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Dehydration and diarrhea in children: Prevention and treatment

Highlights
  • Dehydration is caused by a loss of body fluids, which are made up of water and salts. 
  • Children with diarrhea need to keep drinking the right amount of fluids to avoid dehydration. 
  • Call your child’s doctor or seek medical advice at a local clinic or hospital if you see signs of dehydration

What is diarrhea?

Diarrhea is a very common problem in babies and children. It is usually mild and brief.  “Acute” diarrhea lasts less than 1 week.

A child has diarrhea if she has more bowel movements than usual, and if stools are less formed and more watery. Sometimes children with diarrhea have other symptoms, such as fever, loss of appetite, nausea, vomiting, stomach pains, cramps, and blood and/or mucus in the bowel movement.

Diarrhea can be dangerous if not treated properly because it drains water and salts from your child's body. If these fluids are not replaced quickly, your child can become dehydrated and may need to be hospitalized.

How does diarrhea spread?

Diarrhea germs spread easily from person to person, and especially from child to child. They usually spread quickly among children who have not learned to use the toilet.

What causes diarrhea?

There are many different causes of diarrhea. The most common are viral infections.

How can I prevent diarrhea?

Proper handwashing and safe food handling are the best ways to prevent the spread of germs that cause diarrhea.

What should I do if my child has diarrhea?

Children with diarrhea need to keep drinking the right amount of fluids to avoid dehydration.

  • If you are breastfeeding, keep feeding on demand. You can also offer your child the foods he usually eats.
  • If you are formula feeding, you don’t need to dilute the formula. Continue formula feeding, and offer your child the food he normally eats.
  • If your child is not taking other fluids well, offer an oral rehydration solution (ORS).

What is dehydration?

Dehydration is caused by a loss of body fluids, which are made up of water and salts. When sick children have diarrhea or are vomiting, they can lose large amounts of salts and water from their bodies can become dehydrated very quickly.

Dehydration can be very dangerous, especially for babies and toddlers. Children can even die if they are not treated.

What are the signs of dehydration?

Call your child’s doctor or seek medical advice at a local clinic or hospital if you see signs of dehydration, including:

  • decreased urination (fewer than 4 wet diapers in 24 hours in infants or no urine for over 8 hours in older children),
  • increased thirst, 
  • absence of tears, 
  • dry skin, mouth and tongue, 
  • faster heart beat, 
  • sunken eyes, 
  • grayish skin, 
  • sunken soft spot (fontanelle) on your baby’s head. 

Healthy children can spit up, vomit or have a loose stool once in a while without being in danger of dehydrating.
 

What is an oral rehydration solution?

An oral rehydration solution (ORS) is a mixture of water, salts and sugar in specific amounts. These solutions can be absorbed even when your child is vomiting or has serious diarrhea.

Oral rehydration solutions can be used to:

  • keep children well hydrated when their diarrhea is serious. 
  • replace lost fluids when children show signs of mild dehydration. 

Oral rehydration solutions are available at pharmacies in ready-to-serve preparations. It is best to buy an ORS that has already been mixed.

It’s important to give small amounts of the ORS often (for example, 1 teaspoon every 5 minutes), gradually increasing the amount until your child can drink normally.

For the first 4 hours

Babies under 6 months of age 30 to 90 mL (1 to 3 oz.) every hour
Children 6 months to 2 years of age 90 to 125 mL (3 to 4 oz.) every hour
Over 2 years of age 125 to 250 mL (4 to 8 oz.) every hour

If your child refuses to take the ORS by the cup or bottle, give the solution using a medicine dropper, small teaspoon or frozen pops.

If your child vomits, you may need to stop giving food and drink, but continue to give the ORS using a spoon.

  • Give 15 mL (1 tbsp.) every 10 min to 15 min until the vomiting stops.
  • Increase the amounts gradually until your child is able to drink the regular amounts.
  • If your child continues vomiting for longer than 4 to 6 hours, take your child to the hospital.

After 4 hours until 24 hours: Recovery stage

  • Keep giving your child the oral rehydration solution until diarrhea is less frequent.
  • When vomiting decreases, it’s important to start your child breastfeeding as usual, drinking formula or whole milk, or eating regular food in small, frequent feedings.

After 24 to 48 hours, most children can resume their normal diet.

Once your child starts eating normally, his bowel movements may increase at first (1 or 2 more each day).  It can take as long as 7 to 10 days for his stool to become completely formed again. This is part of the normal healing in a child’s bowel system.

What foods should I avoid giving to my child?

  • Do not give your child sugary drinks like fruit juice or sweetened fruit drinks, carbonated drinks (pop/soda), sweetened tea, broth or rice water. These do not have the right amounts of water, salts and sugar and can make your child’s diarrhea worse.
  • If your child is having frequent diarrhea, make sure she is drinking liquids (but not just plain water) and eating food. Drinking only water may lead to low blood sugar or low sodium levels in your child’s blood.

Talk to your doctor before giving over-the-counter medications to stop diarrhea.

When should I call the doctor?

Call your doctor or seek medical advice if your child:

  • has diarrhea and is less than 6 months of age.
  • has stomach pains that are getting worse.
  • has bloody or black stools,
  • vomits blood
  • is still vomiting after 4 to 6 hours.
  • has diarrhea and a fever with a temperature higher than 38.5°C (101.5°F).
  • has the signs of dehydration listed above.

Diarrhea lasting for more than 1 to 2 weeks is considered chronic. Talk to your child’s doctor if this is the case.


Reviewed by the following CPS committees:
Acute Care Committee
Nutrition and Gastroenterology Committee
Public Education Advisory Committee

Last Updated: June 2013