To support continuity of care, One Pediatrics practices routinely follow up with patients seen in a hospital setting. In recent months, we’ve noted an increase in the number of pediatric patients treated for dehydration in the emergency room. With this data in mind, we hope to reduce the frequency of children needing urgent treatment.
While dehydration isn’t uncommon as a symptom of other illnesses, it’s not usually an ailment by itself. Kids become dehydrated after prolonged fevers, vomiting, diarrhea, or even simply from not taking in enough fluids while they feel unwell, over-exercise, or overheat.
PREVENTING DEHYDRATION
On a normal daily basis, children are more susceptible to dehydration than adults. They have faster metabolisms and a higher ratio of body surface area to weight, are often on the move, and don’t regularly think about their fluid needs. Kids should have water always accessible during the day, even if they’re relaxed. Consistent intake will help prevent an imbalance once they’re active. The American Academy of Pediatrics says children ages 1-3 years need approximately 4 cups of beverages per day, including water or milk. During ages 4-8, increase the amount to about 5 cups, and 7-8 cups for older kids. During exercise, kids should hydrate at least every 20 minutes.
When illness strikes, especially gastrointestinal viruses, children may not be interested in fluids or struggle to keep them down. If the child is vomiting, offer small sips of water or ice cubes until they can tolerate an ounce of fluid in one hour, then increase to 2 ounces the following hour, 3 ounces the next, etc. Be careful with sports drinks like Gatorade—they contain electrolytes but also lots of sugar that can make diarrhea worse. Sugar in general should be limited, but you can offer a 1:1 mix of juice and water if necessary. Artificial sweeteners are also known to cause further stomach upset.
Any illness can lead to dehydration if a child isn’t taking in enough fluids. Kids with sore throats, for example, may avoid consuming anything because it’s uncomfortable. Flu, Covid-19, or even a common cold may simply cause so much fatigue that a child misses water breaks because they’re sleepy. You can offer fruit-based popsicles for raw throats, or water-heavy foods like soup, applesauce, melon, etc.
RECOGNIZING DEHYDRATION
By knowing the signs of dehydration, you can address it before it becomes severe. The most common signs in babies are fewer wet diapers (normally 6-8 per day), extra sleepiness, sunken soft spot (fontanelle) on top of their head, and no tears when crying.
Even after a child can communicate their needs and/or recognize thirst, they might be easily distracted from taking a water break or picky about what they want to drink. Symptoms of dehydration include dry/sticky lips and mouth, irritability, dark urine, and flushed skin. Older kids and adolescents will experience these same symptoms, plus headaches, lightheadedness, and cramps.
Severe dehydration can trigger a rapid heart rate, extreme fatigue, confusion, and unresponsiveness. If your child is experiencing these symptoms, seek immediate medical attention. Heat stroke, when the body’s core temperature is dangerously high, will cause these symptoms.
TREATING DEHYDRATION
On a typical day, make sure all kids over age 1 have consistent access to water. Ideally, kids should have a water bottle at school every day and on family outings. Babies under 6 months should drink breast milk or formula only, and 6 months to 1 year should have one cup of water per day in addition to their milk/formula intake.
If your child is sick and dehydration is a concern, contact your pediatrician’s office right away. Do not give kids any medication (like anti-nausea or anti-diarrhea medicines) unless directed or prescribed. Your doctor can also provide guidance on proper amounts of electrolyte solution (Pedialyte) and fever management.
Severe dehydration is treated with IV fluids in a hospital setting, bypassing the need to take in liquids by mouth, and may also require prescription medication to treat the cause.
If you’re ever concerned about your child’s hydration level, whether they’re well or sick, let your pediatrician know. Dehydration is highly manageable until it becomes a serious problem, and our providers have years of experience treating habitual or illness-based symptoms. We will also help with next steps if it’s time to seek hospital-level treatment.