Dehydration In Children

What is dehydration in children?

Dehydration is the loss of body water. Dehydration occurs when your child loses more body water than he drinks. Body salts that your child needs, such as sodium, may be lost as well. Your child's dehydration may be mild, moderate, or severe (very bad).

What may cause my child to get dehydrated?

The following may cause your child to become dehydrated:

• Not drinking enough liquids: Your child needs to drink enough to replace the water he loses during the day. Children who are playing may lose body water by sweating. When the weather is hot, your child needs to drink more because he loses more fluids.
  
  
• Losing too much body fluid:
  
  
  • Having a fever: A higher than normal body temperature may cause your child to sweat and lose more fluids through his skin.
    
    
  • Having diarrhea: Three or more watery stools a day may cause your child to become dehydrated.
    
    
  • Vomiting: Throwing up causes your child to lose body water. If your child is trying to drink liquids but continues to vomit, he may become dehydrated.
    
    
  • Urinating too much: Children with untreated diabetes (high blood sugar) may lose too much body water in their urine.

What may increase my child's risk of getting dehydrated?

Ask your child's caregiver for more information about the following factors that increase the risk of dehydration:

• Being very young: Babies are at greater risk of dehydration than older children, especially those younger than 6 months old. This is because more of their body is made up of water, and they lose fluids more easily than older children. Babies also have to rely on others to give them liquids. Babies with low birth weights (weighing less than normal at birth) are even more at risk for dehydration.
  
  
• Playing sports: When your child plays sports in hot weather, he may sweat more than usual. He can get dehydrated if he does not drink enough liquid to replace the fluids he has lost.
  
  
• Being underweight or obese: Children who are malnourished (have not eaten enough to grow as they should) are at risk for dehydration. If a child has a very low body weight from not eating enough, he is at greater risk for dehydration. Children who are obese (weighing more than caregivers suggest) are also at higher risk.

What medical problems increase my child's risk of getting dehydrated?

If your child has an infection, he is at greater risk of dehydration. He may not want to eat or drink much. Having a fever makes him sweat more, losing water through his skin. If he throws up, he loses water in the vomit. If he has loose stools, he loses water in his stools. Gastroenteritis is a stomach and bowel infection. It is the most common cause of dehydration in children. Lung infections, including colds, flu, pneumonia, and bronchiolitis, also can cause dehydration. Other medical conditions that increase the risk of a child getting dehydrated include:

• Diabetes or heart problems: Diabetes and heart development problems cause increased sweating and greater fluid loss.
  
  
• Pyloric stenosis: Pyloric stenosis causes narrowing where the stomach connects to the intestine. This condition causes vomiting.
  
  
• Mouth sores: Mouth sores can cause pain with eating and drinking. A child with mouth sores may not want to eat or drink.
  
  
• Cystic fibrosis: Cystic fibrosis (CF) is a genetic disorder. Children with CF may not know when they are thirsty, so they may not drink enough liquid.
  
  
• Meningitis: Meningitis is an infection of the tissue layer that covers the brain and spinal cord. This condition causes fever and vomiting.

What signs and symptoms may my child have with dehydration?

Your child may show few or no signs of dehydration if it is mild. He may be very ill if he is severely dehydrated. Your child may have one or more of the following:

• Mild to moderate dehydration:
  
  
  • He acts thirsty and wants to drink.
    
    
  • He acts tired, sleepy, restless, or fussy.
    
    
  • His mouth is dry and has sticky mucus.
    
    
  • He urinates less than usual, or his urine is a dark yellow color.
    
    
  • His feet and hands feel cool.
  
  
• Severe dehydration:
  
  
  • He drinks poorly or does not drink.
    
    
  • He acts very sleepy or will not wake up.
    
    
  • He cries without tears.
    
    
  • His mouth and tongue are very dry.
    
    
  • His eyes look sunken in.
    
    
  • He urinates very little or none at all.
    
    
  • His feet and hands are cold. They may be pale or bluish in color.

How do caregivers diagnose dehydration in children?

Your child's caregiver will watch how your child acts. He will check your child's breathing and heartbeat. He will look at your child's eyes, skin, mouth, and tongue. Your child's caregiver will ask you how much your child has been drinking or urinating. Tell him if your child is vomiting or if he has diarrhea. Urine and blood samples may be taken and sent to the lab for tests. Ask caregivers for more information about these and other tests your child needs.

How is dehydration in children treated?

If your child has dehydration, he should not be fed solid food until his dehydration has been treated. If your child has diarrhea or is vomiting, he will be given the food he usually eats as soon as possible. Babies should continue to breastfeed or drink formula. Treatment may include any of the following:

• Oral liquids:
  
  
  • If your child is mildly to moderately dehydrated, he may need an oral rehydration solution (ORS). An ORS is a special drink that contains the right amounts of salt, sugar, minerals, and nutrients in water. It is the best oral liquid for replacing his body fluids. Ask your child's caregiver where you can get ORS.
    
