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Is My Toddler Dehydrated?

Is My Toddler Dehydrated?

By Amalah

Hello Amy,

I’ve been reading your work since I first learned that I was pregnant and have loved your down-to-earth advice. I have been staying home with my almost 17 month old son since he was born. At 12 months I started working two days a week, but they were short days and my son was only in daycare from about 8am until 3 or 4pm. Next week I go back to work for real. Full time, long days, and an hour long commute. I’m sad, but more importantly, terrified that my kid won’t drink enough.

My son is moving to the toddler room at daycare on Monday and they won’t allow him to have a bottle. He has always refused a sippy cup. He can and does drink from an open cup at home, but they won’t offer an open cup at daycare for obvious reasons. Until recently he had three bottles of milk a day. I know, I know, but he won’t drink! I cut out one bottle a couple of weeks ago and am now only offering bottles after breakfast and before bed. That means that when he only has sips at daycare he doesn’t have anything significant to drink from 7am until 7pm. And I’m afraid that this will make him dehydrated when he is at daycare five days a week.

I’ve been told that kids drink when they are thirsty enough. But I learned when he was 10 months old that that isn’t exactly true for my kid. He weaned himself and basically wasn’t drinking anything, except I didn’t know how much he should have been drinking so I let it go on for awhile. As soon as I offered a bottle his wet diaper count tripled.

So what do I do? We are back to a low wet diaper count, even with the open cups at home. I know I offer water more often at home than they do at daycare and still he isn’t drinking enough. I HAVE to go back to work on Monday and I HAVE to keep my kid hydrated, but they seem to be opposing goals at the moment. I know that my going back to work anxiety is contributing to my concern, but I also feel like I’m failing my kid. Any advice you offer would be appreciated.

K

It will probably never cease to amaze me just HOW MANY WAYS our toddlers find to freak us out. My kid, at this age, lived his life on a non-stop water drinking binge, to the point that I was convinced he was diabetic and dragged him in for testing. He was fine. He just really liked drinking water, and still does.

So. My gut agrees with your second-to-last sentence: Your anxiety level over the hydration issue is stemming from the whole Bigger Picture of going back to work and guilt and the general huge adjustment of handing your baby over to another caregiver after almost 17 months (mostly) spent at home. It’s perfectly normal to worry about…well, a million different things while you’re in the middle of this transition. In my experience (for whatever that’s worth), you’ll feel better a couple weeks in, once you get used to the new routine, have work tasks to channel your energy into and focus on, and can look back and take a deep breath because everybody is alive and well.

However, I am in no way dismissing your concern as Irrational Mommy Guilt. It is absolutely possible for a toddler to dehydrate himself — it’s actually quite common for them to ignore their thirst during playtime and not request a drink until they’re not feeling well. Playing outside in hot and humid weather puts toddlers at particular risk. So there is a distinction between “whatever, he’ll eat when he’s hungry” and “whatever, he’ll drink when he’s thirsty,” because sometimes they just don’t.  That said, let’s look at some toddler hydration facts and see if we can find you some peace of mind.

At 17 months, milk should be limited to about 16 to 24 ounces a day. Assuming the bottles you mention are 8 oz each, three bottles a day puts him at the VERY TOP of the recommended limit. Two bottles a day still gets him enough milk for a 24-hour period. Obviously, I can’t technically recommend that you keep up with the morning and bedtime bottles for various reasons (dental, speech & sleep crutch that’s only going to get harder to withdraw), but if it helps keep your anxiety in check for the first few weeks to know he’s getting enough milk, you won’t hear much ruckus from me about it.

Let’s also talk about wet diaper counts. You didn’t mention specifics, other than you think it’s currently “low.” And “tripled” once you caved and re-introduced the bottle. I’m curious as to what “low” is. Obviously, a 17-month-old is not going to go through as many diapers as a newborn, or a baby under 12 months who gets the majority of his nutrition through breastmilk or formula. As he gets bigger, so does his bladder and his capacity to hold more urine…and for a lot longer. And while there is no one set “correct” number of diapers because it varies SO MUCH between babies, around 5-6 diapers a day (or 24-hour period) is pretty normal at this age, especially for a kid who was probably never a heavy wetter.

