Dehydration means having too little fluid in the body. Dehydration is a special consideration in SAM children because signs of dehydration for well-nourished children (slow skin pinch, sunken eyes, dry mouth, absent tears, and weight loss) may be already present in severe malnutrition due to tissue loss and changes in the salivary and lachrymal glands. Therefore these signs can be misleading for diagnosing dehydration in malnutrition and must be used with caution. It is also difficult to tell if the child is responding to rehydration fluid as signs of dehydration may remain even when the child is fully rehydrated.