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Why Can't Babies Have Water? About the Risks and When It's OK

24-02-2020 · Baby tummies are quite small.In fact, at birth, a baby’s belly only holds about 1 to 2 teaspoons, or 5 to 10 milliliters (mL)!Clearly, it does empty fast — …

24-02-2020
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It’s a bright, sunny day outside, and your whole family is feeling the heat and guzzling water. Your newborn surely needs some hydration, too, right?

Yes, but not of the H2O variety. Your little one — if under 6 months old — should be receiving both nutrition and hydration from breast milk or formula, not water.

You probably know this, but you might not know why. It’s because babies’ bodies aren’t suited for water until several months after birth. Tiny tummies and developing kidneys put them at risk for both nutrient loss and water intoxication. Here’s the scoop.

Baby tummies are quite small. In fact, at birth, a baby’s belly only holds about 1 to 2 teaspoons, or 5 to 10 milliliters (mL)! Clearly, it does empty fast — which is why your babe needs so many feedings in a 24-hour period — but you want to fill that little tummy with nutrient-rich breast milk or formula.

So it makes sense that one risk of giving your baby water is that you’ll be filling their belly with a really quite useless substance (at least to a baby) and leaving no room for those vitamins, minerals, fat, and calories so crucial for growth and development. This can cause serious problems.

Baby’s tummy does grow over the first 6 months of life, but it’s pretty gradual. By the time they’re 1 month old, their stomach capacity is about 2.7 to 5 ounces (80 to 150 mL). By 6 months — when you can introduce little sips of water — they can generally hold about 7 ounces (207 mL) at a time.

Another very serious risk of giving babies water before they’re ready is water intoxication.

Hold the front door. Water — toxic?

Absolutely. In fact, water can be toxic to anyone if drunk in large quantities. But unsurprisingly, “large” is very relative to size and age here. An adult with healthy kidneys, for example, would have to drink several liters in a short period of time to get to the point of water intoxication.

That said, it does happen to people, particularly soldiers and athletes, who tend to be in situations where they can become dehydrated quickly and then overcompensate.

In short, when the kidneys are given more water than they can handle, the excess water ends up in your bloodstream. This dilutes the fluid in your bloodstream and lowers the concentration of important electrolytes, like sodium. Too much dilution and you’re at risk for hyponatremia, which literally means too little (hypo) salt in the blood (natremia).

And baby kidneys can’t handle as much water as adult kidneys — not by a long shot. In addition to being much smaller than an adult’s kidneys, a baby’s kidneys are also not as developed. So they can’t process as much water at a time.

So giving a baby younger than 6 months even a moderate amount of water in a short period of time can lead to hyponatremia, which at its most dangerous can cause brain swelling and even death. In fact, because the brain is still developing as well, the swelling can happen more easily in an infant with hyponatremia than in an adult with hyponatremia.

The thing is, most parents aren’t filling bottles with water and giving them to their infants.

The risk comes from things that you might not even give a second thought.

For example, while many swimming schools don’t offer lessons to babies under 6 months, some will start them as young as 4 months. There’s nothing inherently wrong with introducing a baby to the pool if it’s done safely — but without the proper precautions, babies can swallow pool water and experience water intoxication as a result.

Another seemingly harmless act that can lead to trouble is diluting formula or breast milk. Going back to our hydration scenario, it might seem to make sense to mix more water into your baby’s formula powder on a hot day. But don’t do this — it deprives baby of nutrients and can also lead to them getting more water than their kidneys can handle.

Because formula and breast milk are calorie rich, they stay in the body longer rather than overwhelming the kidneys. As a nice side effect, staying in the body longer also means they’re good at keeping your little one hydrated — no extra water needed.

At around 6 months of age, it’s OK to introduce small amounts of water — we’re talking on the teaspoon or tablespoon scale, not the full-bottle scale. It’s a good time to start introducing the concept that thirst can be quenched with water, but your baby’s main source of hydration (not to mention nutrition) should continue to be breast milk or formula.

Most babies will see water as a sort of novelty at this age and still prefer their milk. Some might even balk at the taste and make a face, especially if they were expecting something else! That’s OK — this will change.

By 1 year old, your baby — who’s just about a toddler, if you can believe it! — can have water in larger quantities as they want it, along with cow’s milk and a nutritious diet.

Related: When can baby drink water?

