"When can I give my baby water?": A must-read guide for parents
Whether your baby is exclusively breastfed or formula-fed, until he is six months old and ready for solids, he does not need extra water
We all know that water is essential to sustain life. Children and adults can’t live without it; neither can any other living beings. However, when it comes to babies under the age of six months, the rules related to water are different.
In this article, we’ll tell you why water is may be not so good (and unnecessary) for your baby under six months of age and when you can start introducing water, including how much.
Why babies under six months don’t need water
Whether your baby is exclusively breastfed or formula-fed, until he is six months old and ready for solids, he does not need extra water.
Healthline quotes paediatrician Dr. Alan Greene as saying “the amount of water present in breast milk and formula is adequate for a baby’s health, taking into account water lost through urine, stool, and lungs.”
Here’s why giving your infant or newborn water may not be best for his health:
- Water has no calories but fills your baby nevertheless. This will make him less interested in drinking milk. It could also result in weight loss and increased bilrubin levels.
- Your baby could get water intoxication (we discuss this on the second page of this article), which is a potentially serious condition.
- Your baby’s kidneys are still not capable of handling too much fluid and giving your little one water causes their kidneys to flush out electrolytes and sodium, leading to dehydration and an electrolyte imbalance.
Exclusively breastfed babies certainly do not need additional water, especially before they start solids at around six months of age.
Kelly Bonyata (IBCLC) explains that breastmilk is 88% water (especially the “fore milk”) and this gives your baby all the fluids he needs. Other lactation experts from organisations such as the World Health Organisation (WHO) and La Leche League International (LLLI) agree that exclusively breastfed babies do not require additional water.
Even in the first few days of life, a mother’s colostrum gives her baby adequate hydration and no supplementation of other fluids is needed.
“What about ‘sugar water?'”
You might have been advised by older relatives to give your newborn sugar water.
However, this practice is not recommended by professional medical bodies such as the Academy of Breastfeeding Medicine, which advises: “Supplementation in the first few days interferes with the normal frequency of breastfeedings. If the supplement is water or glucose water, the infant is at increased risk for increased bilirubin, excess weight loss, longer hospital stay, and potential water intoxication.”
In fact, even some medical practitioners routinely give infants very small amounts of sugar water as a method of pain relief when they are subject to short but painful procedures, such as a heel prick or injection.
However, research published in the Lancet advises that sucrose is not an effective pain relief measure.
Formula milk is made up of around 80% water and hydrates your baby just fine, making additional water unnecessary, especially before six months of age.
According to paediatrician Stephen R. Daniels, you should stick to the milk powder-water ratio as instructed on the formula tin/packet, when making it up. Adding too much water to formula not only dilutes the nutrient content, but also places your baby at the risk of water intoxication.
Hot days, babies and water consumption
We live in a hot, steamy part of the world and you may be wondering about whether it’s okay to give your baby under 6 months of age water to drink when you are out and about on a hot day.
The answer is still “no” as pointed out by a body of thorough research (Almroth and Bidinger, 1990; Ashraf et al., 1993; Sachdev et al, 1991).
Even when it is very hot outside, exclusively breastfed babies still do not need additional water. On such days, you’ll notice that little ones tend to nurse more frequently, but for a shorter duration each time. What’s happening here is that they are getting plenty of thirst-quenching foremilk, which keeps them well-hydrated.
This also means that mummy needs to drink plenty of water so she can keep up with her baby’s increased demand for milk on a hot day.
Formula-fed babies too don’t need extra water on hot days; you just need to increase the frequency of feeds and make sure you prepare the formula according to instructions.
In cases when a baby becomes dehydrated or very sick with a tummy bug (that causes excessive loss of bodily fluids), then his doctor may advise that you give the appropriate dosage of an oral rehydration solution (not water).
When exactly can you give baby water, and how much of it can you give? And what is water intoxication? Keep reading on the next page.
When to give water to babies
Newborns and infants upto 6 months of age
These babies should not be given water in addition to breastmilk or formula, unless on medical advice.
Babies between 6 and 12 months of age
- Once your baby is six months old, it’s okay to give tiny sips of water to help him get used to a sippy cup. Around two ounces per 24 hours is the expert-recommended amount of water to be given at this age. Any more than this may interfere with his milk intake, which is still much more important at this stage.
- When your baby starts solids, give a small amount of water after his meal to prevent constipation. Don’t let water replace breastmilk or formula, however.
- As your baby approaches his first birthday, you could increase the amount of water he drinks in keeping with his increased activity levels.
Babies aged 12 months and above
- By this age, your little one will probably have reduced his milk intake and increased his solid food consumption to three meals a day plus snacks.
- Due to these factors in combination with increased physical activity levels, your baby’s water intake will naturally increase.
- The United States Department of Agriculture recommends that toddlers get around 1.3 litres of liquid water a day (around 4.23 cups). This is not restricted to just water and could include water from all sources of food and drink, including milk.
- If you have trouble getting your energetic toddler to drink enough fluids, try introducing water in fun, colourful sippy cups or drop an ice cube in his cup. You could also include water-rich foods in his diet such as watermelon, grapes and various kinds of soups.
Water intoxication in babies
What is it?
An infant’s kidneys are still immature and cannot handle or excrete too much fluid quickly. So giving water to a baby under six months of age (in addition to breastmilk/ formula) may result in too much fluid for his body to handle, leading to an imbalance of electrolytes and a drop in blood sodium levels.
Water intoxication in infants can be caused by as little as 8 oz (approx. 240 ml) of plain water in a day, on top of breastmilk or formula, and can lead to brain swelling and even death.
Signs and symptoms
- Lethargy, drowsiness and lethargy
- Excessive sweating
- Low body temperature (<97 °F or 36.1 °C)
- Excessive urination (6-8 wet diapers a day)
- Seizures (facial twitches, lips smacking, rolled-back eyes, rhythmic jerky movements of the arms and legs)
If you notice any of these symptoms, get immediate medical assistance for your child.
*Please note that the information in this article is based on the author’s own research. If you are concerned about any matter related to your baby’s health (including if you need more clarity about babies and water consumption), please seek the opinion of a medical professional.
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