It’s important to understand the connection between gastroenteritis and dehydration, as gastroenteritis is one of the most common causes of dehydration among pediatric patients. Here, we will provide essential insights into pediatric dehydration as well as strategies to manage it effectively.

Understanding Pediatric Dehydration

Dehydration occurs when the body loses too much fluid to the point that it doesn’t have enough electrolytes to function properly.¹ Common causes of dehydration in infants and young children are diarrhea, vomiting, and fever.¹

Signs and symptoms of dehydration in pediatric patients may include:

• Dizziness²
• Headache²
• Dark-colored urine²
• Fatigue²
• Crying with few or no tears³
• Unusual sleepiness or fussiness³

Gastroenteritis and Dehydration in Pediatrics

The following are common gastrointestinal infections that can cause dehydration:

• Norovirus is an extremely contagious virus that causes inflammation of the stomach or intestines.⁴ Symptoms will usually develop 12 to 48 hours after exposure, and while most people recover within 1 to 3 days, the virus can still be contagious for a few days after recovery.⁴ Infants and young children with norovirus may vomit and/or have diarrhea many times a day, which can lead to dehydration.⁴
• Rotavirus often causes severe watery diarrhea and vomiting in infants and young children.² Symptoms of rotavirus usually start about 2 days after exposure, and the vomiting and watery diarrhea can last for 3 to 8 days.² Infants and young children with rotavirus may become dehydrated and need to be hospitalized in severe cases.²

Management Strategies

Handwashing and good hand hygiene are key to preventing gastrointestinal infections that cause dehydration. Once gastroenteritis has been identified, treatment approaches may include:

• Oral rehydration therapy (ORT)
• IV fluids
• Monitoring hydration status

ORT is a very effective method for treatment or prevention of dehydration at home, as caregivers can be instructed to give small amounts of fluids every few minutes over a few hours.⁴ As the patient’s symptoms resolve, they can begin eating small amounts of food and gradually return to an unrestricted diet.¹ In a course of ORT for a mild-to-moderately dehydrated patient, a 50 to 100 mL volume should be administered over 3 to 4 hours,¹ but factors like the child’s age and level of dehydration should be taken into account:

• Children younger than 2 years with mild dehydration should receive an additional 50 to 100 mL of fluid for every episode of vomiting or diarrhea.¹
• For older children, age, weight, and estimated or measured losses should guide the replacement volume. Typically, 10 to 20 mL/kg of body weight should be replaced for each diarrheal stool.¹

Drinks like Pedialyte^® and other oral rehydration solutions can be purchased over the counter and are helpful for treating mild dehydration, as they can help replace much-needed electrolytes.⁴

Be Proactive

When it comes to managing and preventing dehydration in children, proactive strategies are key. Being prepared in advance for gastroenteritis can help reverse mild to moderate dehydration and prevent a severe case. Healthcare professionals can support caregivers by providing them with hydration education, as well as reminding them to ask for input if they are ever concerned about their child’s hydration levels.  

References: 1. Daley SF, et al. Pediatric Dehydration. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK436022/ 2. US Centers for Disease Control and Prevention. About Rotavirus. https://www.cdc.gov/rotavirus/about/ 3. Nationwide Children’s. Dehydration: Giving Liquids at Home. https://www.nationwidechildrens.org/conditions/dehydration#:~:text=Dehydration%20means%20that%20your%20child,the%20main%20causes%20in%20babies 4. US Centers for Disease Control and Prevention. About Norovirus. https://www.cdc.gov/norovirus/about/?CDC_AAref_Val=https://www.cdc.gov/norovirus/about/treatment.html