A better indication of his hydration level, rather than the number of diapers, is the color and smell of his pee. If it’s a light color (or practically invisible in a disposable) and only has a mild odor, he is FINE and perfectly hydrated. If his pee is darker colored and really bad smelling, then yes. He is dehydrated and needs some fluids. If there are tinges of blood in the urine, he is seriously dehydrated. Note that it is NORMAL for the first morning diaper to be darker colored/worse smelling, because he’s gone all night without liquids. (Most of us wake up at least mildly dehydrated.) But after his morning milk and breakfast, his body should adjust and his next diaper should be lighter and milder smelling. If his first wet diaper after daycare more or less passes the color/smell test (again, it’s normal for it to vary), you can rest assured he got enough fluids during the day, one way or another.

Because! At 17 months, he can also get a LOT of required liquids and hydration through solid foods. Fruit and yogurt both have a good amount water content in them, for example. Certain vegetables do too (cucumber is 96% water!). So if he’s devouring fruit and veggies during the day, it’s not surprising that he’s not craving a lot of extra water. And if he’s NOT, well, consider offering those instead of trying to push plain water on him. Not sure what the food/snack situation at your daycare is, but if you’re packing foods yourself, load him up with juicy fruits, yogurts, even those squeezable fruit sauce tubes, etc. Healthy fruit popsicles are a another good option for a post-playground-on-a-hot-day hydration source. Here are a few different lists of high-water content foods for inspiration.

Now. If you’re still reading at this point and freaking out because 1) he’s not wetting 5 diapers in 24 hours, 2) his wet diapers consistently look dark and smell bad, and 3) he refuses to eat any of the food items on any of those lists, then you should go to your pediatrician for advice. Perhaps he should get some Pedialyte or it’s okay to tempt him with diluted juice, but that’s a call the doctor should make, after confirming that hydration levels actually ARE a cause for real concern.

Some kids drink a lot. Others…not so much. Some soak through a dozen diapers a day through toddlerhood and others do not. My water-crazed toddler went through the fewest diapers; my heaviest wetter almost always left half-full cups of milk or water behind at mealtimes. IT SOMETIMES JUST DOESN’T MAKE ANY SENSE. Other than they exist to drive us crazy and scare the crap out of us. I’m hopeful that’s what’s going on with your son, and that you can find some peace of mind with some different snack offerings during the day and fluids in whatever type of cup/dispenser he’ll accept when he’s with you.

Amalah
About the Author

Amy Corbett Storch

Amalah

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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Comments

  • MYriam

    I would add 3 things… 1st) peer pressure and routine. You kid will probably want to do like the other kids, and there are built-in time to drink at daycare. 2) Trust the teachers. They have seen a lot of kids, and know how to deal with them. Mention your concerns about hydration and put your worry on the back burner for a bit. My breastfed daughter hadn’t had a bottle before starting daycare. In less than 2 weeks, she was a pro. 2) Have you consider the spoutless type of cup, like the Miracle Cup or the 360 (http://www.munchkin.com/cups/spoutless-cups.html). They are easy to clean, no spill, no straws to loose cup. 

    • I was also going to mention maybe trying more of a training cup than a standard sippy cup (they have ones that don’t leak but you drink from them like an open cup – it might seem like a step backwards if your child is already good at drinking from an open cup, but if the daycare won’t allow that then maybe it’d be a good compromise). Also, maybe it’s time to try a billion different sippy cups to see what your child will prefer? Both of my kids took forever to find the just right cup (with the first he did much better with a straw cup than a standard sippy opening, and my second preferred the Take and Toss sippy cups to straws or fancier sippy options. Go figure!). And BOTH of them always loved to drink from my straw topped water bottle. So re-opening the type of cup discussion might be helpful since he’s older now than it sounds like he was the last time you tried!

