Dehydration (Infant/Toddler)

Dehydration occurs when too much fluid has been lost from the body. This may occur after prolonged vomiting or diarrhea, or during a high fever. It may also be due to poor fluid intake during times of illness. Symptoms include thirst, dizziness, weakness and fatigue, or drowsiness. Body fluids must be replaced with an oral rehydration solution (ORS). This is available without a prescription at drug stores and most grocery stores.

Monitor your child for signs of dehydration. These include:

  • Dry mouth

  • Increased thirst

  • Decreased urine output or fewer wet diapers

  • Lack of tears when crying

  • Sunken eyes

  • Flat fontanelle. This is the soft spot on a baby’s head.

Home care

For vomiting

To treat vomiting and prevent dehydration, give small amounts of fluids at frequent intervals.

  • Start with ORS at room temperature. Give 1 teaspoon (5 ml) every 1 to 2 minutes. Even if your child vomits, keep feeding as directed. Much of the fluid will still be absorbed.

  • Unless instructed differently by your healthcare provider, the total volume of ORS should be 5 teaspoons per pound, or 50 milliliters per kilogram (ml/kg) over 4 hours. If you have a 20-pound (9.1-kg) child, this would mean giving 100 teaspoons of ORS, or just over 2 cups of liquid total over 4 hours.

  • As vomiting lessens, give larger amounts of ORS at longer intervals. Continue this until your child is making urine and is no longer thirsty (has no interest in drinking). Do not give your child plain water, milk, formula, or other liquids until vomiting stops.

  • If frequent vomiting continues for more than 2 hours with the above method, call your doctor.

  • After the total ORS amount is given, your child can resume a regular diet.

  • Make sure to wash hands or use an alcohol-based hand sanitizer often.

Note: Your child may be thirsty and want to drink faster, but if he or she is vomiting, give fluids only at the prescribed rate. The idea is not to fill the stomach with each feeding since this will cause more vomiting.

Follow-up care

Follow up with your healthcare provider, or as advised. Call if your child does not improve within 24 hours or if diarrhea lasts more than 1 week. If a stool (diarrhea) sample was taken, you may call in 2 days (or as directed) for the results.

When to seek medical advice

Call your child's healthcare provider right away if any of these occur:

  • Repeated vomiting after the first 2 hours on fluids.

  • Occasional vomiting for more than 24 hours.

  • Frequent diarrhea (more than 5 times a day); blood (red or black color) or mucus in diarrhea.

  • Blood in vomit or stool.

  • Swollen abdomen or signs of abdominal pain.

  • No urine for 8 hours, no tears when crying, "sunken" eyes or dry mouth.

  • Unusual behavior changes, fussiness, drowsiness, confusion or seizure.

  • Fever (see Fever and children, below)

Call 911

Call 911 if your child shows any of these symptoms or signs:

  • Trouble breathing

  • Confusion

  • Is very drowsy or difficult to awaken

  • Fainting or loss of consciousness

  • Rapid heart rate

  • Seizure

  • Stiff neck

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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