Parents: Can You Spot Dehydration?

Common Symptoms

dehydrated girl in hammock outside
Dejan Ristovski/Stocksy United

Parents often worry about dehydration when their children get sick and have diarrhea and vomiting. Fortunately, you can usually avoid serious complications of dehydration by recognizing the early signs and symptoms of dehydration and getting quick medical attention.

Kids and Dehydration

Fortunately, kids don't get dehydrated very easily. They aren't going to get dehydrated if they just have a cold, have vomited a few times, or even if they have a lot of diarrhea, but are drinking well and not throwing up.

So how do kids get dehydrated?

Dehydration is most common when your child is losing more fluids than they are taking in, either because they are vomiting a lot or having very frequent watery diarrhea.

If you are able to get your child to drink enough fluids, even if it is a very small amount at each time (the classic treatment for vomiting and diarrhea), you can often prevent your child from getting dehydrated. The big mistake that many parents make is to give their child too much to drink too quickly, which usually leads to more vomiting.

Detecting Dehydration

Among the classic signs and symptoms that your pediatrician will look at to determine if your child is dehydrated include:

  • Has your child lost weight? The amount of weight loss usually correlates to how dehydrated a child is, so 5 percent weight loss likely means that they are 5 percent dehydrated.
  • Is your child urinating less often? How often and how much they are urinating? (Children with diabetes may continue to urinate frequently, even when they are severely dehydrated, so this isn't always a reliable sign.)
  • the presence of tears, a moist mouth and tongue, and whether or not their eyes are sunken
  • their capillary refill (Briefly press on your child's nail bed so that it blanches or turns white, and see how long it takes to return to normal.)
  • skin fold recall or skin turgor test (Gently pinch your child's skin on their abdomen, hold it for a few seconds, and then let it go to see how long it takes to return to the normal position.)

    These signs and symptoms can also help determine if your child is only a little dehydrated or has severe dehydration.

    Symptoms of Minimal Dehydration

    Most children who are sick, either with a cold or mild stomach bug, will have minimal or no dehydration. These children are alert and appear well and have:

    • normal thirst or may refuse some liquids
    • a moist mouth and tongue
    • normal to slightly decreased urine output
    • less than 3 percent weight loss
    • normal heart rate, pulses, breathing, and warm extremities
    • capillary refill less than 2 seconds
    • instant recoil on skin turgor test
    • eyes not sunken (and/or fontanel in a baby)

    Symptoms of Mild to Moderate Dehydration

    Once their dehydration worsens, children may begin to feel tired, restless, and irritable, which makes it difficult to get them to drink more fluids. Other signs and symptoms of mild to moderate dehydration, for which you should usually call your pediatrician, include:

    • increased thirst
    • a dry mouth and tongue
    • decreased urine output
    • 3 to 9 percent weight loss
    • normal to increased heart rate and pulses, normal to fast breathing, and cool extremities
    • capillary refill greater than 2 seconds
    • recoil on skin turgor test in less than 2 seconds
    • slightly sunken eyes (and/or fontanel in a baby)

      Symptoms of Severe Dehydration

      Severe dehydration is a medical emergency and you should seek immediate medical attention. These children appear lethargic (meaning they are difficult to keep awake) or may be unconscious. They also may have:

      • poor drinking or may be unable to drink
      • a parched mouth and tongue
      • minimal or no urine output
      • greater than 9 percent weight loss
      • increased heart rate, weak pulses, deep breathing, and cool, mottled extremities
      • capillary refill that is very prolonged or minimal
      • recoil on skin turgor test in more than 2 seconds
      • deeply sunken eyes (and/or fontanel in a baby)

      Be sure to seek medical attention before your child develops signs of moderate or severe dehydration.


      Managing Acute Gastroenteritis Among Children. MMWR. November 21, 2003 / 52(RR16);1-16

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