Oral Fluid Intake Chart - Hydralyte
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1Oral fluid intake chart
Medical Clinic Name:
Doctor Name:
Child’s Name:
Date:
/
/
Age:
Weight kg:
Your child should drink
mL every 15 minutes
Fluid replacement table
Please give your child:
• Hydralyte
(iceblock or liquid)
™
Child’s age
Volume every
Total volume in
15 minutes
first 6 hours
• Frequent breast feeds or diluted juice (1 part apple juice to
4 parts water) if Hydralyte
is not tolerated
™
Up to 12 months
15 mL
200–400 mL
1–3 years
25 mL
400–600 mL
Encourage your child to drink small sips at regular intervals –
3–6 years
30 mL
600–900 mL
this is more effective than large amounts less often.
6–12 years
50 mL
900–1500 mL
Every 15 minutes write down how much fluid your child has
taken, this information will be useful for your doctor.
12–Adult
75 mL
1500–2000 mL
Please tick the relevant column if your child vomits, has diarrhoea or passes urine during that 15 minute period.
Time
Type of fluid
Amount of fluid
Vomited?
Diarrhoea?
Urine?
taken (mL)
Use only as directed and seek further medical advice if symptoms persist. Always read the label.
Reference: Paediatric Handbook 2003. 7th Edition. Blackwell Science. Chapter 24 Gastrointestinal Conditions. P 370-373.
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