Dehydration

What is dehydration?

Dehydration is a condition in which the body doesn't have enough water to work properly. Your child's body can lose a lot of water if he or she has diarrhea, is vomiting, or has been exercising for a long time without having anything to drink. If water is not replaced in the body, it can cause decreased activity, weakness, electrolyte imbalances, and, in severe cases, death.

What are the symptoms?

Infants and young children are at greatest risk for dehydration. Sick children may become dehydrated if they do not feel well enough to drink, have stomach pain, or a fever.

With mild dehydration, children may:

• have sticky or dry mouths
• urinate less
• be thirstier than usual
• be slightly more fussy
• be less active than usual.

With more severe dehydration, children often:

• are less alert
• are very sleepy
• have sunken eyes
• urinate much less, if at all
• lose weight.

Dehydration can be a medical emergency. Call your healthcare provider IMMEDIATELY if:

• Your child is much less active than usual.
• Your child is hard to wake up.
• Your child appears limp and weak.
• Your child doesn't seem to recognize you.

Your child may need to be treated in the hospital for these symptoms.

How can I help take care of my child?

Encourage your child to drink. Dehydration, no matter what the cause, needs to be treated by replacing lost fluids.

Mild dehydration due to illness in infants under 1 year old

Encourage, but do not force, your child to drink. If you are not breast-feeding your child, give him or her special clear liquids with electrolytes, such as Pedialyte, instead of formula for the first 12 to 24 hours. You can buy oral electrolyte solutions without a prescription at supermarkets and drugstores. If you are breast-feeding and your baby is urinating less often than normal, offer an electrolyte solution between breast-feedings for the first 6 to 24 hours.

If your child is vomiting, give small amounts of breast milk or the electrolyte fluids more often than you usually feed. The child will be better able to keep the liquid down and will still get the same amount of fluid.

For most illnesses, start giving a bottle-fed baby full-strength formula again after 12 to 24 hours of being able to keep down clear liquids.

Mild dehydration due to illness in children over 1 year old

Encourage but do not force your child to drink. Give popsicles and half-strength lemon-lime soft drinks (half water, half soft drink) and electrolyte solutions to start. You can also try giving your child water or ice chips. Electrolyte solutions like Pedialyte or Gatorade will help your child replace both fluids and electrolytes that have been lost.

If your child is vomiting, he or she should drink small amounts of liquid often rather than a lot all at once. Start with 1 teaspoon to 1 tablespoon every 5 minutes and increase gradually.

If your child is not vomiting or having diarrhea, water or an electrolyte solution alone works well in the first few hours, although your child may eat regular food if he or she is hungry. Bland food, rice, crackers, applesauce, banana, and toast are good as a bland diet. If your child tolerates clear liquids or a bland diet for 12 to 24 hours, you can start giving your child what he usually eats and drinks.

Mild dehydration due to exertion in older children

Follow the instructions given above for mild dehydration in children over 1 year old. Your child will probably be quite thirsty and should be allowed to drink as much as she or he wants. Pure water is OK for the first hour or two, but after this, your child will need drinks containing sugar and electrolytes. If your child has been exercising heavily, have him rest in a cool, shady place until he is rehydrated.

Mistakes to avoid

• Do not restrict your child to clear liquids for longer than 12 to 24 hours.
• Avoid highly concentrated solutions, such as boiled milk, and drinks with a lot of sugar such as colas and apple juice (unless you dilute them with water).
• If your child is vomiting and you are giving him small amounts of fluid often, remember to gradually increase the amount of fluids you are giving.
• Avoid drinks and foods that contain caffeine.

How can I help prevent dehydration?

• Make sure your child drinks often during activities such as long sports events, or being outside when it is very hot, dry, or windy.
• Remember that children often get mildly dehydrated during travel or when fluids aren't available. Encourage drinking during travel and carry water or electrolyte drinks with you when you travel.
• At the first sign of vomiting or diarrhea, be aware of the need to replace lost fluids.

When should I call my child's healthcare provider?

Call IMMEDIATELY if:

• Your child does not make tears while crying.
• Your child has a dry or sticky mouth.
• Your child has no urine in over 8 hours.
• Your child is dizzy or unsteady while standing or walking.
• Your child appears less alert than usual.
• Your child refuses to drink fluids.
• Your child starts to act very sick.
• Your child's vomiting gets worse or lasts longer than 24 hours.