What are the symptoms of dehydration?
Dehydration is a loss of body fluids, which are made up of water and salts. When sick children vomit or have diarrhea, they can lose large amounts of water from their bodies and can become dehydrated very quickly. Healthy children can spit up, vomit, or have a loose stool once in a while without being in danger of dehydrating.

Dehydration can be very dangerous, especially for babies and toddlers. Children can even die if they are not treated.

What are the signs of dehydration?

• decreased urination (less than 4 wet diapers in 24 hours)
• no tears
• dry skin, mouth and tongue
• sunken eyes
• grayish skin
• sunken soft spot (fontanel) on infant's head

What are the symptoms of diarrhea?
Diarrhea is a very common problem in childhood. Usually, it is mild and brief. Sometimes, it can be severe, especially in infants.

Every child has a different pattern of bowel movements, so it is sometimes difficult to tell if a child has diarrhea or just a loose bowel movement. A child has diarrhea if there are more bowel movements than usual, or if stools are less formed and more watery than usual. A child with diarrhea may also have fever, loss of appetite, nausea, vomiting, stomach pains, cramps, and blood and/or mucus in the bowel movement.

How is it transmitted?
Diarrhea germs are easily spread from person to person, and especially from child to child. They usually spread readily among children who have not learned to use the toilet. The spread of the infection can be reduced if adults and children wash their hands carefully after every diaper change and going to the toilet, and before preparing and eating food.

What causes diarrhea?
Many different germs cause diarrhea. Most commonly, it is caused by a virus and so cannot be cured with antibiotics. Occasionally bacteria causes diarrhea: examples include Campylobacter, Salmonella, Shigella and Escherichia coli. Some bacterial diarrhea can be cured with antibiotics.

What can happen if diarrhea is not treated properly?
Diarrhea can be dangerous if not treated properly because it drains water and salts from the child. If these are not put back quickly, dehydration can occur and hospitalization may be necessary. It is most important that the child with diarrhea continues to drink an appropriate quantity of fluids to avoid dehydration.

What are oral rehydration solutions?

• water
• salts
• sugar

They are available at drugstores in ready-to-serve preparations, pops and powders.

How can you treat vomiting and diarrhea?
At the start of vomiting or diarrhea:

If breastfeeding, it is important continue to breastfeed on demand and offer oral rehydration solution (ORS), such as Gastrolyte® (be sure to mix according to directions) or Pedialyte®.

If not breastfeeding, stop all food and drink and give ORS as follows:

First six hours

Six months and under
30 to 90 mL (1 to 3 oz.) every hour

Six to 24 months
90 to 125 mL (3 to 4 oz.) every hour

Over two years
125 to 250 mL (4 to 8 oz.) every hour

If infant refuses ORS by the cup or bottle, give this solution using a medicine dropper, small teaspoon or pops. If child vomits, continue to give ORS using a spoon. Give 15 mL (1 tbsp.) every 10 to 15 minutes until vomiting stops, then give regular amount. If vomiting does not stop after 4 to 6 hours, take your child to the hospital.

Six to 24 hours: recovery stage

• Keep giving the oral rehydration solution until diarrhea is less frequent.
• After 24-48 hours, most children can resume their normal diet.
• When vomiting stops, it important to have your child drink usual formula or whole milk and regular food in small frequent feedings.
• Do not give fruit juices or sweetened desserts until the diarrhea has stopped.
• Stools may increase at first (one or two more each day). It may take 7 to 10 days or longer for stools to become completely formed. This is part of healing the bowel.

What should parents avoid giving their children if they have diarrhea or are vomiting?
DO NOT give sugary drinks such as: Kool-Aid®, fruit juice/drinks, pop, Jell-O®, sweetened tea, broth or rice water. These have the wrong amounts of water, salts and sugar. These can make your child's diarrhea worse.

DO NOT give over-the-counter medications to stop diarrhea. These will prevent the body from getting rid of infection.

When should parents call their child's doctor?

• your child has diarrhea and is less than 6 months of age
• your child has bloody or black stools
• your child starts to vomit and is still vomiting after 4-6 hours
• your child has a fever: temperature greater than 38.5¼C (101.5¼F)
• your child has signs of dehydration:
• decreased urination (less than 4 wet diapers in 24 hours)
• no tears
• dry skin, mouth and tongue
• sunken eyes
• grayish skin
• sunken soft spot (fontanel) on infant's head

If diarrhea or cramping continues after 5-7 days, your doctor may suggest lactose-free milk until diarrhea improves.

Careful handwashing after going to the bathroom or changing diapers will prevent spread of infection to others.