with fluid replacement.
- If the child vomits so much that it is not possible to give any fluid replacement at all.
- Infants, that is, children under three months who have a lot of vomiting and diarrhea- we would like to assess at the paediatric emergency room.
- Children who have huge pains in the stomach, even if it is only for short bursts.
- Signs the child shows of dehydration (see above) which do not get better after a few hours of fluid replacement.
- Is the child very drowsy, difficult to wake, has cold, pale and clammy skin or just hangs like a rag doll.
- Has the child copious diarrhea with blood. If the child has a few diarrhea incidents per day with some blood in them, you should go to the health centre the next weekday.
- When you are no longer able to cope and have no one to help you at home. Then explain this at the hospital "I am alone and can no longer cope, I have to sleep!". Otherwise, it may be difficult for the paediatrician to understand that it is not possible to continue at home when the child is not dehydrated.
Share at work!
Speaking of point eight above: It is a full time job and more to care for a child with a stomach ailment at home. Make sure you two share the load if it is at all possible. A parent with the stomach flu can't take care of a sick child. In this case the other parent must stay home. If you are a single parent, you will need help from another adult.