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Fluids, like water, are one of the most important things our bodies need to function properly. Dehydration occurs when our bodies lose more fluids than we are able to take in through food and drink. Illnesses that cause fever, vomiting or diarrhea can increase the amount of fluid our bodies lose and can quickly lead to dehydration. Signs of dehydration in children include tiredness, thirst, pale skin, dry mouth or dark circles under their eyes. Children who become dehydrated may refuse to nurse or drink fluids and may not want to eat or play. Seeing your child this way can be scary and it may seem difficult or impossible to keep them well hydrated especially when they vomit every time they eat or drink.
The best way to rehydrate a child is by giving them fluids by mouth in a specific way we call oral rehydration therapy. Oral rehydration is an easy and inexpensive way to treat your child at home and is usually just as effective as giving fluids through an IV line in the hospital.
·Using a small medicine cup or an oral syringe measure out the recommended amount of fluid based on your child’s weight. If your child weighs less than 22 pounds, give them 10 mL. If they weigh between 23 and 44 pounds, give them 20 mL. If your child weighs more than 44 pounds, give them 35 mL.
·Set a timer for 5 minutes and give your child one medicine cup or syringe full of fluid. If your child refuses you may need to gently squirt the fluid in their mouth using an oral syringe.
·When the 5-minute timer goes off give your child another cup or syringe of fluid and reset the timer for another 5 minutes
·Continue giving your child one cup or syringe of fluid every 5 minutes for 30 minutes (6 total doses).
·Between doses of fluid do not allow your child to eat or drink anything, this may cause them to vomit.
·If your child vomits during oral rehydration reduce the amount of fluid by half and continue trying for 15 minutes.
After you complete 30 minutes of oral rehydration give your child a 15-minute rest then allow them to drink and eat normally. If you child vomits repeat oral rehydration for another 30 minutes.
It may seem simple but oral rehydration is a very effective treatment for dehydration, we often use it in the hospital on even severely dehydrated children before considering using an IV line.
It may be tempting to use water for oral rehydration, but plain water won’t replace some of the other important things your child’s body requires. Electrolytes are essential minerals that we lose along with fluids when we are sick. Replacing electrolytes will increase the effectiveness of oral rehydration. Luckily there are several over-the-counter fluids that contain the electrolytes your child’s body needs. Fluids are available in a variety of flavors at most pharmacies and supermarkets. For older children you can also try sugar-free sports drinks.
Avoid sugary drinks like soda or fruit juices. These can actually cause more diarrhea and make rehydration harder. If fruit juice is the only fluid you have or if your child refuses to drink anything else you should mix the juice with water. Use equal amounts of water and juice if you’re mixing the two.
It’s normal for your child to lose their appetite when they are sick, especially if they are dehydrated. After completing oral rehydration, you should continue offering your child meals as usual but do not force them to eat when not hungry, this can cause vomiting. Avoid spicy, greasy or fried foods and offer bland, soft foods that are easily digested. Good options include rice, bananas, oatmeal, toast and mashed potatoes. Your child’s normal appetite will return as they get over their illness.
You should bring your child back to the urgent care or emergency department if they are limp or difficult to wake up, this can be a sign of severe dehydration. If your child is unable to complete oral rehydration because of severe vomiting, is refusing to drink or hasn’t urinated in 24 hours they should be evaluated by your doctor or brought to the hospital. Severe belly pain, bloody vomit bloody diarrhea or any new symptoms should also be evaluated by a healthcare professional. If you need help deciding whether your child needs to go to the hospital you can have a video chat with a pediatric provider 24 hours a day, 7 days a week
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