Talk to your pediatrician if you have any concerns about your baby’s hydration or their readiness for water. Depending on if your baby was born prematurely or has certain health conditions, your timeline for introducing water may vary.

In addition, if your baby shows any of these signs of water intoxication, head to the hospital immediately:

  • inconsolable crying
  • vomiting
  • lethargy
  • seizures
  • tremors

Fortunately, parents are usually aware — by word of mouth or from their pediatrician — that they shouldn’t give young babies water. But now you also know the why behind the guideline.

When Can Babies Drink Water: Age Recommendations and ...

02-11-2018 · The CHOC Children’s hospital in Orange County, California recommends that a 1-year-old gets approximately one 8-ounce cup of water every day. …

02-11-2018

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While it seems unnatural to not provide water to your little ones early on, there’s legitimate evidence as to why babies shouldn’t have water until they’re about 6-months old.

The World Health Organization (WHO) notes that babies that are breastfed don’t need additional water, as breast milk is over 80 percent water and provides the fluids your baby needs. Children who are bottle-fed will stay hydrated with the help of their formula.

Assuming that your child is feeding well, either through breast milk, formula, or both, their hydration status shouldn’t be a cause of concern.

Giving your baby water before six months isn’t recommended for the following reasons.

  1. Water feedings tend to fill up your baby, making them less interested in nursing. This could actually contribute to weight loss and elevated bilirubin levels.
  2. Providing water to your newborn could result in water intoxication, which can dilute the other nutrient levels in the baby’s body.
  3. Too much water causes their kidneys to flush out electrolytes, including sodium, leading to imbalances.

When your little one is at the stage where you’re introducing pureed solids, water could also be introduced.

According to the Children’s Hospital of Philadelphia (CHOP), once solids are introduced around 4 to 6 months, a baby’s milk intake reduces from a range of 30 to 42 ounces per day to around 28 to 32 ounces per day.

It all depends on how solids are introduced, what kinds of solids are introduced, and how often they’re being consumed. The goal for babies between 6 and 12 months is to ensure adequate nutrition intake and overall growth.

In order to effectively achieve this, introduce solids slowly and in multiple exposures. It’s acceptable to supplement with water at this time. However, assuming adequate formula or breast milk intake, your child may not need more than 2 to 4 ounces of water over a 24-hour period.

Water is traditionally introduced through a sippy cup. In this time period, as your child becomes more active, you may find that providing additional water in occasional instances is helpful.

Buy: Shop for a sippy cup.

Once your child is 12-months old, their milk intake will reduce, ideally to a maximum of 16 ounces per day.

At this stage, you may have established a routine involving breakfast, lunch, and dinner, while introducing a variety of new foods. Due to the increased activity of your child, the reduced milk intake, and the varied food intake, water intake will naturally increase.

The CHOC Children’s hospital in Orange County, California recommends that a 1-year-old gets approximately one 8-ounce cup of water every day.

This amount increases each year. The number of 8-ounce cups an older child consumes each day should correspond with their age (up to a maximum of eight 8-ounce cups per day). For example, a two-year-old should consume two 8-ounce cups per day.

Staying hydrated can help your child have proper bowel movements and replenish any lost fluids.

For most children, all you need to do is provide frequent access to water and they will drink enough to meet their needs. If you seem to have trouble encouraging your child to consume water through a sippy cup, try these additional tips to ensure adequate hydration.

Encourage small, frequent sips

Offer small amounts of water throughout the day. Your child will be hydrated but not full from other fluids, which may affect their meal intake.

If you use diluted fruit juice, limit their intake to 4 ounces of pure juice per day.

Make fluids fun

Young kids seem to be intrigued by colors and shapes. You could use colorful cups and fun-shaped straws so that your little ones are excited about consuming water.

Buy: Shop for cups and straws.

Be mindful of weather and activity

Kids aren’t able to regulate their body temperature as easily as adults, so it’s harder for them to recover and cool off. Encourage fluid intake before, during, and after activities.

As a guideline, encourage at least 4 ounces of fluid every 20 minutes, or whenever a break happens. An ounce of water is equal to about one “gulp” from your little one.

Incorporate water-rich foods

Foods such as soups or fruits such as watermelon, oranges, and grapes are rich in water. You can also flavor water with lemon, lime, cucumber, or oranges to make it fun and tasty.

