What are the fluid requirements for a 10-month-old baby with moderate dehydration due to vomiting?

Fluid Requirements for a 10-Month-Old Baby with Moderate Dehydration Due to Vomiting

For a 10-month-old baby with moderate dehydration due to vomiting, administer 50-100 mL/kg of oral rehydration solution (ORS) over 3-4 hours for initial rehydration, followed by 60-120 mL of ORS for each vomiting episode, up to approximately 500 mL/day. 1

Initial Rehydration Phase

• For moderate dehydration, provide 50-100 mL/kg of ORS over 3-4 hours 1, 2
• For a 10-month-old baby (likely <10 kg), this equals approximately 350-700 mL total for initial rehydration 1
• Administer in small, frequent amounts (5-15 mL every 1-2 minutes) to minimize vomiting 2, 3
• If vomiting persists despite small-volume administration, consider nasogastric administration of ORS at 15 mL/kg/hour 2

Ongoing Replacement of Losses

• After initial rehydration, replace ongoing losses with 60-120 mL ORS for each vomiting episode (for babies <10 kg) 1
• Total daily replacement should not exceed approximately 500 mL/day 1
• Continue replacement as long as vomiting persists 1
• If the baby cannot tolerate oral intake despite small-volume administration, consider nasogastric tube administration 1, 2

Type of ORS to Use

• Use low-osmolarity ORS for all age groups and causes of dehydration 1, 2
• Appropriate commercial formulations include Pedialyte, CeraLyte, or Enfalac Lytren 1
• Avoid inappropriate fluids such as apple juice, sports drinks (Gatorade), or commercial soft drinks, which have improper electrolyte content and high osmolality 1, 2, 3

When to Consider IV Fluids

• If severe dehydration develops with altered mental status, shock, or failure of oral rehydration therapy 1
• If persistent vomiting prevents adequate oral intake despite proper administration techniques 1, 4
• If signs of ileus develop 1

Feeding During Illness

• Continue breastfeeding throughout the illness if applicable 1, 3
• Resume age-appropriate diet immediately after rehydration is complete 1, 2
• Avoid restricting food during the illness as this can prolong diarrhea 2, 5

Monitoring and Assessment

• Reassess hydration status after 3-4 hours of therapy 2
• Monitor for signs of improvement: moist mucous membranes, presence of tears, normal capillary refill, and improved alertness 3
• Weigh the baby to assess fluid status and response to therapy 3
• If dehydration worsens despite oral rehydration, seek immediate medical attention for possible IV therapy 1, 5

Common Pitfalls to Avoid

• Do not use anti-diarrheal medications in infants and children 1, 2
• Do not delay rehydration; start immediately when dehydration is recognized 3
• Do not use inappropriate fluids like sports drinks or sodas for rehydration 1, 2
• Do not withhold feeding after rehydration is complete 1, 2