How can I tell if my child is dehydrated?

Suzanne Berman, M.D.

Here are some guidelines about an all-too-common pediatric problem. If, after reading them, you think your child is dehydrated, let our office know right away.

Why do children get dehydrated?

Basically, a child gets dehydrated when he loses more fluid than he takes in. Ill children don't eat and drink as much as usual. They also tend to lose more fluid than usual, due to:

Lots of vomiting or spitting up.
Lots of diarrhea and loose stool.
High fever with sweating.
Rapid breathing with panting.

A child can have any of these things and do all right as long as fluid input ''catches up'' to fluid output. However, if output is greater than input for more than a day or two, a child will get dehydrated.

Is my child dehydrated?

Dehydrated children can have the following:

Decreased urination. Infants should urinate at least every 4-6 hours. Older children should urinate 2-3 times a day.
No tears with crying.
Less saliva, with a tacky, cracked texture to the mouth and lips.
Poor skin color: grey, pale or mottled.

How much fluid does my child need?

Minimum fluid requiremenrs are proportional to your child's weight.

10 pounds: 2 cups per day

20 pounds: 4 cups per day

30 pounds: 5 cups per day

40 pounds: 6 cups per day

50 pounds: 6.5 cups per day

60 pounds: 7 cups per day

A child can get this fluid from any source, including juice, milk, water, Popsicles, lemonade, etc. Even most foods have some fluid content.

Note that these rules of thumb are minimums. A particular child may need more to keep up, depending on his illness and symptoms.

What should I do if my child gets dehydrated?

Have him seen in the office right away. We can determine how dehydrated your child is and recommend a course of action, depending on why he is dehydrated. Most of the time we can treat this at home. Occasionally, we recommend IV fluids in the hospital.