Weiss Pediatric Care

Drinking Fluids During Illness

Definition

  • Child drinks less than normal amounts of fluid during an illness

Call or Return If

  • Trouble swallowing gets worse
  • Signs of dehydration occur
  • Poor drinking lasts more than 3 days
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Causes

  • Main cause. Mouth ulcers or sore throat.
  • Common cause in babies. Nasal congestion or blocked nose in bottle or breastfed infant. Reason: Can't breathe while sucking.
  • Common cause. Nausea (upset stomach) from a virus, but without vomiting.
  • Trouble breathing with a viral illness that affects breathing such as croup. Reason: Baby gets tired out from sucking and breathing at the same time.

Dehydration: How to Know

  • Dehydration means that the body has lost too much fluid. These are signs of dehydration:
  • Decreased urine (no urine in more than 8 hours) happens early in dehydration. So does a dark yellow color. If the urine is light straw colored, your child is not dehydrated.
  • Dry tongue and inside of the mouth. Dry lips are not helpful.
  • Dry eyes with decreased or absent tears
  • In babies, a depressed or sunken soft spot
  • Slow blood refill test: Longer than 2 seconds. First, press on the thumbnail and make it pale. Then let go. Count the seconds it takes for the nail to turn pink again. Ask your doctor to teach you how to do this test.
  • Fussy, tired out or acting ill. If your child is alert, happy and playful, he or she is not dehydrated.
  • A child with severe dehydration becomes too weak to stand. They can also be very dizzy when trying to stand.

 

After Care Advice

Overview:
  • Eating less solids during an illness is normal. Drinking less fluids is not.
  • The main risk for your child is getting dehydrated. Dehydration means the body has lost too much fluid. Usually that's defined as losing 5% or more of body weight.
  • Your job is to increase fluid intake.
  • Here is some care advice that should help.
Offer Lots of Fluids:
  • Give your child lots of their favorite liquid.
  • Age under 1 year: Continue offering formula or breast milk. You can also try ORS (such as Pedialyte).
  • Age over 1 year: Offer chocolate or regular milk, fruit drinks, juice or water. You can also try popsicles.
  • The type of fluid doesn't matter, as it does with diarrhea or vomiting.
Solid Foods:
  • Don't worry about solid food intake.
  • It's normal not to feel hungry or want to eat when sick.
  • Preventing dehydration is the only thing that is important.
For A Sore Mouth:
  • If the mouth is sore, give cold drinks.
  • Do not use citrus juices.
  • For babies, offer fluids in a cup, spoon or syringe rather than a bottle. Reason: The nipple may increase pain.
  • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed.
Liquid Antacid for Mouth Sores:
  • For mouth pain, use a liquid antacid such as Mylanta or the store brand. Give 4 times per day as needed. After meals often is a good time. Age: Use for children over 1 year old.
  • For children over age 6, can use 1 teaspoon (5 ml) as a mouth wash. Keep it on the ulcers as long as possible. Then can spit it out or swallow it.
  • For younger children age 1 to 6, put a few drops in the mouth. Can also put it on with a cotton swab.
  • Caution: Do not use regular mouth washes, because they sting.
Nasal Washes To Open a Blocked Nose:
  • Use saline nose drops or spray to loosen up the dried mucus. If you don't have saline, you can use clean tap water. (If under 1 year old, use distilled water or boiled tap water.)
  • STEP 1: Put 3 drops in each nostril. (If age under 1 year old, use 1 drop. Also, do 1 side at a time.)
  • STEP 2: Blow (or suction) each nostril out while closing off the other nostril. Then, do the other side.
  • STEP 3: Repeat nose drops and blowing (or suctioning) until the discharge is clear.
  • How often: Do nasal washes when your child can't breathe through the nose. Limit: No more than 4 times per day.
  • Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
  • Saline nose drops can also be made at home. Use 1/2 teaspoon (2 ml) of table salt. Stir the salt into 1 cup (8 ounces or 240 ml) of water. You must use distilled or boiled water for this purpose.
  • Reason for nose drops: Suction or blowing alone can't remove dried or sticky mucus. Also, babies can't nurse or drink from a bottle unless the nose is open.
  • Other option: use a warm shower to loosen mucus. Breathe in the moist air, then blow each nostril.
  • For young children, can also use a wet cotton swab to remove sticky mucus.
For Shortness of Breath:
  • For trouble breathing, feed more often. Feed every ½ hour.
  • Offer smaller amounts per feeding.
  • Reason: This allows your baby to rest in between feedings.
What to Expect:
  • Normal appetite should gradually come back.
  • Sometimes, it takes a week.
  • It depends on your cause of your child's illness.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
Article 2694