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Community Paediatric Review Vol 15 No 3

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Community Paediatric Review Vol 15 No 3 Fluid Intake in Infants and Young Children Problems with too many sweet drinks Illness/Fever When children are unwell they may not feel like drinking Sweet drinks such as cordial, soft drink, sports drinks and Why water is important children are consuming spring or rain water, a fluoride or eating despite an increased need for fluids. This is an supplement may be necessary but this should be fruit juices are not necessary for children and excess Water has many important roles in the body. It helps appropriate time to offer flavoured beverages such as discussed with the child’s dentist. consumption can contribute to common nutritional c p r Community Pædiatric Review transport nutrients, maintains blood volume, regulates watered down juice or flat and diluted soft drink to problems. A NATIONAL PUBLICATION FOR COMMUNITY CHILD HEALTH NURSES AND OTHER PROFESSIONALS body temperature and removes waste products. Milk or milk products are essential for ensuring young encourage fluid intake and provide some energy children (over 12 months) have an adequate intake of key • Toddler Diarrhoea (kilojoules). Infants and young children: Juices and soft drinks are especially concentrated and nutrients such as calcium and zinc. However, too much Gastroenteritis/Diarrhoea some children may find it difficult to digest such large www.rch.org.au/ccch Sleep and Settling Development in Infants • Have a higher metabolic rate which increases heat milk may contribute to nutrient deficiencies as the child Maintaining hydration is critical in children with loads of sucrose or fructose. Managing toddler production, waste products and fluid requirements. will easily fill up on milk at the detriment of other foods. diarrhoea/gastroenteritis. The principle of fluid VOL 15 NO 3 SEPTEMBER 2006 It is widely known that an unsettled infant can What is sleep? diarrhoea may be as simple as removing fruit juice. • Have immature kidneys and do not concentrate urine Limit milk to 600ml/day and encourage children to eat a replacement is offering small amounts frequently. Clear be a major cause of stress for some parents. An initiative of the Sleep is a physical and mental resting state in as well as adults. varied diet. Cow’s milk should be offered in a cup, avoid • Dental caries fluids familiar to the child will be accepted but must be Not surprisingly infant sleep and settling is a Centre for Community which a person becomes relatively inactive and offering it in a bottle, as this promotes tooth decay and Regular consumption of sweet beverages contributes diluted to ensure a glucose solution of about 2%. An Oral major component for health professionals • May not be able to verbalise that they are thirsty and Child Health, unaware of their environment. It is worth excessive intake of milk. to tooth decay and poor oral health. Putting babies or Rehydration Solution (ORS) available from pharmacies working with families. Of interest is the debate unlikely to have independent access to beverages. Royal Children’s remembering however, that infant sleep is as young children to bed with a bottle also increases the over the counter, may be used. ORS helps to more about what techniques are appropriate for Hospital, Melbourne individual as the infant themselves. All these factors contribute to an increased risk of What milk is best? risk of decay. effectively restore fluid by replenishing electrolyte parents and children. Some organisations have Sleep serves as a restorative function for our dehydration in infants and young children. Full fat dairy products are recommended for children • Fussy eating balance. Be mindful that children may refuse some of questioned some settling techniques that could these because of the taste. If a child is breast fed then EXECUTIVE INDEX bodies and minds and is very necessary for Dehydration can be life threatening. Symptoms to be under two years of age, skim milk and reduced fat Always ask what type and volumes of fluids children be detrimental to an infant’s mental health this should continue during the period of illness. normal functioning during the day. aware of include sunken eyes, decreased urine output, milks should not be used for this age group. are drinking. Children may fill up on sweet drinks or and/or parent-infant attachment. Sleep and Settling 1 irritability and dry skin, mouth and eyes. Dehydration can milk and be less inclined to eat a variety of food. Sleep can be divided into 2 distinct stages. Between the age of 2 and 5 years, children do not Author: Development in When considering sleep and settling also contribute to constipation as the colonic contents development, it is important to understand the usually need the