Doctors’ Notes



While parents may not consider “dehydration” as a scary diagnosis, significant dehydration is one of the most common reasons pediatric patients get taken to the hospital emergency room.

Dehydration occurs when a person’s fluid intake doesn’t keep up with the body’s fluid intake requirement. Dehydration can become serious over several days, but can occur rapidly within a day.

A common reason for significant dehydration in children is viral illnesses. These illnesses cause vomiting and/or diarrhea, and may even be associated with fever or rash. To make matters worse, just when kids with these conditions need more fluid, they are likely to eat and drink less, because they lose their appetite and sometimes even feel nauseated.

Signs of Dehydration

What makes dehydration so dangerous is the depletion of water. Our body is mostly made up by water, so when our body doesn’t get as much as it needs, it tries to preserve the water we still have inside. One way this demonstrates itself is that we don’t urinate (or “pee”) as much. This is a key indicator, especially since it is relatively easy to assess.

Depending on the level of dehydration — mild, moderate, or severe — our bodies display more and more worrisome symptoms. Increased thirst, headache, and a dry mouth can be associated with mild dehydration. As the condition worsens, patients can develop more significant headaches, agitation, and even lethargy.

Parents can use urinie output as a marker of dehydration severity. Normally, kids and adults urinate at least three times per 24 hours. Infants should urinate at least every three to four hours. As a person becomes more dehydrated, their body avoids losing water by putting out less “waste” water in the form of urine.

The more dehydrated, or “dry,” a person becomes, the darker, stronger smelling, and more concentrated their urine becomes. Other signs and symptoms, such as the ability/inability to make tears or sweat, are not very reliable.  Similarly, a sunken skull fontanel (or “soft spot”) or skin turgor (“skin stretchiness”) are later markers of significant dehydration and not reliable markers either.

There are many viral illnesses that cause gastrointestinal (“GI”) symptoms such as nausea, vomiting, diarrhea,, abdominal pain, gassiness, bloating and more. A great battle against possible dehydration was won when the vaccine for rotavirus, a leading viral cause of vomiting and diarrhea, became a regular part of the U.S. vaccination regimen; it rapidly eliminated millions of doctor visits, trips to the ER, and hospitalizations caused by the disease and its effects. But there are, of course, still plenty of viral illnesses that cause the problem.

Drinking an adequate amount of appropriate fluids can treat most cases of dehydration.  If you think your child is becoming dehydrated, you should call us in the office.

Dr. Wolynn is the President and CEO of Kids Plus Pediatrics.