While I’m not the almighty authority on such a topic, nor is it my bread n’ butter specialty, I feel compelled to share some basic insights on seizures in infants and children. Plus man, November is Epilepsy Awareness month. I got your awareness right here!
This will not be an exhaustive and comprehensive look into this problem. Rather, the intent of this post is to help parents of children with seizure problems eliminate one simple and frequent cause – what I believe to probably be the most prevalent and easy-to-correct of all causes… low sodium levels. This article will also highlight some important features of human physiology that can be useful in general health and well-being, and hopefully keep parents from doing dumb shit, like restrict sodium in their child’s diet (or their own diet, especially while nursing) or constantly encourage water consumption on par with the growing compulsive drinking trend.
Like most things I write about, at first glance this will seem too simple to possibly be true – especially for a parent who has gone through several doctors and heard an endless array of complex medical explanation for their child’s disorder (explanations that quickly brush aside the primary focus of this article as being the cause of seizures – hyponatremia or low sodium levels). But I’m EXTREMELY confident that a little at-home experimentation with some of the basic principles I’m about to discuss is very worthwhile.
It’s known that hyponatremia and water intoxication is a growing trend in the United States, and is presumably a growing trend elsewhere too. Some have likened it to an epidemic. Likewise, the presentation of seizures and some of the early warning signs of seizures when hyponatremia is present is extremely high. If you were an infant with hyponatremia in one study done, your chances of having seizures would have been precisely 41 out of 60. That’s astronomically high.
The problem is that hyponatremia, or low sodium levels, is something that is detectable only with a blood test. -Emia of course referring to blood. The thing is, blood levels of sodium are not constant, and are ever in flux. A kid, or an adult, could very well have hyponatremia for a couple hours in the morning and then actually have HYPERnatremia later on in the day. Trying to monitor such a thing with blood is not very useful, and not even really necessary as you can get a pretty crude measure of the sodium concentration of the extracellular fluid (which includes the blood) just by monitoring urine color, frequency, and concentration – and probably body temperature and the warmth of the extremities as well, as cold hands and feet and and hypothermia are next to inseparable from hyponatremia. It may not be as precise as a blood test, but it’s practical and can be monitored any time day or night. A simple drop of urine from a soiled diaper onto a $21 tool called a refractometer is more than enough to get a ballpark measure on blood sodium levels, simply by testing the amount of dissolved solids in the urine. Generally anything below a brix of 3.0 is in the danger zone for hyponatremia and seizures, although it’s unlikely that hyponatremia would be severe enough to trigger a seizure until urine brix fell below 1.0.
Of course, we live in the day and age of turning everything over to a medical doctor to solve, and I understand that seizure seems to be too complex of a thing to figure out on your own, as a parent. But you have a huge advantage. You are around your child 24 hours a day. Your doctor has to figure everything out in a quick visit with no observation of what your child eats and drinks, no monitoring in changes in urine concentration or body temperature throughout the day, and no observation of the radical changes that occur in urine concentration (and therefore the extracellular fluid) that takes place all day every day. You, as a parent, can monitor these things and make simple minor changes that can completely eradicate hyponatremia all the time. That’s important. It only takes one big dive into low urine concentration to possibly trigger a seizure in an infant or young child. And your child may not be in that state at all when getting blood drawn at the doc. Hyponatremia thus would rarely look like a culprit, but in my experience in working around this issue and seeing how valuable a higher urine concentration can be, and how common it is to have a “crash” below 3.0 brix one or several times per day, there’s simply no way that it can be a rare cause of seizure in children like it is presumed to be.
Hey man, peeing is believing.
