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| |    The Importance of Fluids for Children with Sickle Cell Disease by Lewis Hsu, M.D., Ph.D. and William Muller, Ph.D reviewed by Laura Jana, M.D., F.A.A.P. In normal blood, the red blood cells that carry oxygen to organs and tissues are soft and round, allowing them to easily pass through tiny blood vessels. In sickle cell disease, however, the hemoglobin becomes stiff and pointed, a process known as sickling. The simple act of consuming extra water, however, can dramatically delay this effect. Even a little bit can make a tremendous difference--drinking 10 percent more water, for example, can slow down sickling by 1,700 percent. It is especially important for children with sickle cell to drink plenty of water because the kidneys--along with all the other organs--are damaged by sickle cells and cannot retain water very well. Since they urinate more than children without the disease, it is easy for them to become dehydrated if they don't drink enough to replace the water lost in the urine. What kind of fluids are needed? No surprise, water is the best fluid for children with sickle cell to consume. Other fluids like juice, milk, soup, fruit, or sports drinks are also fine to add some variation, as are popsicles. On the other hand, drinks with caffeine (cola, coffee), alcohol, or methylxanthine (a stimulant like the caffeine found in tea) are not a good idea. These ingredients make the kidney excrete more water into the urine. If your child is fond of cola or tea, try to limit him to no more than a couple of servings a day. How much should my child drink? That depends on his size. What pediatricians call the maintenance rate of fluids is a minimum to avoid dehydration, and half again this amount is even better. The table below shows how much an individual child should drink. Drinking more than the amount indicated is fine and may be necessary when the child is ill, exercising, or hot. In particular, when having sickle cell pain, make sure that he drinks at least the high end of the recommendation (1= times the maintenance amount). Metric units version Body weight: liters recommended range per day 5 kg: 0.5 to 0.7 10 kg: 1 to 1.4 15 kg: 1.2 to 1.8 20 kg: 1.4 to 2.2 25 kg: 1.5 to 2.3 30 kg: 1.7 to 2.5 35 kg: 1.8 to 2.7 45 kg: 2 to 3 55 kg: 2.3 to 3.4 65 kg: 2.5 to 3.8 75 kg: 2.8 to 4.1 English units version Body weight 8 oz. cups recommended range per day 10 pounds 2 to 3 25 pounds 4 to 6 30 pounds 5 to 8 45 pounds 6 to 9 55 pounds 7 to 10 75 pounds 8 to 11 100 pounds 9 to 13 130 pounds 10 to 15 150 pounds 11 to 17 175 pounds 12 to 18
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