Your baby may be ready take their first sip of water at six months. However, it’s important to realize that newborns, infants, and toddlers have very different hydration than from adults.

What we’d expect ourselves to do in hot weather or during activity is quite different from what they would be encouraged to do. As long as you pay attention to your child’s activity and give them plenty of access to water after age 1, you’ll make appropriate decisions.

Anita Mirchandani, MS, RD, CDN, received a BA from NYU and an MS in clinical nutrition from NYU. After completing a dietetic internship at New York-Presbyterian Hospital, Anita became a practicing registered dietitian. Anita also maintains current fitness certifications in indoor cycling, kickboxing, group exercise, and personal training.

At What Age Can Babies Drink Water?

Until your little one is eating solid food, your baby will get all the water he needs from breast milk (which is actually 80 percent water) or formula. After your baby turns 6 months old , you can start offering a little water.

Water is something that everyone needs to drink, right? Well, it turns out that babies get all the hydration they need from breast milk or formula in the first several months.

Find out when it’s OK to start giving your baby water, and why it’s important not to give your baby water until he’s started on solids. Plus, get some answers to some frequently asked questions about safely giving your baby water when the time comes.

At What Age Is It OK to Give Your Baby Water?

Water is not recommended for your baby in his first six months. Until your little one is eating solid food, your baby will get all the water he needs from breast milk (which is actually 80 percent water) or formula. After your baby turns 6 months old, you can start offering a little water.

Why Shouldn’t You Give Water to Your Baby Under 6 Months?

For babies under 6 months, drinking water can lead to diarrhea and even malnutrition.

With breastfed babies, the introduction of water can cause the baby to breastfeed less or stop entirely, leading to malnutrition. Less frequent nursing can, in turn, result in a reduction in breast milk supply as well.

How and When Do You Introduce Water to Your Baby?

The best way to introduce water to your baby (who is 6 months or older) is to give her a small amount in a sippy cup. Don’t force her to drink the water if she rejects it.

Your baby’s need for liquids will increase when she starts eating solid foods.

This is why the time when you start giving solids is also a good time to slowly introduce water. Gradually giving your little one water also gives her a chance to get used to water’s plain flavor.

Drinking water will also help your child develop healthy habits. Giving your baby juice is not recommended, as it can cause her to crave sweetened drinks, which can lead to her becoming overweight or obese later on.

Is It OK to Mix Formula With Water?

It’s OK to mix powdered formula with water. Just be careful to follow the manufacturer’s guidelines on how much water to add.

What's dangerous is adding extra water to the formula. Diluting formula or giving your baby water in addition to formula can lead to a condition called water intoxication.

Diluting infant formula beyond the manufacturer’s directions reduces the nutrients your baby is getting. This can lead to slowed development, electrolyte imbalances, and possibly seizures.

Be sure to follow the manufacturer’s directions when mixing infant formula, and check out these formula feeding guidelines.

Does Tap Water Need to Be Boiled for Babies?

Some tap water might not be clean enough for your baby. Check with your local health department if you’re unsure about the quality of the tap water in your home.

If the water isn’t safe, you could use bottled water instead, or boil the tap water for mixing with infant formula or for giving your baby once he’s over 6 months old.

To boil tap water, bring cold water to a boil for 1 minute. Then set it aside to cool to room temperature for about 30 minutes before using it. It’s a good idea to test the water on your wrist to ensure it’s at room temperature before giving it to your baby.

Should You Give Water to a Dehydrated Baby?

Your baby may become dehydrated if she has a fever, is vomiting, has diarrhea, or for certain other reasons.

Some signs of dehydration may include

  • a dry mouth

  • fewer wet diapers

  • fussiness

  • sleepiness

  • a soft spot on the head.

If you suspect your little one may be dehydrated, do not give your baby water. The best fluid to keep your baby properly hydrated is breast milk or formula.

Contact your baby’s healthcare provider right away if you suspect your little one may be dehydrated. Your provider may suggest a rehydration solution, drops, vitamins or minerals in syrup form, or medicine to hydrate your little one.

Should You Give Your Breastfeeding Baby Water on Hot Days?

Your baby does not need water before the age of 6 months even if it’s a hot day and/or you live in a hot climate. The best option will be to keep your baby hydrated with your breast milk or formula.

What Is Water Intoxication in Babies?

