DRINKING FLUIDS, DECREASED
DEFINITION
- Child drinks less than normal amounts of fluid
Causes
- Main cause: Sore mouth or throat. See MOUTH ULCERS or SORE THROAT after using this topic to check for dehydration.
- Common cause in infants: Blocked nose in bottle or breastfed infant (Reason: can't breathe while sucking). See COLDS after using this topic.
- Common cause: Nausea from viral stomach infection without vomiting
- Difficulty breathing with bronchiolitis or croup. (Reason: not enough energy to both suck and breathe.)
Complication
- Dehydration
See More Appropriate Topic (instead of this one) If
- Age under 12 weeks and breastfeeding, See BREASTFEEDING QUESTIONS
- Age under 12 weeks and formula feeding, see BOTTLEFEEDING QUESTIONS
- If Mouth Ulcers are the cause, see MOUTH ULCERS
WHEN TO CALL YOUR DOCTOR
Call 911 now (your child may need an ambulance) if:
- Not moving or too weak to stand.
Call your doctor now (night or day) if:
- Your child looks or acts very sick.
- Signs of dehydration, such as:
- Has not urinated in more than 8 hours.
- Crying produces no tears.
- Very dry mouth (rather than moist).
- Sunken soft spot.
- Excessively sleepy child.
- Too weak to suck or drink.
- Refuses to drink anything for more than 12 hours. (8 hours if less than 12 months old)
- Could have swallowed a foreign body.
- Wheezing or stridor with breathing
- Difficulty breathing not better after you clean out the nose.
Call your doctor within 24 hours (between 9am and 4pm) if:
- You think your child needs to be seen.
- Unexplained difficulty drinking and also has fever.
- Poor drinking present > 3 days.
Call your doctor during weekday office hours if:
- You have other questions or concerns.
Parent care at home if:
- Drinking adequate amounts of fluid AND no signs of dehydration and you don't think your child needs to be seen.
HOME CARE ADVICE FOR DECREASED FLUID INTAKE
- Increase Fluid Intake: Give your child unlimited amounts of her favorite liquid (e.g., chocolate milk, fruit drinks, Kool-Aid, soft drinks, water). The type doesn't matter, since your child doesn't have diarrhea or vomiting.
- Solid Foods: Don't worry about solid food intake. It's normal for the appetite to fall off during illness. Preventing dehydration is the only important issue.
- For Sore Mouth:
- If the mouth is sore, give cold drinks.
- Avoid citrus juices.
- For infants, offer fluids in a cup, spoon or syringe rather than a bottle (Reason: The nipple may increase pain).
- Older child can use 1 teaspoon of a liquid antacid as a mouthwash 4 times per day after meals.
- Give acetaminophen (e.g., Tylenol) or ibuprofen for pain relief.
- For a Blocked Nose: Suction it out using warm water or saline nosedrops in infants and toddlers. Make saline nosedrops by adding ½ teaspoon of table salt to 1 cup (8 oz.) of warm water.
- For Shortness of Breath: For mild bronchiolitis or difficult breathing, offer small frequent (every 1/2 hour) feedings so the infant can rest briefly between them.
- Call Your Doctor If:
- Difficulty swallowing becomes worse
- Signs of dehydration
- Poor drinking present over 3 days
- Your child becomes worse
And remember, contact your doctor if your child becomes worse or develops any of the "Call Your Doctor" symptoms.
REFERENCES
- Armon K, Elliott EJ. Acute gastroenteritis. In: Moyer V, Davis RL, Elliott E, et al, eds. Evidence Based Pediatrics and Child Health.London, England: BMJ Publishing Group; 2000. p. 273-286.
- Gorelick MH, Shaw KN, Murphy KO. Validity and reliability of clinical signs in the diagnosis of dehydration in children. Pediatrics. 1997;99(5):E6.
- Jospe N and Forbes G. Fluids and electrolytes: Clinical aspects. Pediatr Rev. 1996;7:395-404.
- Morrison JE Jr and Pashley RT. Retropharyngeal abscess in children: A 10-year review. Pediatr Emerg Care. 1988;4:9-11.
- Nicklane PJ and Kelley PE. Management of deep neck infection. Pediatr Clin North Am. 1996;43:1277-1296.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
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