SYMPTOMS

What is pediatric edema?

Edema refers to an increase in fluid within a child's skin tissues, commonly occurring in areas such as the eyelids, hands, feet, lower limbs, and scrotum.
The affected skin typically loses elasticity, feels firmer, and appears swollen compared to surrounding areas.

• If it occurs in the feet, the child's shoes may no longer fit properly. Swelling in the eyelids may cause a puffy appearance.
• If present in the scrotum, it may appear significantly enlarged.
• Severe edema can make the skin appear translucent, and the child's weight may increase noticeably.
• Children with generalized edema often have swollen internal organs as well. Swelling of the intestinal mucosa may lead to poor digestion.
• Fluid may accumulate in the abdominal or thoracic cavities (ascites or pleural effusion). The child may exhibit reduced activity, lethargy, fatigue, and a pale complexion.

Why does pediatric edema occur?

Edema occurs primarily when excess fluid from the blood enters the skin and subcutaneous tissues. Observable swelling indicates fluid leakage into the tissues. Possible causes include:

• Low blood protein levels, preventing fluid retention in the blood. This is seen in malnutrition or nephrotic syndrome.
• Increased vascular permeability, allowing fluid to enter tissues more easily. Common in allergic reactions.
• Changes in vascular pressure, often seen in children with heart dysfunction.
• Localized edema (not systemic) may result from pressure or allergies (e.g., insect bites).
  Edema itself is not painful, and children typically report fatigue rather than pain. Parents may notice reduced activity. Some cases may involve decreased urination or foamy urine.

TREATMENT

How to Reduce Edema in Children?

• If your child indeed has edema, first observe the swollen areas of the skin and how long the swelling lasts. Check whether it appears and disappears suddenly, whether there is weight gain, or if shoes, socks, or clothing feel tighter. Monitor the child's urination. If the child has persistent systemic edema, they should be taken to the hospital for tests to determine the cause, including heart and kidney examinations, followed by targeted treatment. The heart and kidneys are vital organs, and early detection and intervention can lead to better outcomes. Delayed treatment may cause irreversible damage to the body.
• For localized edema—where only a small area of skin is swollen with no significant change in elasticity—rule out whether it is caused by pressure on the skin. Changing clothes to avoid tightness or adjusting sleeping positions may help.
• Sudden skin swelling is often related to allergies triggered by new substances the child came into contact with before the swelling. If the child breathes normally, rinse the skin with clean water and identify and avoid the allergen. Common allergens include protein-rich foods like seafood, egg whites, nuts, and milk, as well as medications like penicillin. If itching is severe, apply calamine lotion topically. Oral antihistamines like loratadine can also help reduce swelling. If the child shows signs of breathing difficulty, seek emergency medical care immediately for epinephrine treatment to relieve laryngeal edema, oxygen therapy to improve hypoxia, and life-saving measures.
• When systemic edema occurs, the child should not drink large amounts of water; fluid intake should be controlled. Seek medical attention promptly to identify the cause and receive targeted treatment.

DIAGNOSIS

When should a child with edema seek medical attention?

• Persistent edema: Persistent edema means swelling that lasts for 24 hours without improvement due to activity, sleep, or eating. The skin feels hard and lacks elasticity. In such cases, medical examination is necessary.
• Rapid weight gain accompanied by reduced urination and skin swelling. This abnormal weight increase indicates the body's inability to expel fluids, leading to accumulation. Immediate hospital visit is required to check for possible kidney disease.
• The child appears pale, inactive, unusually quiet, and becomes breathless with minimal activity, needing frequent rest. This requires urgent medical attention to rule out heart disease.
• If any of the following symptoms occur: inability to eat, no urination, extreme fatigue, or confusion, seek immediate medical care.

POTENTIAL DISEASES

What are the possible causes of edema in children?

• Kidney diseases: Common conditions include nephrotic syndrome and acute glomerulonephritis. Kidney diseases are often accompanied by reduced urine output, and symptoms such as reddish urine or foamy urine may also be observed.
• Malnutrition: Common manifestations in such children include thin or swollen limbs, a bony appearance with a distended abdomen. Due to improved economic conditions, such cases have become relatively rare.
• Edema caused by abnormal heart function: More common in older children. These children often tire easily and are reluctant to engage in physical activity. They may become breathless even with slight exertion. This condition requires attention.
• Allergic edema: Also known as angioedema. It often occurs suddenly after exposure to an allergen. Common sites include the lips, throat, trachea, and skin. The swelling progresses rapidly and can be visibly observed. Sudden throat swelling can affect breathing, posing a risk of airway obstruction and life-threatening complications.
• Edema caused by abnormal lymphatic vessels: If due to congenital developmental abnormalities, this type of edema usually persists from birth and is difficult to resolve. Additionally, tumor compression, filariasis infection, or connective tissue diseases can impair lymphatic function, leading to edema.
• In infants, due to loose skin tissue, changes in sleeping posture may sometimes cause eyelid swelling, which easily subsides after adjusting position and is not pathological. However, if the swelling persists or feels firm to the touch, medical attention should be sought promptly.