Illnesses

Dehydration

Your child is dehydrated when his or her body has lost too much water. This may happen when your child has an illness that results in fever, vomiting or diarrhea. It may also happen in very hot weather particularly when your child is very active. Most cases of dehydration are mild and can be managed at home, but if your child is moderately or severely dehydrated, it's important to seek medical help quickly.

• YNHH Health Library: Dehydration and stroke

Symptoms
Infrequent urination: When your infant or child urinates less than every six hours, he or she is probably moderately dehydrated.

Dry mouth and eyes, cold fingers: Check his or her mouth, eyes and fingers. Your child should have a moist inner mouth, non-sunken eyes and pink, warm fingers. A mildly dehydrated child may have a dry mouth, but his or her eyes should be non-sunken and fingers should be warm and pink. Dehydrated children will have a dry mouth, sunken eyes and cold, mottled fingers and may cry without tearing. When severely dehydrated, your child will be inactive and quiet.

One test doctors use is to press gently on a fingernail tip until the pink fingernail bed turns white. Release the pressure. If the child's fingernail doesn't return to its usual pinkish color in less than two seconds, he or she may be very dehydrated.

What you can do

• If your child is dehydrated, several products to replace lost fluids are available without prescription in grocery and drug stores, including: Pedialyte, Infalyte, Rehydralyte, Naturalyte and Pediatric Electrolyte brands. These products have the combination of nutrients and minerals your child needs while most other fluids (including fruit juice, chicken broth, soft drinks and sports drinks) do not. Try giving your child a teaspoon of one of these products every few minutes rather than encouraging him or her to gulp down large quantities. These solutions tend to be salty so your child may prefer a flavored variety. You can also freeze the solutions into a popsicle. Children who vigorously fight taking these solutions are often not dehydrated and may just need extra water.
• After you've tried replacing the fluid, recheck your child's mouth, eyes and fingers, as described above.
• Keep a list of approximately how much fluid your child has drunk and how many times he or she has urinated, vomited or had diarrhea. This will help you and your doctor decide if your child needs more help.
• Once you get even a little fluid into your child, you may find it easier to get more fluid in. Children often perk up much more quickly than sick adults and they may vomit less, feel better and be more cooperative.
• Once you've replaced some fluid and your child's vomiting decreases, you can resume your child's normal diet, which should include lots of complex carbohydrates such as rice, potatoes, whole-grain breads and cereals, lean meat, yogurt, fruit and vegetables. Include the child's usual milk source (breast milk or formula for infants, full strength cow's milk for older children). Avoid fatty foods or food high in simple sugars such as juices and soft drinks.
• Medicines exist to decrease some symptoms of vomiting and diarrhea, but they are not recommended for children. They have potentially dangerous side effects in children. Appropriate fluids – not medicines – are the key to treatment.

When to call your doctor

• If your child becomes more than mildly dehydrated, try pressing on the fingernails, as described above.
• If you cannot get the products described above.
• Call if your child has vomiting or diarrhea lasting longer than 48 hours, significant abdominal pain or any bloody diarrhea or bloody or dark green vomit. You can help your doctor if have an idea of how much fluid has gone in and out of your child.

Reviewed: Robert LaCamera, MD, September 1999
Last revised: June 6, 2007 (dh)

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All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.