Dehydration: Signs and Symptoms

Weight Loss, Dark Urine & Thirst Indicate Dehydration

Dehydration prevention should be taken seriously by providing your child much needed fluids throughout the day, and throughout the week.

Dehydration prevention should be taken seriously by providing your child much needed fluids throughout the day, and throughout the week.

Surprisingly common

  • Kids become dehydrated very easily: dehydration can begin when an athlete loses as little as 1 percent of body weight. In a 70-pound child, that is less than 1 pound of weight lost through sweat. This about half a liter of body water lost. It is not uncommon for some athletes to lose as much as 5 to 8 pounds through sweat during a game or practice.
  • Dehydration affects performance: as little as a 2% decrease in body weight from fluid loss (e.g. 1.2 lb for a 60-lb athlete, less than 4 pounds for a 200-pound athlete) can lead to a significant decrease in muscular strength and stamina.
  • Dehydration affects cognition: a 3% decrease in body water can adversely affect cognitive function. In the sports context, this may affect a child's ability to pay attention to the coach or remember a play. A body water deficit of 2% to 3% can compromise sports performance, heat dissipation, and cardiovascular function.
  • Most kids are dehydrated playing sports: two studies of kids at summer sports camps showed that a majority were dehydrated, with 25 to 30 percent showed signs of serious dehydration putting them at increased risk of heat-related illnesses. Kids were dehydrated despite the availability of water and sports drinks, frequent breaks and coaches' encouragement to stay hydrated. The studies also showed that, once children become dehydrated, it is nearly impossible for them to catch up.
  • The majority of children are dehydrated before they start playing sports: the same studies at summer sports camps found that almost two-thirds of children were dehydrated even before they hit the field to start practicing. This puts the child at a disadvantage in the sport and increases their risk of heat illness.

Dehydration signs and symptoms
How to know if your child is dehydrated?

If your child tires easily and repeatedly during practices and appears irritable, or her performance suddenly declines, dehydration, and/or inadequate calorie intake may be the cause.

The following are also signs that your child may be dehydrated:

  • Thirstiness 
  • Headache [Note: could also be a sign of concussion] 
  • Dizziness [Note: could also be a sign of concussion] 
  • Tired or feeling weak 
  • Urine is bright yellow in color (urine should be almost clear) 
  • Apathy or lack of energy 
  • Grumpiness 
  • Trouble concentrating [Note: trouble concentrating could also be a sign of concussion] 
  • Nausea [Note: nausea could also be a sign of a concussion] 

The following are signs that your child is severely dehydrated:

  • Dry lips and tongue
  • Sunken eyes 
  • Bright colored or dark urine, or urine with a strong odor 
  • Infrequent urination 
  • Small volume of urine 

Progressive effect

The progressive effects of dehydration are serious. As a child becomes dehydrated, heart rate increases, blood flow to the skin decreases, and a body temperature can rise steadily to dangerous levels. To avoid a potentially life-threatening medical emergency,

  • Rapid weight loss represents a loss of body water. This can easily occur during the course of a youth sports practice or game. If a child losses weight within one practice or game, it is water that they lost, not fat.
  • A loss of just 1-2% of body weight (1.5 to 3 pounds for a 150 pound athlete) can negatively impact performance.
  • A loss of 3% or more of body weight can increase the risk for exertional heat related illness.
  • Athletes should therefore be weighed before and after warm weather practice sessions and contests to assess fluid losses.
  • Athletes with high body fat percentages can become dehydrated faster than athletes with lower body fat percentages while working out under the same environmental conditions.
  • All athletes have different sweating rates and some lose much more salt through their sweat than others. Additionally, some lose more water than others leading to increased levels of dehydration. As children mature into teenagers and young adults sweat rates increase and more salt is conserved.
  • Clothing, such as dark, bulky, or rubber protective equipment can drastically increase the chance of dehydration and heat illness.
  • Poor acclimatization/fitness levels, medications and fevers can all greatly contribute to an athlete’s dehydration problems.

What to Drink for Sports, What Not to Drink...Hydrate Before Sports, Re-Hydrate During and After Sports Dehydration

For most exercising athletes, the ideal fluid for pre-hydration and re-hydration is water. Water is quickly absorbed, well-tolerated, an excellent thirst quencher, and cost effective.

The use of a sports drink with appropriate carbohydrates (CHO) and sodium as described below may prove beneficial in some general situations and for some individuals.

