OHSU

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

See More Appropriate Topic (instead of this one) If

WHEN TO CALL YOUR DOCTOR

Call 911 Now (your child may need an ambulance) If

  • Not moving or very weak

Call Your Doctor Now (night or day) If

- Your child looks or acts very sick

- Signs of dehydration, such as:

  • Has not urinated in over 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 over 12 hours (8 hours if under 12 months old)
  • Refuses to drink and new onset of drooling
  • Could have swallowed a foreign body
  • Wheezing or stridor with breathing
  • Difficulty breathing not better after you clean out the nose

- You think your child needs to be seen urgently

Call Your Within 24 Hours (between 9am and 4pm) If

  • You think your child needs to be seen. but not urgently
  • Unexplained difficulty drinking and also has fever
  • Poor drinking present over 3 days

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

Patient Home Care If

  • Drinking adequate amounts of fluid AND no signs of dehydration and you don't think your child needs to be see

HOME CARE ADVICE FOR Drinking Fluids - Decreased

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.

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.

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.

Nasal Washes To Open a Blocked Nose:

  • Use saline nose drops or spray to loosen up the dried mucus. If not available, can use warm tap water.
  • STEP 1: Instill 3 drops per nostril. (Age < 1 year, use 1 drop and do one side at a time)
  • STEP 2: Blow (or suction) each nostril separately, while closing off the other nostril. Then do other side.
  • STEP 3: Repeat nose drops and blowing (or suctioning) until the discharge is clear.
  • Frequency: Do nasal washes whenever your child can't breathe through the nose.
  • Saline nasal sprays can be purchased OTC
  • Saline nose drops can also be made: add 1/2 tsp of table salt to 1 cup (8 oz) of warm water
  • Reason for nose drops: suction or nose blowing alone can't remove dried or sticky mucus.
  • Another 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.
  • Importance for a young infant: can't nurse or drink from a bottle unless the nose is open.

For Shortness of Breath: For mild bronchiolitis or difficult breathing, offer small frequent (every ½ hour) feedings so the infant can rest briefly between them.

Call Your Doctor If:

  • Difficulty swallowing becomes worse
  • Signs of dehydration
  • Poor drinking present over 3 days
  • Your child becomes worse


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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Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 9/15/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.

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