Drinking Fluids Decreased

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

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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.
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HOME CARE ADVICE FOR DECREASED FLUID INTAKE

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.

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REFERENCES

  1. 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.
  2. Gorelick MH, Shaw KN, Murphy KO. Validity and reliability of clinical signs in the diagnosis of dehydration in children. Pediatrics. 1997;99(5):E6.
  3. Jospe N and Forbes G. Fluids and electrolytes: Clinical aspects. Pediatr Rev. 1996;7:395-404.
  4. Morrison JE Jr and Pashley RT. Retropharyngeal abscess in children: A 10-year review. Pediatr Emerg Care. 1988;4:9-11.
  5. 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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