Intake/Output Worksheet

How to record intake and output for your child:

  • Always record the time of each intake or output episode.

  • Intake should be recorded in ounces or milliliters. This can usually be found on the container. If your child is using a sippy cup or bottle, these are usually labeled as well

    o   1  cup = 8 oz; lots of sippy cups are made to hold about 6 oz

  • If your child is potty-trained, try to use the urine hat provided to measure urine output. If your child is not potty-trained and uses diapers or pull-ups record the number of wet diapers or pull-ups. For example, you change 1 wet diaper, record as “1”.

  • Record stools as to how many the child has. For example, you change 1 dirty diaper; you record the number of stools as “1”. If your child is potty-trained and has formed stools or diarrhea which can’t be measured, record each one in the same way.

  • Record vomiting episodes as to how many the child has unless you have a way to measure (in most cases you won’t). For example, your child vomits once; you record this as “1”.

  • You can use the notes section of the form above to record the characteristics of stool, emesis or urine (color, consistency).