Water intoxication, also called hyponatremia, is a condition in which the sodium level in the blood becomes abnormally low. Drinking too much water can cause this condition.

A baby who is given water under the age of 6 months may be at risk for this condition.

Symptoms of hyponatremia can include

  • nausea/vomiting

  • headache

  • confusion

  • drowsiness

  • irritability

  • seizures.

Water intoxication requires emergency medical attention, and treatment may include intravenous electrolytes or medications. Contact your baby’s healthcare provider if you notice any of the symptoms listed above, or if you have any concerns about water intoxication.

Even though giving your baby water may seem harmless, it’s not recommended until your little one is 6 months old. Your baby is getting all the nutrients and hydration she needs from breast milk or formula.

With all those feedings, you’ll also be doing lots of diaper changes. To make the task a bit more rewarding, download the Pampers Club app to earn rewards for your Pampers purchases.

How we wrote this article The information in this article is based on the expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.

People also ask
  • When should a baby start drinking water?

    Why you should waitWater feedings tend to fill up your baby, making them less interested in nursing. ...Providing water to your newborn could result in water intoxication, which can dilute the other nutrient levels in the baby’s body.Too much water causes their kidneys to flush out electrolytes, including sodium, leading to imbalances.
    When Can My Baby Start Drinking Water?
  • When do you start giving babies water?

    You can start giving your baby water at 6 months old but stick to 4-8 ounces. At this point, the purpose of giving your baby water is to let them practice drinking it. At one year old, your baby requires water and they should have 8 to 32 ounces daily.
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Drinks and cups for babies and young children

07-12-2020 · Beakers and cups for babies. Introduce your baby to drinking from a cup or beaker from around 6 months and offer sips of water with meals. Using an open cup or a free-flow cup without a valve will help your baby learn to sip and is better for your baby’s teeth.

07-12-2020

You should continue to breastfeed or give your baby first infant formula until they're at least 1 year old.

Breastfeeding will continue to benefit you and your baby for as long as you carry on.

As your baby eats more solid foods, the amount of milk they want will decrease.

Once your baby is eating plenty of solids several times a day, they may even drop a milk feed altogether.

Introduce your baby to drinking from a cup or beaker from around 6 months and offer sips of water with meals.

Using an open cup or a free-flow cup without a valve will help your baby learn to sip and is better for your baby’s teeth.

It might be messy at first but be patient, your baby will gradually learn how to drink from an open cup.

Once your baby is 1 year old, feeding from a bottle should be discouraged.

When using a bottle or trainer cup, don't put anything in it other than breast milk, formula milk or water and do not add anything else (including sugar, cereals, baby rice or chocolate powder) to the feed.

Comfort sucking from a bottle on sweetened drinks causes tooth decay in young children. Drinks flow very slowly through a teat, which means the sugary substance will be in contact with their teeth for longer.

Read more about how to look after your baby's teeth.

It's important to choose the right kind of beaker or cup.

A cup or a beaker with a free-flow lid (without a non-spill valve) is better than a bottle or beaker with a teat as it will help your baby to learn how to sip rather than suck.

As soon as your child is ready, encourage them to move from a lidded beaker to drinking from an open cup.

Not all drinks are suitable for babies and young children. Here's what to give to your child and when.

Breast milk

This is the only food or drink babies need in the first 6 months of their life.

It should continue to be given alongside an increasingly varied diet once you introduce solid foods from around 6 months.

The World Health Organization recommends that all babies are breastfed for up to 2 years or longer.

Breastfeeding up to 12 months is associated with a lower risk of tooth decay

Formula milk

First infant formula is usually based on cows' milk and is the only suitable alternative to breast milk in the first 12 months of your baby's life.

Follow-on formula isn't suitable for babies under 6 months, and you don't need to introduce it after 6 months.

First infant formula, follow-on formula or growing-up milks aren't needed once your baby is 12 months old.

Cows' milk can be introduced as a main drink from 12 months.

Read more about the types of infant formula.

Non-cows' milk formula

Goats' milk formula is available and produced to the same nutritional standards as cows' milk formula.

Goats' milk formula isn't suitable for babies with cows' milk protein allergy. It is not less likely to cause allergies in babies than cows' milk formula as the proteins they contain are very similar.

You should only give your baby soya formula if a health professional advises you to.

