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Advice for Patients
August 2010

Dehydration and Oral Rehydration

Arch Pediatr Adolesc Med. 2010;164(8):784. doi:10.1001/archpediatrics.2010.140

Dehydration means that the body has lost too much fluid. Dehydration can be caused by not drinking enough fluids, vomiting, or diarrhea. Infants and small children are more likely to become dehydrated than adolescents and adults because they can lose fluid quickly. If dehydration becomes severe it can be serious and life-threatening. Luckily, there are many things parents can do to help prevent these serious complications .

Signs of dehydration

  • Child is less playful

  • Urinates less often

  • Has dry lips or mouth

  • Fewer tears if crying

  • Soft spot on head appears sunken

Signs of serious dehydration

  • Child is very fussy or very sleepy

  • Has sunken eyes

  • Has cool hands and feet

  • Urinates only 1 to 2 times per day

If you are worried that your child is dehydrated, call your pediatrician. If the dehydration is mild, your pediatrician may recommend treating it at home with oral fluids. This means encouraging your child to suck or drink small amounts of fluids. If your child is sick and will not eat any solid foods for a day or so, this is not likely to be a problem; however, it is most important to focus on providing fluids during a vomiting illness.

Fluids can include

  • Oral rehydration fluids. These are also called electrolyte solutions. These fluids are made for situations when a child is vomiting or has diarrhea. These fluids provide water as well as electrolytes (like salt), which the body loses during vomiting or diarrhea. It is best to give small amounts of these frequently, rather than a whole bottle or cup at once. Examples of oral rehydration fluids include Pedialyte and Enfalyte as well as many generic versions of these fluids. You can buy these electrolyte solutions at pharmacies and grocery stores. A common concern among parents when using electrolyte solutions is that children may think they taste bad and not want to drink them. A recent study in this month's Archives tested different oral rehydration solution tastes by asking children to drink them. The authors found that Pedialyte solutions were most acceptable to children.

  • If a breastfed infant develops diarrhea, usually you can continue breastfeeding. You can additionally give the infant an electrolyte solution, but only if your doctor feels this is necessary.

Fluids to avoid giving your child when he or she is sick

  • Fluids that have caffeine, including soda, coffee, or tea.

  • Dairy-based fluids, like milkshakes or chocolate milk.

  • Acidic juices (like orange juice) or very sugary juices, as they can make diarrhea worse. Small amounts of apple juice or white grape juice are okay.

  • Do not give your child too much water. Because your child may be losing salts and electrolytes by vomiting or having diarrhea, these fluids need to be replaced by fluids that also have salts and electrolytes, such as oral rehydration fluids.

Inform yourself

To find this and other Advice for Patients articles, go to the Advice for Patients link on the Archives of Pediatrics & Adolescent Medicine Web site at http://www.archpediatrics.com.

Source: American Academy of Pediatrics: http://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/Treating-Vomiting.aspx.

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The Advice for Patients feature is a public service of Archives of Pediatrics & Adolescent Medicine. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your child's medical condition, Archives of Pediatrics & Adolescent Medicine suggests that you consult your child's physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.