It is important that nurses obtain a history of
the child’s usual fluid intake and compare this
to intake over the past 48 hours. Whenever
possible, fluids should be replaced orally, and
offered frequently in small amounts. Children
often refuse fluids when they are very hot, and
may vomit, however this is not necessarily a
sign of serious illness. Children are more likely
to be receptive to food and drink when their
temperature has dropped and they are more
alert. Nurses should advise parents of this
window of opportunity and encourage them
to offer fluids and snacks as soon as a child is
thirsty and hungry. The assessment of a young
child’s hydration should focus on whether the
mucous membranes (lips and tongue) are moist
(NICE 2013). Indications of serious illness
associated with dehydration in infants include
dry mucous membranes, increased heart rate,
weak pulse, prolonged capillary refill time,
reduced urine output, and a history of not
feeding (RCN 2013b).