Traditional sports drinks containing appropriate concentrations of CHO (6-8%) and sodium may provide additional benefit in the following general situations:

  • Prolonged continuous activity of greater than 45 minutes 
  • Extremely intense activity with risk of heat illness
  • Extremely hot and humid conditions
  • Traditional sports drinks with appropriate CHO and sodium may provide additional benefit for the following individual conditions: 
    • Poor hydration prior to participation
    • Increased sweat rate
    • Poor caloric intake prior to participation
    • Poor acclimatization to heat and humidity 
    • A 6-8% addition of CHO to water is the maximum that should be utilized. Any greater concentration will produce slow emptying from the stomach and a bloated feeling. 
    • The other ingredient that may be helpful is a low concentration ( 0.3 - 0.7 g/L) of sodium which may help with cramping. 
    • All fluids should be served cold to optimize gastric emptying. 

What not to drink during sports

  • Fruit juices with greater than 8 percent carbohydrate content and soda can both result in a bloated feeling and abdominal cramping. 
  • Carbonated beverages, beverages containing caffeine
  • Athletes should be aware that nutritional supplements are not limited to pills and powders; many of the new energy drinks on the market contain stimulants such as caffeine and/or ephedrine. These stimulants may increase the risk of heart or heat illness problems when exercising. 
  • Many of these drinks are being produced by traditional water, soft drink, and sports drink companies. As is true with other forms of supplements energy drinks or fluid supplements are not regulated by the FDA. Thus, the purity and accuracy of contents on the label are not guaranteed.
  • Many of the beverages which claim to provide additional power, energy, etc., have additional ingredients that are not necessary, some that are potentially harmful, and some that are substances actually banned by such governing bodies as the NCAA and the United States Olympic Committee. 

Hydration tips and fluid guidelines

In general, an athlete does not voluntarily drink sufficient water to prevent dehydration during physical activity so that by the time she becomes thirsty, she is already dehydrated. It is therefore important for athletes to drink before, during, and after practices and games.

Thus, the American College of Sports Medicine specifically recommends athletes:

  • Drink 16 ounces of fluid 2 hours before exercise. 
  • Drink another 8 to 16 ounces 15 minutes before exercise. 
  • Drink 4 to 16 ounces of fluid every 15 to 20 minutes during exercise. 
  • Drink 24 ounces of fluid after exercise for every pound lost during exercise in order to return to full hydration within 6 hours. 

The volume and color of your child's urine is an excellent way of determining if he is well hydrated. Large amounts of clear urine mean your child is hydrated, small amounts of dark urine mean that he needs to drink more!

The NFHS Sports Medicine Advisory Committee strongly recommends that coaches, certified athletic trainers, physicians, and other school personnel working with athletes not provide or encourage use of any beverages for hydration of these youngsters other than water and appropriate sports drinks that meet the above criteria. They should also make information available to parents and athletes on the potential harm and lack of benefit associated with energy drinks.

Thirsty? Think Salt!

You've heard the old saying that the human body needs 8 glasses of water a day to stay healthy. Did you know that was a myth? In fact, it is one of the biggest pop medical myths of our time. No one is quite sure where it came from and no scientist to date has been able to prove that 8 is the number. What we do know is that our bodies need fluids to function, water being one of them, and an important one since 80% of our body is comprised of water. However, to be "water balanced" we need salts (electrolytes), too, especially sodium and potassium, and some sugar, namely glucose.

Typically, we lose water and salt together in tears, sweat, urine and stool. As we go about a typical day with a normal diet that water and salt gets replaced just fine. But sometimes, in special situations, we can lose a bit more of water or salt such as with fever or gastrointestinal illnesses and we need more fluids than we typically need. Sports and warm weather are the two other special circumstances that put people at very high risk for becoming dehydrated and the people at most risk are kids. This is when we need to worry about becoming dehydrated and where rehydration with fluids, including sports drinks, play an important role.

The only other way to replace fluids when dehydrated is by an intravenous line and sometimes that is needed. However, with proper hydration before, during and after a sports workout or game, a child can be spared this simple yet often unsettling procedure.

Many parents don't know that sports drinks are designed as rehydration fluids, not for general use, so they end up not giving them to their children out of fear of all the "extra calories" they supposedly contain. It is true that extra calories might be an issue (and, for some kids, is an issue) if you gave sports drinks to your kids to drink during the day as regular hydration. But used for their intended purpose - to re-hydrate and replaced energy stores used during exercise - the extra sugar in a sports drink simply replaces the sugar your child uses up during exercise.

The Bottom Line - Think Hydration & Stay Hydrated

We're showing you this again, as urine color is an easy way to identify if your child is showing signs of dehydration.

We're showing you this again, as urine color is an easy way to identify if your child is showing signs of dehydration.

We live in an area that sees high temperatures throughout the football and cheer season. Dehydration prevention should be taken seriously by providing your child much needed fluids throughout the day, and throughout the week.  The worst thing you can do is allow your child to head off to practice without being properly hydrated.  So put a plan together and provide your child a mix of water and reputable sports drink to replace water and electrolytes.  Let's have fun and stay safe!

Story submitted by: Ron McFadden
Source(s): USA Footbal

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