Dehydration Signs You Can See at Home

Dehydration is usually gradual and usually visible, which is why a short list of things to check is more useful than a rule about ounces. Vomiting and diarrhoea are the commonest causes in the first years, and hot weather plus a reluctance to drink is the second.

What to look at

Nappies are the most reliable signal: fewer wet nappies than usual, or urine that is dark and strong-smelling. A sunken soft spot on the head in a baby under a year. Dry lips and a dry mouth. Skin on the back of the hand or the abdomen that does not spring back promptly when gently pinched. Fewer tears when crying. And behaviour: an unusually sleepy, floppy or irritable baby is the most concerning sign of the group.

• Fewer wet nappies, or dark urine, is the earliest sign.
• Offer small amounts often: 5 to 10 ml every few minutes for a vomiting child.
• Oral rehydration solution is more effective than juice or plain water.
• If a child refuses all fluids for 8 hours, call for advice.

What to do

Give fluids in small, frequent amounts rather than a large bottle, because a full stomach often triggers more vomiting. Oral rehydration solution has the right balance of salt and sugar and is genuinely better than any home-made alternative; give it by spoon or syringe every few minutes if you have to. Continue breastfeeding through a bug, as breast milk is well tolerated and hydrating. Avoid giving a large volume of juice, which can worsen diarrhoea.

Go for assessment if a child is drowsy, difficult to wake, has not passed urine for eight to twelve hours, is vomiting green fluid, has bloody diarrhoea, or is too unwell to drink. In a baby under six months, call earlier rather than later, because the margin is smaller and they have less reserve.