Understanding Hydration with a Blended Diet

Happy Nutrition and Hydration Week!

When we talk about Blended Diet there is often a focus on Nutrition. Hydration is less frequently discussed but is no less important. In this blog I’ll explain why hydration is important, discuss how much fluid is needed and what counts as fluid when using blended diet. Finally, I’ll suggest ways to keep track of hydration and highlight when to add in additional water.

Why is Hydration Important?

Our bodies are made mostly of water (50-60%) and every cell, tissue and system needs water in order to function properly. Dehydration occurs when the body loses more water than is taken in. Water is essential to: 

1.         Regulate Body Temperature: when the weather is warm or during physical activity the body regulates temperature by sweating.

2.         Digest Food and Absorb of Nutrients: water helps absorb nutrients, it helps food move through the intestine. Dehydration leads to constipation and abdominal discomfort.

3.         Transport Nutrients, Oxygen and Immune Cells: Blood, the body’s transport system is made mostly of water.

4.         Remove Waste and Toxins: Water is needed to help the kidneys flush out waste products through urine. Chronic dehydration, can cause urine infections and kidney stones.

5.         Maintain Skin Health: water is needed to hydrate the skin from within making the skin supple. Dehydration leads to dry or even broken skin. This is  especially important in wound healing.

6.         Cognition and Mood: even mild dehydration has been found to cause headaches and lead to fatigue and irritability

7.         Maintain Electrolyte Balance:  Sodium, potassium, chloride and magnesium are needed for nerve function and muscle contraction. Fluid is needed to keep these electrolytes in balance. Imbalances can lead to muscle cramps and fatigue.

 It’s vital to replenish lost fluid to maintain hydration and avoid dehydration.

How much fluid is needed?

General advice is for children to drink 6-8 cups of fluid per day (a cup is about 200ml). However, the amount of fluid needed per day really varies depending on age, gender, body size, activity levels and climate.  It’s also important to remember some medical conditions will affect the amount of fluid needed, for example, some children struggle to maintain body temperature meaning they sweat less, where as others may have excess losses, for example, in cases of chronic diarrhoea. Importantly, some prescribed medications will affect hydration, like medicines used to control excess drooling.  Your dietitian will be able to estimate your child’s fluid requirements using a prediction equation, taking into consideration these factors but this is just a good starting point, you will need to monitor for signs this the right amount.

What counts as fluid?

Many foods have a high water content and when blended will contribute to the overall fluid content of the blend. Any liquid added to the foods in the blending process such as water, milk, juice or commercial enteral formula also counts. It would be very time consuming to calculate the fluid content of every blend. As a general rule of thumb a blend tends to be 70-75 percent fluid. Water flushes given before, between and after blends and medications all count toward daily intake.  Even large volume medication will contribute toward daily fluid intake, especially in small children. Some families find giving water flushes about 30 minutes before a blended meal helps with tolerance.

Is my child well hydrated?

The easiest way to keep track of hydration is to look at the colour of the urine. Dark yellow or amber coloured urine is often a sign of dehydration, although some foods, vitamin supplements and medicines do change the colour too. Weeing less often than normal is another sign of dehydration. Other things to keep watch for are a sunken eyes, dry skin, dry mouth and lips, low blood pressure and being more tired or grumpy than normal. If you notice any of these signs ongoing or in combination its best to look at the hydration plan with your dietitian.

Additional fluids

There will be times when the amount of fluid your child needs is increased. When unwell with a fever, they will sweat more. In the summer months or on warm weather holidays too, extra fluid will be needed as more fluid is lost through sweat. A glass or two extra as additional water flushes over the day should help keep them well hydrated.  When fluid is lost due to diarrhoea and vomiting because of a stomach bug it’s a good idea to replace lost electrolytes too, your pharmacist will be able to advise you on oral rehydration salts which are available over the counter and can be given through a feeding tube.   

I hope you’ve found this a useful introduction to hydration- Happy Blending!