Dehydration panic - please help

[FionaSH]

Hi, I think this sort of fits in the health section and the breast/bottle feeding section...

My DS had surgery on Monday on his mouth - as of Tuesday he was back eating his solids (!!!) and whilst I wasn't expecting him to resume his normal length and number of breastfeeds, I did think he'd try. He won't even look at the boob. He's never taken a bottle (unable to due to his cleft), and he's too young to reliably take milk or water from a cup. Currently we are syringing milk in, which is slow and laborious, and worst of all he hates it and gets really upset.

The dietician told us he needs to have 1.4l of water a day (!!!) I'm sneaking milk into his solids, and giving him extra snacks during the day to up the water content through his food.

His nappies are much drier than usual and this morning his wee was quite yellow. Not so yellow during the day today, but still not as much wee as usual. In terms of his behaviour he is fine in himself so I don't think he is dehydrated yet... the hot weather is really making me panic though.

Everyone is telling me not to worry, but I can feel the panic attack starting everytime we start syringing milk in and he just spits it out.

I don't really know what my question is, it just helps to write it down. I'm so tired after several nights on the childrens ward with him and finding it hard to be rational. Can he get all the water he needs through his food?

Any comments gratefully received.

how old is he?

doe he have wet nappies?

Lots of wet food will help - grapes, cucumber, jelly. Try making lollies from diluted juice or milk blended with strawberries.

Have you tried him with a straw ? They can drink from them from 6 months no problem with a bit of imitation. But if he is old enough for solids, he should be able to drink from a cup - either an open one (shot glasses are a great size to use) or a free flow one like the Tommy Tippee one with the flip spout. Show him you drinking, then offer it to him

That sounds like an awful lot of fluid - normally babies need more like a pint of milk a day

sorry, just read the nappy bit.

if his nappies are drier than usual, make contact with GP asap.

He's 6 months.
They're not very wet - he is doing some wee, but not very much.

well then he needs checking over. call GP surgery now and explain, they might get GP to call you before they finish for the day... otherwise NHS direct/24.

CMOT - good ideas but at the mo can only have purees, and can't use anything hard in his mouth like a straw for fear or wrecking the surgery he's just had done. Ill keep persevering with the cup. I have a variety of different ones in the hope he'll take to one of them. Using the doidy at the moment.

I've spoken with our nurse and she seems to think that he's getting enough from his food. We came out of hospital yesterday and I wish we'd stayed because at least the could have put him on a drip - but my husband and the rest of the family think I'm overreacting and am just depressed (which I probably am - but would still be worried about him dehydrating even if I wasn't!!!)

when did you speak to nurse?

if you press on his nailbed so that it turns white, when you let go, how long does it take to go back to normal?

also check how cold his extremities are and how moist in and around mouth is.

Blinks - it goes back to normal virtually straight away.

I spoke with the nurse this afternoon. I just feel confused because the doctor/dietician/nurse have all told me different things - 1.4l of water vs that's rubbish, yes he can get it all from food, no he can't, yes you can be discharged vs no stay another day. I don't know whether I should be worried or not!!

He's just refused his pudding, and he'll go to bed without a bedtime feed (he was having a bed time one and a dreamfeed), so basically he now won't have any liquid until breakfast and its 28 degrees in his nursery. (cue panic)

that's a good sign that he's sufficiently hydrated. have you tried spoon feeding?

keep checking urine output, how fast nail bed capillary refills, how moist outside and inside mouth is.

any concerns through night phone nhs direct/24 and they'll assess things.

have you got a portable fan for his room?

and wake him up when he would normally dreamfeed and offer fluids.

Still syringing milk, and spoonfeeding water. His wee is really dark yellow in his morning nappy, but he's just done a really runny poo?! He's weaned so usually his poo is formed. He's on 7.5ml calpol 4 times a day and 3ml of Ibuprofen 3 times a day - could this cause the dodgy poo??

Thanks!!

Don't know how old he is, but when DS had a dreadful tummy bug and couldn't hold food down and was also having runny poo, we basically had a couple medicine syringes and about every 5 minutes, we popped 5-10ml of liquid (watered down squash mostly switched off with just water) into his mouth. Time consuming, pain in the bum, but it kept him hydrated until he was up to drinking himself. Because it was small amounts at a time, he didn't bring it all back up either, which was a bonus.

calpol can cause runny poos.

Hope he is better soon....

We had this a few times with DS

I see form your OP hes too young to reliably use a cup, but if its ok for him to use to cup after the surgery I would just sit with him watching dvd etc and have a relaxed go at cupfeeding.

DS probably swallowed 25% and spat out the rest when we did this but he found ut less aversive than the syringe. Didnt bother teaching him not to spit etc, just let it be a game and happy he swallowed some.

We also used icecream whisked (so it was like the whipped icescream you get on a cone), whisked with tinned pears and its juice etc.

When he was at his worst I held a bottle with a fast flow teet over his mouth and let it drip in , pausing so he could swallow. takes a long time but if you sit cuddling him while watching a dvd it will probably seem less aversive than syringe again.

Also keeping at the back of your mind that if does get dehydrated/ stop wetting nappies, you can go to A & E and he will be put on a drip there, might help you to feel better (remove the worst of your fear IYSWIM)

Hope he feels better soon

Thanks guys I'm trying not to panic and just to focus on the fact he is alert, playing and doing wees, so even though he's having much less fluid than usual he is probably ok.
Keeping at the back of my mind that there's always a&e and a drip in the worst case scenario does help too.
He has his nose splints out on Tuesday so I'm hoping then he'll resume the boobfeeding. The splints are completely compacted so he can only breathe through his mouth, and I guess the idea of blocking his mouth up with a boob isn't much fun for him. Also been suggested it might remind him of the anaesthetic mask?! I don't know what sort of memory capacity a 6mo has??
The runny poo has thrown me a bit, but guess that prolonged use of paracetamol etc would play havoc with his poor tum.

If he's on an antibiotic, that can cause runny poo as well.