  • Tiffany

    If it makes you feel better, a lot of the time kids drink more water at daycare than at home, partly because it’s all that’s on offer, partly because everyone else is. I run s dayhome, & have had kids who literally just do NOT drink water at home, but they’ll drink it all day long here. Good luck going back to work 🙂

  • MR

    I’d try skipping sippy cups and going straight to a water bottle. Make sure you find out the rules for water bottles at your daycare (some allow only certain kinds), but one like the camelbak ones are no spill and are different enough from sippies, that he just might go for it. Of course, you have to teach them not to tip it back first, but that’s not too bad.

  • Jenelle

    I too was going to suggest a straw cup instead of a sippy cup. We like the Tommee Tippee ones, but admittedly they have a lot of annoying parts to clean. But they truly don’t leak if put together properly. 

    Also, as a pediatrician, we would be more worried about the total amount of fluid he gets over the whole day, rather than necessarily drinking on a regular schedule. So if he drinks at home in the morning and evening and eats normally at daycare, he should be fine. Perhaps switch out the bottle at home to a daycare-acceptable cup so that he only has one option, rather than holding out all day for the bottle at home.

  • L

    My kid drank a ton of water and still does – and he didn’t go through a ton of diapers. So, I’m with Amy, sometimes the fluids-to-diaper equation doesn’t make sense! That said – I also thought he was drinking so much because he was dehydrated, and my doc said the same thing Amy’s did: check the color and odor of the diapers. My kiddo is potty trained now and I still sometimes keep an eye on what his output looks like, especially during the summer (it’s hot here and he’s a sweaty little boy, so I’m aware of his increased risk). So! Don’t panic. Adjustments are hard, but you are already ahead of the game because your aware of the extra anxiety you have 🙂

  • Jamie

    I had trouble with a boy who wouldn’t take a sippy cup or drink anything other than milk.  My pediatrician basically told me as long as there were wet diapers, number didn’t really matter, he was getting enough to drink. She actually said, he could go all day without drinking anything and be fine, and I shouldnt give in.  I couldnt do it, so gave him a bottle at night and in the morning.  I finally figured out he really liked those yogurt smoothies and would sip on those. Then I figured out I could pour them into the straw cup his brother uses and he would drink if he saw that is what was going in.   They get expensive, so I bought Kefir which is a similar taste, and starting giving him cups of half kefir and half milk.  Eventually he started taking other liquids in the cup.  It was a long haul, but eventually it worked itself out.  My daycare was great about trying different things.

  • S

    Why are there “obvious reasons” for not allowing open cups?! In early intervention group class, they gave all the kids (12+ mo) open cups to practice with unless there were severe physical disabilities in conjunction with a choking risk. By 18 months, kids should be able to use them. Your kid should have a straw bottle like a munchkin or contigo to bring with him. If he can’t use a straw, teach him. Totally agree on cutting out the milk bottles. The best advice I got for that was to first cut the morning bottle and go right into breakfast.

  • CeeBee

    Also, please consider taste. I have always been able to taste subtle nuances in anything. Butter sat out overnight? I can’t eat it. And water is no different. I find that a lot of municipal tap water tastes like a swimming pool and what child can’t wait to sip from a big cup of chlorine? We ended up buying a very rural house and the well water is divine. I would see if he’s happy to drink a clean tasting bottled water over the tap. But also, I’d start cutting out the milk. Like foods, it takes time to acquire taste for anything including water in general.

    • Kate

      I agree, most tap water tastes gross. We have a Zero Water pitcher and now my water doesn’t taste like anything. Do keep in mind that you’re then removing the flouride from the water as well and may want to add it back in.

  • Hannah

    Also, try offering him water in the car on the way there and back. My son sometimes drinks a whole 250 ml in the car and it’s one of the only places where he doesn’t have anything better to do.