Rather, from my point of view, hyponatremia should be assumed to be the cause of infant seizures until proven otherwise. A simple blood test is not proof otherwise any more than one random urine sample that happens to have plenty of salt in it is proof that hyponatremia has nothing to do with this disorder. I think this should be the first thing to be addressed, as a parent of a child who has developed seizures, because it can be corrected easily, simply, at home, with no medical interventions, drugs, barbaric brain scans and other forms of poking and prodding. I mean make sure, REALLY MAKE SURE, that it’s not the cause before you go down any other routes. Without further ado, here are some useful and very clear, pun totally intended, tips. You don’t have to do all of them per se. You can pick and choose what’s reasonable to you…
- Don’t give an infant with seizures plain water, especially when the kid is cold and peeing frequently with pale-colored urine as it is. EVER!!!
- If you are giving a kid formula, be very careful about adding too much water to the formula when mixing. To the formula, add a tiny pinch of salt. If you want it to be more precise, add enough to where the formula is somewhere in the neighborhood of 0.1-0.2% salt – or 1-2 grams salt per liter (one infant formula I just looked up has 725 mg/l – so not a huge increase). Further still, you can add a little cream or sugar to the formula to make it increasingly calorie-dense, which also assists in increasing extracellular sodium levels and might be a safer way to do it because excess salt can cause kidney problems in infants if you take that too far. To prevent calculation mistakes, remember to multiply the sodium content shown in the label by 2.5 to get the amount of salt in the formula to see how much salt is in the formula per serving.
- If you are breastfeeding and that is all the child is getting, that still doesn’t mean that your milk is adequate or is to be worshipped as the perfection of nature or something. It may need added salt or increased calorie-density in the form of added cream to be good enough to prevent hyponatremia in your child, especially if you yourself urinate frequently, have a low body temperature or feel cold a lot of the time, have a history of dieting, drink more than a liter/quart of beverages per day (water being the worst from a hyponatremia perspective) in addition to the water you get in your food, or shy away from salty foods/restrict sodium.
- Better yet, increase the quality of your own breastmilk by increasing your intake of calories, carbohydrates, and salt in proportion to your total fluid intake. The total fluids in your body will thus have a stronger concentration, including your breast milk. Keeping yourself warm all the time with some good yellow color to your urine and a brix above 3 will almost certainly increase the octane of your milk.
- Monitor the warmth of the hands and feet of the infant. Add calories and/or salt to the food they are receiving to get them warmer. This basically increases the ratio of food to water – a small shift can be very powerful.
- Put a spoonful of a sugar/salt mixture under the tongue in roughly a 10:1 ratio if you suspect a seizure coming on, notice a sudden drop in urine concentration or body temperature, etc. Be careful with giving an infant salt straight like this. It should not be abused but should be reserved for emergency seizure prevention.
- Take note of the time of day/night seizures are most likely to occur, and give added salt and calories as a preemptive measure.
- Measure urine concentration with a refractometer and try to get urine concentration above a brix of 3 – into the no-seizure zone. Even a slight increase from 1-2 brix might be enough to eliminate seizures though.
- Salt the bathwater. Salty water has known beneficial properties. The salt in the bath shouldn’t really be looked at as some medicament, it’s just that taking a bath in straight water, or drinking water while in the bath like the picture shown, can aggravate hyponatremia. Salt in the water helps keep that from happening.
- Make this your own research project, and don’t necessarily follow any of the prescriptions and ratios and stuff I have laid out above. I have not spent a lot of time with infants or even seen an infant have a seizure. So I don’t know enough to correct this precisely with infants. I only do this with older kids and adults but many of the same rules apply. Armed with a few basic principles you’ll be able to figure this out on your own to a much greater level of precision than anything I can put into a general prescription even if I had surrounded myself with seizing infants for an entire decade.
As a 2nd reminder, be very cautious about extremes. A little bit too much water or a little bit too much salt can both be harmful. These have to be very fine-tuned and minor adjustments. And don’t fear water either. As a kid’s metabolism rises and stabilizes he/she will actually crave, like, and need water.
As of December 1, 2012 you can now read more about the dangers of overhydation/hyponatremia for both children and adults in the book Eat for Heat.
Interesting related links and studies…