extra fat from milk and milk • Weight gain Tanya Lewis, Dietitian Children Infants 1) Non-rapid eye movement (REM) sleep – become dry and hard, making stools more difficult to products, therefore, reduced fat milks are appropriate Recent research shows soft drinks can contribute to parameters of sleep to be able to support the quiet sleep Youth and Women’s Health Service, South Australia Fluid Intake in Infants 5 pass. from 2 years of age. Skim milk should not be used for obesity and industry data suggests that soft drink family and plan an appropriate course of and Young Children It is during this stage that we lie quietly with a children less than 5 years of age. intake is increasing. Habits are formed at a young age action, if any, for the parent to follow. The Fluid requirements regular heart rate and breathing pattern.There is and we should be encouraging our children to be majority of parents already have an idea about The daily fluid intake for children 0 – 12 months old Children with allergies or intolerance to cow’s milk very little dreaming happening in this stage and drinking less soft drink and other sweet beverages. the importance of sleep; however it is the should be around 150ml/kg. After 6 months, a portion of should find a suitable high calcium replacement. Soy understanding of the child’s ability to self it is where the most restorative functions occur. milk is appropriate after 12 months if the child is Situations requiring increased fluid requirements this fluid is provided by solids and it is normal for fluid regulate that makes the process more difficult It is in the earliest months of life that the non- eating a varied diet. Reflection Questions intake to decrease. Hot/humid weather and activity for some parents. REM sleep divides itself into four stages. It is Children 1 – 5 years old should drink at least one litre Children playing outdoors or in a car on a warm day can 1. During hot weather do you regularly these stages that identify progress through What our children are drinking It is important to keep in mind that a parent’s each day. This includes water, milk on cereal and juice. lose high volumes of fluid and are very susceptible to discuss with parents the increased fluid expectations of sleep patterns may not reflect sleep, from drowsiness to a very deep sleep. According to the 1995 National Nutrition Survey, juice dehydration and heat stress. Thirst is not always the best Best fluid choices are described below. needs of their infants and children? the developmental ability of the infant to Stage I: This is a state of drowsiness, and is a was a popular beverage choice, with 85% of boys, aged indicator of hydration and children should be offered fluid Best fluid choices regulate themselves. To “sleep through the similar experience to what you might feel as between 2-3 year old, drinking juice (fruit or vegetable) on more regularly in the warmer weather, particularly if they 2. Have you recently reviewed your night from the day they are born” is an you are drifting off in a lecture or in front of the Breast milk is the best fluid for infants under 12 months. the day of the survey compared to 79% who consumed are active. knowledge of the clinical signs of unrealistic expectation in most cases. TV. You nod off and may miss some of the For the first 6 months, it provides all the nutrition the water. The average intake of juice in this age group was In hot weather, babies will usually naturally demand more infant needs. Infant formula should be used for those 388ml per day, far above the daily recommendation. dehydration in infants and children? fluids and it is acceptable to give formula fed babies small infants who are not breast fed. Cow’s milk should not be NEW Practice Resources Fruit juice contains the vitamins from fruit but it lacks the amounts of cool boiled water after the bottle if they seem 3. Do you currently discuss with parents the introduced as a beverage until the infant is 1 year old, Professionals now have ready access to evidence-based information on a range of early childhood fibre and variety children would be getting if they ate extra thirsty. Breast fed babies may need extra breast however, small amounts of cow’s milk may be used in range of problems that are associated concerns as a result of the Centre for Community Child Health’s new online Practice Resources fresh fruit. If children are drinking juice, it should be feeds and mother should maintain her hydration. It is not food (i.e. on breakfast cereal) after 6 months of age. series. The series is designed to bridge the gap between research and practice, translating limited to one small glass per day, preferably with a meal. usually necessary to offer water; however, occasionally with sweet drinks? evidence into easily understood, practical information.
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