Fluid Intake Decreased

When To Call

Call 911 Now

• Severe trouble breathing (struggling for each breath; can barely speak or cry)
• 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
• Too weak to suck or drink

Call Doctor or Seek Care Now

• 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, but not severe
• Can't move neck normally
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• 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

Contact Doctor During Office Hours

• You have other questions or concerns

Self Care at Home

• Drinking adequate amount of fluids and no signs of dehydration

Care Advice

What You Should Know About A Decreased Fluid Intake:

• 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.

Fluids - Offer More:

• Age less than 1 year: keep giving formula or breast milk. You can also try ORS (such as Pedialyte).
• Age more than 1 year: offer chocolate or regular milk, fruit drinks, juice or water. You can also try popsicles.
• The type of fluid doesn't matter, as it does with diarrhea or vomiting.

Solid Foods - Less Important:

• 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.

Sore Mouth Treatment:

• 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.

Liquid Antacid for Mouth Pain (Age 1 Year and Older):

• 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.

Nasal Saline to Open a Blocked Nose:

• Use saline (salt water) nose spray to loosen up the dried mucus. If you don't have saline, you can use a few drops of water. Use distilled water, bottled 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 saline rinses 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 ½ teaspoon (2 mL) of table salt. Stir the salt into 1 cup (8 ounces or 240 mL) of warm water. Use bottled 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.

For Shortness of Breath - Give Smaller Feedings:

• 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.

Call Your Doctor If:

• Trouble swallowing gets worse
• Signs of dehydration occur
• Poor drinking lasts more than 3 days
• You think your child needs to be seen
• Your child becomes worse

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