Dehydration results when there are excessive fluid losses from the infant or child, usually as a result of the vomiting or diarrhea. Dehydration can also result from any condition in which the child does not take in adequate fluids such as with severe mouth ulcers and other viral infections, such as RSV bronchiolitis. Dehydration is serious and should be evaluated in the office or emergency room. Signs of dehydration include:
- Dry mouth. Place your finger inside the child’s cheek and then rub your thumb and forefinger together. If it is wet, there is not need to worry about dehydration. If, however, it feels sticky or dry, then dehydration may be present. A child that is drooling is not dehydrated.
- Poor urine output. Infants and children usually urinate at least once every eight hours. Decreased urine output in the presence of diarrhea may mean that dehydration is present. No urine output in a 24 hour period is a serious sign of dehydration.
- Absence of Tears. If your child is making tears when she cries, then there is little chance of dehydration. If there are no tears when your child cries, this could possibly indicate dehydration when taken with other symptoms outlined above.
- Decreased skin turgor. Pinching the skin on the back of the child’s hand or abdomen should cause it to snap back into place readily and rapidly. If the skin is slow to return to its place, then dehydration may be present.
- Lethargy. If your child or infant is not alert or shows little interest in her surroundings and little interest in normal activities such as eating and playing and, this behavior is in association with diarrhea and / or vomiting, this may be a sign of dehydration.
Note: The most reliable and important signs of dehydration are items #1 and 2.
Your child should be evaluated by a physician if:
- Signs of dehydration are present.
Treatment of dehydration in Infants:
- If your child is breast fed, continue to breast feed your baby. Smaller more frequent feedings can be helpful. Breast milk is very easy on the stomach and has antibodies and other anti-infectious factors which can help your baby get over a stomach virus more rapidly.
- If your baby is formula fed, continue giving the formula and in addition, give one of the oral re-hydration solutions instead. We recommend Pedialyte or Infalyte. These solutions have simple sugars and salts in them which are easily absorbed and help sustain your child until he or she recovers from the illness. Give these solutions in small amounts, frequently and at room temperature. Even if your infant’s vomiting persists encourage these fluids anyway, in between vomiting episodes. If diarrhea alone is present, begin fluids as outlined below in large amounts. The goal of fluid therapy in vomiting and diarrhea illnesses in children is to give more fluid to the child than is lost in the diarrhea and vomiting so that dehydration won’t result.
- Watch closely for signs of dehydration. (see above signs of dehydration)
Treatment of dehydration in Older Children:
For the first 24 hours:
- Give one of the oral re-hydration solutions. We recommend Pedialyte or Infalyte.
- Give Pediapop popsicles.
- Give soup or other watery foods.