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For a Successful School Year: Get Enough Fluids

September 21, 2016 by  
Filed under Uncategorized

by Mommy MD Guide Ayala Laufer-Cahana, MD

Is the water bottle your constant companion, or are you the type that trusts we can do just fine in between hydration opportunities? Does hydration status really matter all that much?

Clearly, dehydration is an unhealthy, dangerous state. Even mild dehydration – loss of just 2 percent of body weight in water – makes us less alert, affects our well-being, and of course makes us feel thirsty. But going without water for just a few hours hasn’t been studied much up until now.


A new study, led by David Benton, in the American Journal of Clinical Nutrition, recruited 101 undergraduate students, aged 18-30 years, and put them in a warm (86 °F, 30 °C) room for 4 hours, during which they performed cognitive tests.

Half the students got a 5oz drink of water 90 and 180 minutes into the experiment.

The students were not aware that what was tested was the effect of hydration on cognition – they were told that the experiment was about the effects of heat. The tests, which were repeated 3 times throughout the 4-hour study, included memory recall quizzes — in which the students were given lists of words, and asked to recall as many as they could remember immediately after, and then again 20 minutes later — attention tests and subjective mood scores.

Students that didn’t drink water forgot more words in both the immediate and delayed memory recall test, and had poorer attention scores. The students who got some water also reported less anxiety at the end of the test.

The 26 men and 24 women who had no water for 4 hours lost on average 0.72 percent body weight, but at 90 minutes into the experiment the participants lost just 0.22 percent body weight, which is very little. Nevertheless, memory was already affected.


This experiment suggests that even small changes in hydration can make a difference. Mood and alertness are the first to be affected when our body needs food and drink, and while mild changes in body fluids certainly don’t put us in danger of dropping blood pressure or shutting off our kidneys, proper hydration can help a student to perform at his best. Kids also lose a larger proportion of their water due to their smaller size and higher activity levels. The authors cite a few studies that prove that as a first-grader, a drink can help you think, and that 7-9 year olds that got an additional drinkperformed better on visual attention tasks.

As the school year starts, giving kids access to good drinking water, and reminding them to take that drink is a really simple way to make sure studying’s a little bit easier and happier. Hydration affects mood and if we can buy a little peace of mind with a glass of water lets do it.

By federal law, free drinking water has to be available to students during school meals. In between, kids should have access to plain water throughput the day, but policies change state-to-state and district-to-district.

Does your school have functioning water fountains? Unfortunately, due to old pipessome school fountains have been found to dispense water with unsafe lead levels.

So, as the school and academic year commence, encourage kids to pay attention to hydration, check that they have access to water that has been tested, and set an example by drinking enough yourself.

To a happy and healthy school year!

Dr. Ayala

Infectious Diarrhea

August 12, 2013 by  
Filed under Uncategorized

by Mommy MD Guide Stacey Ann Weiland, MD

Infectious diarrhea is one of the most common childhood diseases worldwide, particularly in babies between the ages of 6 and 18 months. While it can be deadly in developing countries, even in the Western world, infectious diarrhea can sometimes be serious enough for parents to seek the advice of a physician, or even require hospitalization for their child.

About 70 percent of all cases of infectious diarrhea are caused by viruses. The most common of these is the rotavirus, which is responsible for 40 percent. Less common, but sometimes more serious, are the bacterial-induced cases, which account for 20 percent, while parasites cause fewer than 5 percent.

Although episodes of infectious diarrhea can occur throughout the year, rotavirus outbreaks show a seasonal pattern in temperate climates, with infections peaking during the winter months.

Generally, the most serious complication of infectious diarrhea is progressive dehydration. Infants may suffer major fluid losses from a combination of continuous watery stools, vomiting, and fever. Infants who develop mild to moderate dehydration may be more agitated or irritable, have diminished tear production, dry mucous membranes, decreased skin turgor, sunken eyes, and decreased urine output. More severe dehydration can lead to lethargy, fast heart rate, deep breathing, cold limbs, and a near absence of urination.

Early and adequate oral rehydration with a glucose-electrolyte solution is the best prevention for complications of infectious diarrhea and hospitalization. Over-the-counter oral rehydration solutions (ORS), such as Enfalyte or Pedialyte, are recommended over and above cola drinks, sports drinks, or homemade mixtures of juice, sugar, salt, and water. Colas contain an excessively high concentration of sugar and little sodium and potassium. Home remedies may lead to severe alterations in a child’s fluid and electrolyte status.

ORS is best given in multiple divided doses over 3 to 4 hours. For infants between 5 and 9 kilograms (11 to 20 pounds), 2 milliliters can be given every minute (120 milliliters /hour). For infants between 9 and 12 kilograms (20 to 26 pounds), 2.5 milliliters can be given every minute (150 milliliters /hour). For infants between 12 and 15 kilograms (26 to 33 pounds), 3.0 milliliters can be given every minute (180 milliliters /hour). If there is no associated vomiting, larger volumes can be given at longer intervals (10 to 15 milliliters every 5 minutes, or 20 to 30 milliliters every 10 minutes). Even for hospitalized children, oral rehydration has proven superior to intravenous therapy.

Breast feeding, formula, and solid food should not be withheld from a child with infectious diarrhea, and should be restarted within 4 to 6 hours after rehydration is started. Further, parents should not switch formulas, change to lactose free, or soy, etc., because this may lead to future food intolerance.

Toddlers should be reintroduced to foods appropriate for their age, starting with complex carbohydrates such as bread, noodles, potatoes, and rice. Juices with a high fructose content, such as apple and pear juice should be avoided.

Probiotics have shown some efficacy in reducing the duration of diarrhea, particularly compounds containing the Lactobacillus species. Antibiotics are generally unnecessary except in certain bacterial- or parasitic-induced cases of infectious diarrhea. Zinc supplementation has undergone intensive investigation in both the treatment and prevention of infectious diarrhea. While recommended by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) since 2004 for children living in developing countries, results in the Western world remain equivocal.

Perhaps the best treatment for your child’s infectious diarrhea is prevention. As with many other infections, breastfeeding has been shown to protect against acute infectious enteritis. Good hygiene also has major benefits. Parents should always wash their hands after diaper changes and before handling food. Consumption of incompletely cooked meats, raw eggs, and unpasteurized milk also increase the risk of infectious diarrhea.

The rotavirus vaccine became available in the United States in February of 2006. Its introduction has led to a dramatic reduction in hospitalizations and emergency treatment due to rotavirus infections. Two different vaccines are currently licensed for infants in the United States, RotaTeq® (RV5) and Rotarix® (RV1). Both varieties can be given in combination with other vaccines and are often paired with the DTaP, Hib, Hepatitis B, Polio, and Pneumoccus vaccinations. The rotavirus vaccine is not a shot, but is given orally at 2, 4, and sometimes 6 months (depending on which vaccine is used).

Want to read more blogs by Mommy MD Guide Stacey Weiland, MD? Here’s her recent blog about raising children to be healthy eaters.

The information on MommyMDGuides.com is not intended to replace the diagnosis, treatment, and services of a physician. Always consult your physician or child care expert if you have any questions concerning your family's health. For severe or life-threatening conditions, seek immediate medical attention.