Ask Dr. Hirsch: Weekly Q&A with Dr. Shari Hirsch, Pediatrician and Lactation Specialist at Lev Pediatric Care

This Week’s Question:

“When my baby isn’t eating much during an illness, how do I know if they’re getting dehydrated? Is three wet diapers enough?”

— T. Ligeti

Dr. Hirsch’s Answer:

Stomach bugs always seem to show up at the worst time, and once the vomiting or diarrhea begins, the big worry is dehydration. The good news is that most cases are mild, and knowing what to look for makes things much easier.

What Causes Dehydration

With a stomach virus, kids lose fluids through vomiting and diarrhea, and sometimes they’re too nauseated to drink. Not every bug leads to trouble, but younger children lose fluids faster, so early signs matter.

Mild Dehydration: Early Signs

These usually mean your child needs extra fluids but can still be managed at home:

• Thirstier than usual

• Dry lips

• Fewer wet diapers or bathroom trips

• Darker urine

• A little more tired or cranky

If they’re urinating every 6–8 hours and taking small sips, things are usually okay.

When to Call the Doctor

These signs mean it’s time to be seen:

• Fewer than 3 wet diapers in 24 hours, or no urine for 8–10 hours

• No tears when crying

• Dry mouth or tongue

• Fast breathing or rapid heartbeat

• Sunken eyes or unusual sleepiness

• Vomiting that prevents any drinking

• Blood in vomit or stool

If your gut says something isn’t right, check in. Parents notice changes early.

A Note About Infants

Babies under 6 months dehydrate quickly. Call if they’re feeding poorly, haven’t had a wet diaper in 6 hours, have a sunken soft spot, or seem overly sleepy.

How to Rehydrate

Give small sips every few minutes.

• Older babies and kids: Pedialyte or another oral rehydration drink works best.

• Avoid sugary drinks, it may worsen the diarrhea.

• Babies under 1: breast milk or formula unless your pediatrician says otherwise.

Bottom Line

If your child is drinking, urinating, and acting fairly normal between episodes, you’re likely on the right track. If they’re looking dry, tired, or not themselves, call your pediatrician. You know your child better than anyone.

​Dr. Shari Hirsch, MD, specializes in infant feeding, including expert newborn support, lactation guidance, and frenotomy (tongue-tie release). She also offers emotional wellness care, with guidance and medication management for attention, mood, and anxiety support.

Lev Pediatric Care is located at Evergreen Uptown Mall in Pomona. Their hours are Sunday through Thursday, 10:00 am to 7:45 pm, and Friday, 10:00 am to 1:00 pm. Same-day appointments are available. To schedule, call 845-579-5700. They also provide free car service to and from doctor visits.

Have a question for next week’s column? Send it to Lev Pediatric Care, and Dr. Hirsch may feature it in an upcoming Q&A