Dehydration in Children

Dehydration in Children Overview

Dehydration means not enough fluid in a child's body. This can result from not drinking, vomiting, diarrhea, or any combination of the 3. Rarely, sweating too much or urinating too much can cause dehydration. Infants and small children are much more likely to become dehydrated than older children or adults.

Remedies for Nausea and Vomiting

Causes of Dehydration in Children

Dehydration is most often caused by a viral infection that causes fever, diarrhea, vomiting, and a decreased ability to drink or eat.
- Common viral infections causing vomiting and diarrhea include rotavirus, Norwalk virus, and adenovirus.
- Sometimes sores in a child's mouth caused by a virus make it painful to eat or drink, helping cause or worsen dehydration.
- Common viral infections causing vomiting and diarrhea include rotavirus, Norwalk virus, and adenovirus.
- Sometimes sores in a child's mouth caused by a virus make it painful to eat or drink, helping cause or worsen dehydration.
More serious bacterial infections may make a child less likely to eat and may cause vomiting and diarrhea.
- Common bacterial infections include Salmonella, Escherichia coli, Campylobacter, and Clostridium difficile.
Parasitic infections such as Giardia lamblia cause the condition known as giardiasis.
Increased sweating from a very hot environment can cause dehydration.
Excessive urination caused by unrecognized or poorly treated diabetes (not taking insulin) is another cause.
Conditions such as cystic fibrosis or sprue do not allow food to be absorbed and cause dehydration.

Symptoms of Dehydration in Children

Be concerned if your child has an excessive loss of fluid by vomiting or diarrhea, or if the child refuses to eat or drink.
Signs of dehydration
- Sunken eyes
- Decreased frequency of urination or dry diapers
- Sunken soft spot on the front of the head in babies (called the fontanel)
- No tears when the child cries
- Dry or sticky mucous membranes (the lining of the mouth or tongue)
- Lethargy (less than normal activity)
- Irritability (more crying, fussiness)

When to Seek Medical Care

Infants and small children can become dehydrated quickly.

Contact your doctor if your child has any of the following:

Dry mouth
Crying without tears
No urine output in 4-6 hours
Sunken eyes
Blood in the stool
Abdominal pain
Vomiting for more than 24 hours, or vomiting that is consistently green in color
Fever higher than 103°F
Less activity than usual
Urination much more than usual

Go to a hospital’s Emergency Department in these situations:

If your child is lethargic (difficult to awaken)
If you cannot reach your doctor
If your child is complaining of severe abdominal pain
If your child's mouth looks dry

Exams and Tests

The doctor will perform a thorough history and physical exam in an effort to determine the cause of dehydration as well as how severe the dehydration is. The doctor will look for evidence of dehydration, as well as signs of illnesses that may cause dehydration.

Certain lab tests may be ordered.
- A complete blood count may identify seriousness or type of infection.
- Blood cultures may identify the type of bacterial infection.
- Blood chemistry may identify any electrolyte abnormality caused by vomiting and diarrhea and may identify serious imbalances in body chemistry caused by illness.
- Urinalysis may identify bladder infection, may give evidence of severity of dehydration, and may identify sugar and ketones in urine (evidence of uncontrolled diabetes).
In some cases, the doctor may order other tests, such as a chest x-ray, a test to check for rotavirus, stool cultures, or lumbar puncture (a spinal tap).