Should Your Child See a Doctor?
Drinking Fluids – Decreased
This Care Guide Covers
- Child drinks less than normal amounts of fluid
See Other Care Guide If
- Age less than 12 weeks and breastfed. See BREASTFEEDING QUESTIONS.
- Age less than 12 weeks and formula fed. See BOTTLEFEEDING QUESTIONS.
- Mouth ulcers are the cause. See MOUTH ULCERS.
- Age over 2 years and sore throat is the cause. See SORE THROAT.
Causes For Drinking Less Fluid Than Normal
- Sore Throat. A sore throat is the most common cause. The pain is made worse by swallowing. Most sore throats are caused by a virus. Strep bacteria cause 20% of sore throats with fever.
- Mouth Ulcers. Mouth ulcers are another common cause of a painful mouth. The pain is made worse by swallowing. Most mouth ulcers are caused by a virus (such as Coxsackie virus).
- Nausea. Nausea means a sick stomach feeling and loss of appetite. Also called an upset stomach, but without vomiting. Usually from a viral infection of the stomach or liver.
- Blocked Nose. A common cause in bottle or breastfed infant. Reason: If nose is clogged, the baby can't breathe while sucking.
- Trouble Breathing (Serious). Shortness of breath from any lung disease can reduce fluid intake. Examples are pneumonia, wheezing or severe croup. Reason: The baby quickly gets tired from sucking and breathing at the same time.
- Foreign Body (Object) in the Esophagus (Serious). The esophagus is the tube from the mouth to the stomach. A swallowed foreign object can become stuck here. Examples are coins or small toy parts. The main symptoms are gagging, refusal of fluids or drooling. The peak age is 1 to 3 years.
- Abscess of Tonsil (Serious). A bacterial infection of the tonsil can spread to the surrounding tissues. The main symptoms are severe trouble swallowing, fever and one-sided throat pain. It's also hard to fully open the mouth. The peak age is teens.
- Dehydration. This is the health problem where the body has lost too much fluid.
When To Call Your Doctor
Call 911 Now (your child may need an ambulance) If
- Not moving or very weak
- You think your child has a life-threatening emergency
Go to ER Now
- Could have swallowed a coin or other foreign object
Call Your Doctor Now (night or day) If
- Too weak to suck or drink
- Signs of dehydration, such as:
- Has not passed urine in more than 8 hours
- Crying does not cause tears
- Very dry mouth
- Sunken soft spot
- Sleepy child
- Will not drink or drinks very little for more than 8 hours
- Will not drink and new onset of drooling
- Trouble breathing
- Your child looks or acts very sick.
- You think your child needs to be seen, and the problem is urgent.
Call Your Doctor Within 24 Hours If
- Poor drinking and also has fever
- Poor drinking lasts more than 3 days
- You think your child needs to be seen, but the problem is not urgent
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
Parent Care at Home If
- Drinking adequate amount of fluids and no signs of dehydration
Care Advice for Decreased Fluid Intake
- What You Should Know About A Decreased Fluid Intake:
Fluids - Offer More:
- Eating less solids during an illness is normal.
- Drinking less fluids is not.
- So far, your child does not have any signs of dehydration.
- Here are some tips to help increase fluid intake.
Solid Foods - Less Important:
- Give your child lots of their favorite liquid.
- Use fluids like chocolate milk, fruit drinks, water or even soft drinks. The type doesn't matter. The type only matters if your child has diarrhea or starts throwing up.
Sore Mouth Treatment:
- 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.
Liquid Antacid for Mouth Pain (Age 1 Year and Older):
- 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 an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Use as needed. See Dose Table.
Nasal Washes To Open a Blocked Nose:
- 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 1 to 6 years. Put a few drops in the mouth. Can also put it on with a cotton swab.
- Age over 6 years. 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.
- Caution: Do not use regular mouth washes, because they sting.
For Shortness of Breath - Give Smaller Feedings:
- Use saline nose spray (such as store brand) to loosen up the dried mucus. If you don't have saline, you can use a few drops of tap water. (If under 1 year old, use distilled water or boiled tap water.)
- Step 1. Put 3 drops in each nostril. (If under 1 year old, use 1 drop.)
- 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. If under 1 year old, no more than 4 times per day or before every feeding.
- 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 warm water. Use distilled water or boiled water to make saline nose drops.
- 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.
Call Your Doctor If:
- 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.
- Trouble swallowing gets worse
- Signs of dehydration occur
- Poor drinking lasts more than 3 days
- Your child becomes worse
Remember! Contact your doctor if your child develops any of the "When to Call" symptoms.
- Armon K, Elliott EJ. Acute gastroenteritis. In: Moyer V, Davis RL, Elliott E, et al, eds. Evidence Based Pediatrics and Child Health.London, England: BMJ Publishing Group; 2000. p. 273-286
- Gorelick MH, Shaw KN, Murphy KO. Validity and reliability of clinical signs in the diagnosis of dehydration in children. Pediatrics. 1997;99 (5):E6.
- Jospe N and Forbes G. Fluids and electrolytes: Clinical aspects. Pediatr Rev. 1996;7:395-404.
- Morrison JE Jr and Pashley RT. Retropharyngeal abscess in children: A 10-year review. Pediatr Emerg Care. 1988;4:9-11.
- Nicklane PJ and Kelley PE. Management of deep neck infection. Pediatr Clin North Am. 1996;43:1277-1296.
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.
Author: Barton D. Schmitt, M.D.
Last Reviewed: 1/2/2014
Last Revised: 4/4/2014 12:32:57 PM
Content Set: Child Symptom Checker
Version Year: 2014
Copyright 1994-2014 Barton D. Schmitt, M.D.