    
  • ORS can be given in small amounts (about 1 teaspoon at a time) if your child is vomiting. Ask caregivers how much ORS your child needs when he is dehydrated and how often you should give it.
    
    
  • Sports drinks are not the same as ORS and should not be given without asking your child's caregiver.
    
    
  • Do not give your child soft drinks (soda) or fruit juices. These can make your child's condition worse.
  
  
• Nasogastric tube: If your child vomits often and cannot keep the ORS down, caregivers may insert a nasogastric (NG) tube. This is a tube that goes from his nose to his stomach. Caregivers can use the NG tube to give your child the ORS he needs.
  
  
• Intravenous liquids: If your child has serious dehydration, caregivers will give him intravenous (IV) liquids. Caregivers will first try to give liquids through a tube placed in a small vein, such as in your child's arm. If small veins cannot be used, caregivers may try to use a larger vein near your child's collarbone. In some cases, liquids may need to be given through a needle placed into your child's leg bone.

What are the risks of dehydration in children?

• During treatment, your child's eyelids, hands, and feet may swell from the liquids he is getting. If your child gets IV treatment, fluid may leak out of the vein and cause swelling. His vein may become inflamed (red and swollen). If an NG tube is placed in his nose, he may have pain or a nosebleed. Some liquid may get into his lungs and lead to a lung infection. If your child's treatment includes drinking an ORS, his bowels may stop working for awhile. This can make his stomach swell.
  
  
• If your child is not treated for dehydration, his symptoms may get worse. Your child may have less energy or become confused or sleepy. He may become unconscious (will not wake up) or have seizures. Your child's organs, such as his kidneys, heart, or brain, may stop working, and he may die. Ask your caregiver if you have questions or concerns.

How can I prevent my child from getting dehydrated?

• If your child is healthy:
  
  
  • Offer him the right kind of liquids: The best liquid to give your baby until he is 1 year old is breast milk or formula. The best liquids to give your older child are milk and water. Sweetened drinks, such as juice or soda, may not decrease your child's thirst. These drinks also may lead to your child being overweight and having dental cavities.
    
    
  • Offer him plenty of liquids every day: Ask your caregiver how much your child should drink every day. The amount of liquids your child needs changes as he gets older. If you are breastfeeding your baby, speak to your caregiver if you feel he is not breastfeeding well.
    
    
  • Have him drink extra liquids: During sports or exercise, and on warm days, your child needs to drink more often than usual. He may need to drink up to 8 ounces (1 cup) of water or a sports drink every 20 minutes.
    
    
  • Keep him cool: On hot days, limit the time your child spends outdoors. Dress your child in lightweight clothes.
  
  
• If your child is ill:
  
  
  • Check his urine: Keep track of how often your child urinates. If he is urinating less than usual, give him more liquids to drink. If his urine is darker in color, make sure he drinks more. Babies should have 4 to 6 wet diapers a day.
    
    
  • Have him drink extra liquids: During illness, your child needs to drink more often than usual. If he is a baby, breastfeed him more often or offer him extra formula. Offer your older child more milk and water than usual. Ask caregivers what other liquids your child should drink when he is ill.
    
    
  • As he recovers: Once your child's symptoms go away, he may need more IV or ORS liquids to prevent him from becoming dehydrated again. If he is still vomiting or has diarrhea, he may be given liquids each time he vomits or has a liquid stool.

Where I can I get more information about dehydration in children?

• American Academy of Pediatrics
  141 Northwest Point Boulevard
  Elk Grove Village , IL 60007-1098
  Phone: 1- 847 - 434-4000
  Web Address: http://www.aap.org
  

When should I call my child's caregiver?

Call your child's caregiver if your child:

• Has vomited more than twice in the past 24 hours.
  
  
• Has had more than 5 loose, watery stools in the past 24 hours.
  
  
• Has stopped breastfeeding or drinking formula.
  
  
• Has been sick and seems to be getting more ill.
  
  
• Is more irritable, fussy, or tired than usual.
  
  
• Has less urine or urine that is dark yellow.
  
  
• Has a dry mouth and lips.
  
  
• Is not drinking the ORS or throws it up after drinking it.
  
  
• Becomes constipated (unable to have a stool) or gets a swollen stomach.

When should I seek immediate help?

Seek care immediately or call 911 if your child:

• Will not drink or breastfeed at all.
  
  
• Has a very dry mouth or cries without tears.
  
  
• Has blood in his vomit or stool.
  
  
• Has a sudden muscle spasm or seems jittery.
  
  
• Has cold hands or feet or his face looks pale (without color).
  
  
• Seems confused and is not answering you, or you cannot wake him up.
  
  
• Has a seizure.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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