Signs of Dehydration in Young and Older Children

Medically reviewed by Dale Garber, MDMedically reviewed by Dale Garber, MD

Dehydration in children occurs when they lose more fluids than they take in. Children dehydrate faster than adults because they have more water in their bodies and burn energy more quickly. When children are active, they are at increased risk of becoming dehydrated as they may forget to drink enough water.

Water is essential for all bodily functions, including blood flow, oxygen delivery, brain function, digestion, and waste removal. Without enough water, your child’s body can’t function properly, leading to dehydration symptoms, such as thirst, dry mouth, and darker or less frequent urine.

Illness and Dehydration

Illnesses like viruses or stomach bugs can lead to dehydration through fever, vomiting, and diarrhea. These conditions can also reduce fluid intake, especially if the child’s throat is sore.

Noticeable Signs a Child Is Dehydrated

Oral Symptoms

Oral dehydration symptoms include:

• Dry lips or mouth

• Dry or pale tongue

• Dry throat

• Thirst

Mood and Behavioral Changes

Mood and behavioral changes involve:

• Crankiness

• Difficulty focusing

• Low interest in activities

• Sleepiness

• Slow movements

• Unusual quietness

Skin and Eye Changes

Skin and eye symptoms include:

• Cool, damp, pale, ashen, or blotchy skin

• Dry skin

• Poor skin turgor

• Sunken eyes

• Tearless crying

Poor Skin Turgor

Poor skin turgor means the skin is less elastic. To check this, gently pinch the back of the child’s hand. If the skin doesn’t bounce back quickly and stays pinched or tented for two to four seconds, the child is low on fluids.

Urine (Pee) Changes

Dehydration can cause a child’s urine to be darker in color and have a stronger smell than usual. You may also notice fewer wet diapers or bathroom trips, indicating less urine output.

Other Noticeable Signs

Additional noticeable signs of dehydration include:

• Dizziness

• Fast breathing or heart rate

• Headache

• Loss of consciousness (not waking up)

• Low blood pressure

• Weight loss

Which Dehydration Signs Are Minor vs. Severe?

Mild Dehydration

Mild symptoms involve:

• A little less urine output

• Darker yellow urine

• Slightly dry mouth

• Slight thirst

• Weight loss (3% to 4% of body weight)

Moderate Dehydration

Moderate signs include:

• Dark urine

• Dry mouth or cracked lips

• Dry, pale, or clammy skin

• Faster breathing or heart rate

• Fewer tears when crying

• Irritability

• Less interactive or playful

• Light-headed when standing

• Low urine output

• Poor skin turgor

• Trouble focusing

• Very thirsty

• Weight loss (6% to 8% of body weight)

Severe Dehydration

Severe signs include:

• Bluish, gray, or ashen skin

• Brownish urine

• Confusion

• Cool, clammy, or blotchy skin

• Intense thirst

• Light-headedness or fainting

• Little to no urine output (oliguria)

• Major irritability or listlessness

• No tears when crying

• Parched mouth and cracked lips

• Poor skin turgor (takes four or more seconds to bounce back)

• Unresponsiveness or seizures

• Very rapid breathing or heart rate

• Weight loss of 10% or more of total body weight

When to Worry

You can manage mild dehydration at home with fluids and rest. For moderate dehydration, contact your pediatric healthcare provider. If they are unavailable, go to urgent care. For severe symptoms, seek emergency care immediately.

How to Rehydrate a Child

At Home

Give your child oral rehydration solutions (ORS) like Pedialyte to replace lost fluids, sugars, and salts for mild dehydration. If your child is experiencing vomiting, give them small sips or 1 teaspoon (5 milliliters) of ORS every five to 10 minutes. Pause for 10 to 15 minutes if vomiting continues, then try again. Offer 1 tablespoon of fluids less often for diarrhea.

Rehydration Tips

Make hydration fun by:

• Telling a story about a superhero who needs to drink to gain strength

• Using themed water bottles, cups, sippy cups, or straws

• Freezing ORS into ice pops

At a Medical Facility

Healthcare providers will assess the severity of dehydration through vital signs, weight, exams, blood tests, and urine tests. If your child can drink and hold down fluids, they may first try ORS or ReSoMal (rehydration solution for malnourished.

ReSoMal

ReSoMal has lower sodium and higher potassium, magnesium, and zinc than standard ORS. Providers typically give it at medical facilities to ensure proper dosage and monitoring.

If your child has moderate or severe dehydration or cannot keep fluids down, the team might give intravenous (IV) fluids to restore hydration quickly. Sometimes, they use a nasogastric (NG) tube, which delivers fluids from the nose to the stomach.

Monitoring a Child During the Rehydration Stages

At a medical facility, the healthcare team will look for signs that your child is getting better, such as having more energy, peeing more often, showing stable vital signs, having normal blood test results, and improving weight.

At home, watch for these signs of improvement:

• Better mood

• Improved skin turgor

• Less thirst

• Moist mouth

• More energy

• More frequent and lighter urine

• Normal body temperature (less than 100.4 degrees F)

Signs a child may be worsening include:

• Dry mouth

• Extreme thirst

• High fever (more than 104 degrees F)

• Irritability

• Less urination or dark-colored urine

• Low energy

• Persistent vomiting or diarrhea

• Rapid heart rate or breathing

• Seizures

• Sunken eyes

• Temperature over 100.4 degrees F for more than three days

• Unresponsiveness

To prevent dehydration once your child has recovered, ensure they drink at least the recommended daily amount of fluids, mainly water and milk. Increase their fluid intake in hot weather or if they show mild dehydration signs. Recommended amounts by age are as follows:

• Ages 1 to 3 years: About 4 cups of fluids

• Ages 4 to 8 years: About 5 cups of fluids

• Ages 9 and older: About 7 to 8 cups of fluids

Tips to Encourage Daily Hydration

To help create healthy hydration habits and make drinking water more fun consider the following:

• Add a slice of fruit to the water for flavor.

• Include water breaks during playtime.

• Offer hydrating snacks like watermelon and cucumber.

• Teach kids to drink water throughout the day, not just when thirsty.

• Use fun stickers to track water intake.

Summary

Dehydration can cause a dry mouth, dark urine, and less frequent urination. In severe cases, children may become listless, confused, breathe rapidly, or faint, needing emergency care. To prevent dehydration, encourage regular fluid intake, especially during play. For sick children, start with oral rehydration solutions (ORS). Severe cases might require IV fluids.

Monitor improvement by checking mood, energy, urine output, skin color, and skin elasticity. If you notice worsening symptoms, trust your instincts and seek medical advice.

Read the original article on Verywell Health.