Toddlers are often too busy playing and exploring to even notice they're thirsty, let alone stop for a water break. And it's not always easy to figure out that your little one needs a drink, especially when he doesn't yet have the words to tell you himself.
Young children are especially vulnerable to dehydration because their small body size means they take in less fluid, so the balance between fluids consumed and those lost can easily get out of whack.[1]
But not to worry. Even if your tot doesn’t always pay attention to his thirst, you can keep him safe in the heat and during stomach bug season by knowing and recognizing the signs of dehydration in toddlers, as well as taking steps to keep him well-hydrated throughout the day.
What are the warning signs of dehydration in toddlers?
The easiest way to track hydration isn’t by counting ounces — with all those spills, it would be nearly impossible anyway. Instead, make sure your little one is frequently sipping from his water bottle throughout the day and producing plenty of clear urine in his diaper (or the potty).
Still, dehydration can occur quickly, especially if your little one is sick (vomiting and diarrhea are the most common causes of dehydration in young kids) or active on a hot day.
A younger toddler may not be able to tell you he’s thirsty, but these warning signs of mild or moderate toddler dehydration are important to look out for:[2]
- Urinating less often (fewer than six wet diapers a day can be a sign of mild or moderate dehydration, according to the American Academy of Pediatrics)
- Darker/yellower and more concentrated urine
- Cracked lips or other signs of dry mucus membranes
- Being less active than usual
- Tearless crying
- Flushed skin
- Loose stools (if the dehydration is caused by diarrhea) or fewer bowel movements (if your little one has been vomiting)
If your toddler’s dehydration is more severe, he’ll be urinating much less often than usual (only once or twice a day) and can have other symptoms as well, such as fussiness, sunken eyes, skin that appears wrinkled, and hands and feet that are cool or look discolored.
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How to prevent dehydration in toddlers
It’s not always possible to prevent dehydration in toddlers, especially if your little one is vomiting as a result of a stomach bug. But if you’re chasing your little one through the park, getting sandy at the beach or simply out for an afternoon stroll, here’s how to make sure your toddler stays properly hydrated:
- Offer enough fluids throughout the day. Toddlers ages 1 to 3 need about 4 cups of fluids daily, according to the AAP, including both milk and water (this recommendation increases to about 5 cups at age 4). Help your tot get enough by offering water with meals and bringing a sippy cup or water bottle along on outings, especially on hot days. In the heat, offer additional water two to three times daily.[3]
- Don’t over-juice. Juice has a high sugar content and doesn’t offer nutritional benefits over whole fruit, so it should be limited to at most 4 to 6 ounces a day for kids between ages 1 and 6, the AAP says. Too much juice can also contribute to diaper rash, tooth decay, obesity and even diarrhea, so it's best that you don't offer it daily or avoid adding it to your child's diet entirely. If your tot does drink juice, make sure it’s natural, 100% fruit juice and reduce sugar content by watering it down by at least 50% (half juice, half water). Naturally sweetened white grape juice is easier on digestion than apple juice.[4]
- Avoid the hottest part of the day. Structure your child’s schedule to limit outdoor play during the most sweltering times of the day, when the sun is highest in the sky. If possible, try to burn off your tot's energy by hitting the park, pool or backyard in the early morning (before 10 a.m.) and in the late afternoon (after 4 p.m.). When it does get too hot, find shade, take a dip in the water if you're at the pool or beach, or head inside. The good news? It’s probably almost time to eat or take a nap anyway!
- Dress your toddler appropriately. Make sure your toddler always wears a wide-brimmed hat and light summer clothing in the heat.
- Choose foods with a high water content. Chunks of watermelon are a great choice because they contain a lot of water. Soups are also good for keeping your toddler hydrated.
Treating dehydration in toddlers
Though toddler dehydration sometimes requires a trip to the hospital to rehydrate with an IV, most of the time you can help get your little one’s hydration back on track from home.[5]
Offering plenty of fluids is the most important way to prevent dehydration and treat mild cases. If your toddler shows any symptoms of dehydration, offer a thirst-quenching drink like water or an electrolyte replacement solution such as Pedialyte, which not only hydrates but replenishes electrolytes that can be lost in sweat. Some toddlers don’t love the salty flavor, though, in which case you can stick to plain water. Pedialyte popsicles work well too.[6]
If your little one refuses Pedialyte and water, consider a sports drink like Gatorade — in very small doses. While sports drinks do contain electrolytes, they're also packed with quite a bit of sugar like juice, so they should only be given in limited amounts.
Treating dehydration from the stomach flu
Dehydration is the most common complication from gastrointestinal illnesses, which are usually caused by viruses. When a child is vomiting or has diarrhea, it can be difficult to keep him hydrated. If vomiting is severe, it can cause a child to lose sodium, potassium and chloride, all of which are important for regulating fluid balance in the body.
Most cases can be treated at home unless your toddler can't tolerate fluids at all. If your little one is sick and is having trouble keeping fluids down, offer sips of water, Pedialyte or other electrolyte replacement drinks frequently.
You can also try waiting an hour after your child vomits and then offering a teaspoon of Pedialyte or water every 10 minutes for an hour. If your little one can keep that down, you can gradually increase the amount of water you're giving him.
Call your pediatrician if your child:
- Has been vomiting for more than 24 hours
- Produces stools that are bloody, greenish or look like coffee grounds
- Won’t take fluids
- Has a swollen abdomen that causes more than mild discomfort
Gradually rehydrate your little one by offering an electrolyte solution for 12 to 24 hours as vomiting and diarrhea subside.
Once he’s on the mend, you can slowly reintroduce foods like applesauce, pears, bananas, rice, dry toast, saltine crackers and flavored gelatin with the goal of returning to a normal diet within a few days.
If your tot had diarrhea, your pediatrician might suggest you hold off on offering milk for a few days. Otherwise, it’s okay to feed toddlers whatever they can keep down — no need for a special diet.
When should you take your child to the hospital for dehydration?
Mild and moderate dehydration in toddlers can usually be managed at home by increasing your child’s fluid intake and offering an electrolyte replacement solution, if your pediatrician recommends it. But when a child is severely dehydrated, he may need to go to the hospital to have fluids administered through an IV.
Here’s how to tell when symptoms are more serious and warrant a trip to the ER:
- Unusual coolness of the hands and feet
- Wrinkled skin
- Extreme fussiness
- Lethargy or unusual sleepiness
- Sunken fontanelle (the "soft spot" on the top of his head)
- Dry diaper for more than 18 to 24 hours
Extreme weather conditions or a simple stomach bug can make monitoring whether your toddler is properly hydrated challenging. By offering enough fluids ahead of time and noticing possible signs that your little tyke is becoming dehydrated early on, you can prevent serious cause for concern.
Whatever the source of your tot's extreme thirst, if you see any potentially worrying symptoms of toddler dehydration, don’t hesitate to contact your pediatrician for guidance.
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