Treatment of water and electrolyte disorders in infants

The article was professionally consulted by Specialist Doctor I Nguyen Thi My Linh - Neonatologist - Pediatrics - Neonatology - Vinmec Danang International General Hospital

Children are very susceptible to water and electrolyte disorders when there is any abnormal health condition and quickly fall into more serious consequences if not detected for timely correction.

Water is the main component in every cell of a living organism. Electrolytes are polar atoms, capable of moving across the cell membrane, both ensuring the stabilization of membrane potential and participating in vital activities. Specifically, electrolytes such as the electrically charged minerals sodium, potassium, calcium, phosphorus and magnesium, are important for nerve and muscle cell function. Therefore, water and electrolyte balance is one of the most important factors to maintain the stability of the homeostasis.
In young children, especially infants, compared with older children and adults, the ratio of water to body mass is still quite high. On the other hand, the infant's nutrition in the first days of life is completely liquid with formula and breast milk; At the same time, the ratio of skin area to body mass is large, and water and electrolyte balance problems are easily affected.

Electrolytes are found in every fluid-containing medium in the living body. Dehydration can upset the electrolyte balance in infants or young children, and conversely, deficiency or excess of specific electrolytes can also alter water distribution.
Children, especially infants, when all sources of water and electrolytes put into the body are completely dependent on other objects will be very susceptible to dehydration, due to their body size which is very small compared to the skin area. and metabolism is always taking place at a very fast rate. Since then, the water and electrolyte balance function needs to be maintained at a much faster rate than in adults.
Any health or medical condition, no matter how simple, can cause electrolyte disturbances in infants. Specifically, when the child vomits many times or with a large amount of the day, the child has diarrhea or high fever, stops suckling or sucks poorly... all increase the risk of electrolyte disturbances. Not only that, when the ambient temperature is too high, especially those in an incubator, making babies sweat a lot can also increase the risk of dehydration and electrolytes.

In addition, electrolyte disturbances will become common and will be difficult to correct if the child has an underlying medical condition. Specifically, diseases that affect the production of adrenal, thyroid and parathyroid hormones... lead to an imbalance in the regulation of sodium, potassium and calcium levels in the blood. Besides, if the child has congenital heart disease, kidney disease can make the body tend to retain sodium and water, causing edema and increased blood pressure. In addition, for children with cancer or in need of a bone marrow transplant, this increases the risk of infection and fever; Chemotherapy drugs also carry an increased risk of water and electrolyte imbalance.

Signs of electrolyte disorders are very different in each child's body. This depends on the cause of the illness and the accompanying health features. However, in most cases, a child with only mild electrolyte disturbances will usually cause no symptoms and be detected only on blood tests. The outward manifestations at this time are mainly located in the causes such as the child has an infection causing high fever, diarrhea, vomiting...
On the contrary, when the child is severely dehydrated, the child will reduce the amount of urine. or dark urine, the baby's skin loses its luster and elasticity, becomes more wrinkled, has pinching marks, and the skin color looks darker than usual. On examination, the child will have low blood pressure and reflexes become slower than usual. At the same time, severe electrolyte disturbances such as severe hyponatremia will cause lethargy, drowsiness, lethargy, muscle weakness, cramps and muscle contractions. Some children may develop shortness of breath, dizziness, and a rapid heart rate.
When parents notice any of the above unusual symptoms, especially if the child is sick or has a high fever, they should take the child to the hospital for examination and treatment as soon as possible.

Prompt diagnosis and treatment of water and electrolyte disturbances in infants is important. Severe dehydration and accompanying electrolyte disturbances can reduce blood and mineral flow to vital organs, including the brain, heart, and liver. In rare cases, this can cause brain tissue to swell or contract, causing seizures, a life-threatening disorder in the heartbeat, known as an arrhythmia.
Therefore, in addition to the signs mentioned above, the water and electrolyte disturbance in the newborn will be determined by laboratory tests with samples of blood and urine of the infant. From there, based on these results, the pediatrician will make an appropriate adjustment plan as well as treat the causes of this condition to help prevent complications.
Specifically, if a child is dehydrated, which is often accompanied by an electrolyte deficiency, parents and caregivers will be instructed to add extra water to the child by adding breast milk or formula. Due to the small volume of the neonate's stomach and still in the horizontal position, the risk of reflux is high, increasing milk intake will be achieved by increasing the number of feedings per day and the amount of milk fed per day. abstinence.

However, for infants who are not able to suckle, it is necessary to provide milk as well as artificial water and electrolyte solutions through a nasogastric tube to ensure adequate tolerability and a steady rate. continuity. Moreover, in the case of children with severe water and electrolyte disorders, especially with severe diseases or in premature and low birth weight infants, the absorption function in the intestinal mucosa has not been realized. Consideration should be given to maintaining intravenous fluid and electrolyte balance.
In short, the role of water and electrolytes is extremely important in every living organism. Particularly for infants, this condition needs special attention, especially when the child has serious comorbidities. At this time, parents should not arbitrarily leave the child at home, but should take the child to the hospital to be tested, adjust the water and electrolyte balance in time, and at the same time solve the accompanying diseases, prevent the progression. heavier.
To have more knowledge about raising children properly, parents should proactively update useful medical information on Vinmec.com website and immediately contact doctors and experts at Vinmec when needing support.