Rehydration for a 17-Month-Old Toddler
For a 17-month-old with mild to moderate dehydration, administer 50-100 mL/kg of oral rehydration solution (ORS) like Pedialyte over 3-4 hours, starting with small volumes (5 mL every 5 minutes) and gradually increasing as tolerated. 1
Severity Assessment First
Before starting treatment, quickly assess dehydration severity:
- Mild dehydration: Thirst, slightly dry mucous membranes, normal vital signs 2
- Moderate dehydration: Decreased skin turgor, dry mucous membranes, capillary refill 2-3 seconds, reduced urine output 1
- Severe dehydration: Altered mental status, capillary refill >3 seconds, poor perfusion, lethargy—requires immediate IV therapy 1
Initial Rehydration Protocol
For Mild to Moderate Dehydration (Most Common)
Calculate total volume needed: A 17-month-old typically weighs 10-12 kg, requiring approximately 500-1200 mL of ORS over 3-4 hours 1, 3
Administration technique:
- Start with 5 mL every 5 minutes for the first 30 minutes 4
- If tolerated without vomiting, increase to 10-15 mL every 10-15 minutes 4
- Continue this pattern until the calculated volume is administered over 3-4 hours 1
Even if the child is vomiting, oral rehydration is still feasible—give one teaspoon (5 mL) every 1-2 minutes using a syringe or medicine dropper 1, 2
For Severe Dehydration
Immediate IV rehydration is mandatory: Administer 20 mL/kg boluses of isotonic crystalloid (0.9% normal saline or Ringer's lactate) until pulse, perfusion, and mental status normalize 1, 4
Once stabilized, transition to oral rehydration therapy 1
Replacing Ongoing Losses
For each diarrheal stool or vomiting episode, give 60-120 mL of ORS (since the child is under 10 kg, use the lower end; if over 10 kg, use the higher end) 1
Alternative calculation method: 10 mL/kg for each watery stool and 2 mL/kg for each vomiting episode 1, 4
Continue replacing losses as long as diarrhea or vomiting persists 1
Critical Product Selection
Use only commercially available low-osmolarity ORS such as Pedialyte 1, 3, 5
Never use: Apple juice, Gatorade, sports drinks, cola, or commercial soft drinks—these have inappropriate electrolyte content and excessive osmolality that can worsen diarrhea 1, 3, 4, 2
Feeding During Rehydration
Resume age-appropriate diet within 3-4 hours after completing the initial rehydration phase 1, 3
Do not delay feeding until diarrhea stops—early feeding shortens the duration of illness 3, 2
If breastfeeding, continue nursing throughout the entire illness in addition to ORS 1, 4
Monitoring and Reassessment
Reassess hydration status after 2-4 hours by checking:
- Skin turgor and mucous membrane moisture 1
- Capillary refill (goal ≤2 seconds) 1
- Urine output (goal >1 mL/kg/hour) 1
- Mental status and activity level 1
If dehydration persists or worsens, restart the rehydration calculation or escalate to IV therapy 1
Alternative Route if Oral Fails
If the child cannot drink but is not in shock, consider nasogastric administration of ORS at 15 mL/kg/hour 1, 3, 5
This is particularly useful for persistent vomiting when oral intake repeatedly fails 5
Common Pitfalls to Avoid
- Never restrict fluids—adequate hydration is essential for recovery 3, 4
- Never use anti-diarrheal medications in children with acute diarrhea 1, 3, 4
- Never delay rehydration waiting for laboratory results in obvious clinical dehydration 2
- Do not use homemade solutions—electrolyte balance is critical and difficult to achieve at home 1
When to Seek Immediate Medical Attention
Escalate to emergency care if: