Dry Cry: A New Definition for Old Criteria in Dehydrated Children

Approximately 3000 children are admitted annually to the Hacettepe University Institute of Child Health Diarrhea Training and Treatment Center (Ankara, Turkey). During our 10 years' experience, we have observed that the absence of tears, which is one of the main criteria for dehydration in childhood diarrhea, is usually ignored. Because for many health care workers decreased turgor and tonus are the most important symptoms of dehydration, the absence of tears is easily overlooked and even leads to underestimation of many moderately dehydrated children in whom only this symptorn is present. However, dehydrated children are usually restless and cry easily during physical examination. So, we suggest to define "absence of tears" as "dry cry." We believe that this term is much easier for the health care workers to recognize and will alert them to detect moderately dehydrated children who are crying without tears, ie, crying dry.