'Goodnight' milk

This isn't suitable for babies under 6 months old. This type of formula isn't needed, and there's no evidence that babies settle better or sleep longer after having it.

Water

Fully breastfed babies don't need any water until they've started eating solid foods. Formula-fed babies may need some extra water in hot weather.

For babies under 6 months, you should not use water straight from the mains tap in the kitchen as it is not sterile. You will need to boil the tap water first and then let it cool down. Water for babies over 6 months doesn't need to be boiled.

Bottled water isn't recommended for making up infant formula feeds as it may contain too much salt (sodium) or sulphate.

If you do have to use bottled water to make up a feed, check the label to make sure the sodium (also written as Na) level is less than 200 milligrams (mg) per litre. The sulphate (also written as SO or SO4) content shouldn't be higher than 250mg per litre.

Like tap water, bottled water isn't sterile, so it will need to be boiled before you use it to prepare a feed.

Always use boiled water at a temperature of at least 70C when you prepare a feed. Remember to let the feed cool before you give it to your baby.

See how to make up baby formula.

Cows' milk

Cows' milk can be used in cooking or mixed with food from around 6 months but shouldn't be given as a drink to babies until they are 12 months old. This is because cows' milk does not contain enough iron to meet babies' needs.

Whole milk should be given to children until they are 2 years old, as they need the extra energy and vitamins it contains.

Semi-skimmed milk can be introduced once your child is 2 years old, as long as they're a good eater and they have a varied diet.

Skimmed and 1% milk aren't suitable for children under 5 years old, as they don't contain enough calories.

Lower-fat milks can be used in cooking from 1 year old.

Unpasteurised milk

Young children shouldn't be given unpasteurised milk because of the higher risk of food poisoning.

Goats' and sheep's milk

These aren't suitable as drinks for babies under 1 year old as, like cows' milk, they don't contain enough iron and other nutrients babies this age need. As long as they're pasteurised, they can be used once your baby is 1 year old.

Soya drinks and other milk alternatives

You can give your child unsweetened calcium-fortified milk alternatives, such as soya, oat or almond drinks, from the age of 1 as part of a healthy balanced diet.

Babies and young children under 5 years old shouldn't be given rice drinks, because of the levels of arsenic in these products.

If your child has an allergy or intolerance to milk, talk to your health visitor or GP. They can advise you on suitable milk alternatives.

Rice drinks

Children under 5 years old shouldn't have rice drinks as a substitute for breast milk, infant formula or cows' milk as they may contain too much arsenic.

Arsenic is found naturally in the environment and can find its way into our food and water.

Rice tends to take up more arsenic than other grains, but this does not mean that your baby cannot eat rice.

In the EU, there are maximum levels of inorganic arsenic allowed in rice and rice products, and even stricter levels are set for foods intended for young children.

Don't worry if your child has already had rice drinks. There's no immediate risk to them, but it's best to switch to a different kind of milk.

See arsenic in rice for more information.

Fruit juice and smoothies

Fruit juices, such as orange juice, are a good source of vitamin C. However, they also contain natural sugars and acids, which can cause tooth decay.

Babies under 12 months don't need fruit juice or smoothies. If you choose to give these to your baby, dilute the juices and smoothies (one part juice to 10 parts water) and limit them to mealtimes.

Giving fruit juice and smoothies at mealtimes (rather than between) helps reduce the risk of tooth decay.

From 5 years old, you can give your child undiluted fruit juice or smoothies. Stick to no more than 1 glass (about 150 ml) a day, served with meals.

Squashes, flavoured milk, 'fruit' or 'juice' drinks and fizzy drinks

These are not suitable for young babies. These drinks contain sugar and can cause tooth decay, even when diluted. 

For older babies and young children, these drinks can fill your child up so they're not hungry for healthier food. Instead, offer sips of water from a cup with meals.

Watch out for drinks that say "fruit" or "juice" drink on the pack. These probably won't count towards your child's 5 A DAY and can be high in sugar.

Fizzy drinks are acidic and can damage tooth enamel so they shouldn't be given to babies and young children.

Diet or reduced-sugar drinks aren't recommended for babies and young children. Even low-calorie drinks and no-added-sugar drinks can encourage children to develop a sweet tooth.

'Baby' and herbal drinks

These usually contain sugars and are not recommended.

Hot drinks

Tea and coffee aren't suitable for babies or young children. If sugar is added, this can lead to tooth decay.