When to give your baby water: A guide for parents

When can baby drink water? This is a question new parents are very privy to.

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 infants under the age of six months, the rules related to water are different.

In this article, we'll tell you why water is not so good (and unnecessary) for your baby under six months of age and when you can start introducing water, including how much.

Can my baby drink water?

Only after they start eating solid meals should babies start taking little sips of water. Before that time, breast milk or formula provides babies with the necessary hydration.

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 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:

1. 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 bilirubin levels.
2. Babies who use bottles of water to quench their thirst and fulfil their urge to suck, miss out on the vital nutrients that come from breast milk and formula.
3. If you give your infant water, they might consume less breast milk or formula. They may not receive enough milk or formula for healthy growth as a result. Giving your infant a lot of water or formula that has been overly diluted in a short period of time might also make them quite ill.
4. Your baby isn't overeating if she frequently drinks water in addition to breast milk or formula. That eventually means your baby won't consume enough calories to gain the proper amount of weight.
5. If you're breastfeeding, giving your child water may eventually reduce your milk production because newborns who drink a lot of water will nurse less frequently.
6. Water intoxication, a potentially deadly condition when electrolytes (such as salt) in a baby's bloodstream get diluted, can result from letting your infant drink a lot of water. This may affect a baby's regular bodily processes and cause symptoms like seizures.
7. 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.

Breastfed babies

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 per cent 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 breastfeeding. 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."

Previously, 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-fed babies

Formula milk is made up of around 80 per cent 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 risk of water intoxication.

Water for baby on a hot day

We live in a hot, humid part of the world and you may be wondering about whether it's okay to give your baby under six 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.

If your infant is under six months old, it's crucial to provide more frequent bottle or breastfed feedings during hot weather. If a doctor hasn't suggested it, do not offer water.

Your infant could want to feed more frequently but for shorter amounts of time.

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. So instead of giving water to your baby, you should make sure to drink adequate water if you're breastfeeding.

In order to make nursing in hot weather more bearable for both you and your baby:

• Put a towel, sheet, or pillowcase in between you and the infant.
• If breastfeeding, recline to minimise skin contact.

If your baby has six to eight pale wet diapers in a 24-hour period, it means they are appropriately hydrated (receiving enough fluids).

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).

What if my baby has a fever?

You might need to give your infant more breast milk if they are under six months old, have a fever, and are breastfed. If they are formula-fed and younger than six months old, you can give them lower doses of formula more regularly. Water shouldn't be given unless a doctor says so.

Continue nursing your infant or giving him or her bottles if they are older than six months. Water can be provided in between feedings. Checking your child's fluid intake is the most crucial thing to do.

What about other beverages?

Soft drinks, cordial, and fruit juice are not recommended for infants under 12 months of age. And as usual, children should not consume caffeinated beverages like tea, coffee, energy drinks, and alcohol.

When can you give baby water?

So when may you feed your child water? The majority of experts advise waiting until your child is roughly six months old and has begun solids.

Between the ages of four and six months, you can introduce solid foods to your infant, although most often, experts advise delaying until closer to six months.

If your infant will accept it, offer her a sippy cupful of water at a time after she begins to drink. In addition to being wonderful practice for the day when all of your baby's beverages will come from a cup, babies often can't get too much water from a cup (only from a bottle).

It's acceptable if your child will only consume water from a bottle for the time being as long as you watch out for (and limit) how much she's getting.

Newborns and infants up to six months of age

These babies should not be given water in addition to breastmilk or formula, unless on medical advice.

Babies between six 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. How much water for a six-month-old baby? 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.

How much water can my baby drink?

Here's a table outlining the recommended amount of water for babies from six months up to one year old:

Please note that these are general guidelines and individual baby's water needs may vary. It's essential to consult with a healthcare professional or paediatrician for personalised advice regarding your baby's specific needs.

While some people might want more, others - particularly breastfed infants - might not require any additional water. But before you give your child water, find out from your paediatrician how much of it she actually needs.

Your toddler requires four cups of drink every day between the ages of one and three. Water and breastmilk or formula should be consumed during this changeover period. Your youngster will require more water as they age. You may encourage your older child to drink enough water in a number of ways.

How should you give your baby water?

Give your infant (who is at least six months old) a modest bit of water in a sippy cup as the easiest approach to introduce water to them. If she refuses to drink the water, don't make her.

When your baby begins eating solid meals, her requirement for fluids will rise.

This is why introducing water gradually at the same time as offering solids is a smart idea. Giving your child water gradually would also allow her time to become used to the taste of plain water.

A healthy habit your youngster can establish is drinking water. Giving your infant juice is not advised since it can make her crave sugary beverages, which might make her eventually gain weight or become obese.

How much water to put in formula milk

Powdered baby food can be diluted with water. Just be sure to adhere to the manufacturer's instructions regarding how much water to add.

It's risky to add more water to the recipe. A condition known as water intoxication can result from diluting formula or giving your infant water in addition to the formula.

Infant formula loses nutrients when diluted beyond the manufacturer's recommendations. This may result in electrolyte imbalances, convulsions, and delayed growth.

When mixing infant formula, be careful to follow the manufacturer's instructions. Also, check the formula feeding recommendations.

Should you use boiling water for baby?

You should be aware that not all tap water is safe for your infant. If you have any questions regarding the quality of the tap water in your home, contact your neighbourhood health department.

If the water is unsafe, you can boil the tap water for your kid to drink after he or she is beyond six months old or use bottled water in its place.

Bring cold water to a boil for one minute to sterilise tap water. After around 30 minutes, lay it aside to cool to room temperature before using it. Before giving the water to your infant, it's a good idea to test the temperature on your wrist to make sure it's at room temperature.

Does a baby who is dehydrated need water?

If your baby has a fever, is vomiting, has diarrhoea, or for other reasons, she may get dehydrated.

Among the warning symptoms of dehydration are:

• drier mouth
• less poopy diapers
• fussiness
• sleepiness
• a rounded area on the head.

Don't feed your infant water if you think they could be dehydrated. Breast milk or formula is the finest liquid to keep your infant well hydrated.

If you believe your child may be dehydrated, call your baby's doctor right away. Your doctor might advise giving your child drops, vitamins or minerals in syrup form, a rehydration solution, or a prescription to keep them hydrated.

Water intoxication in babies

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 eight 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 of water intoxication in babies

• Vomiting and nausea
• Lethargy and drowsiness
• Muscle twitching and cramping
• Excessive sweating
• Low body temperature (<97 °F or 36.1 °C)
• Excessive urination (six - eight 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.

Don't give water to your baby if he is six months old and below. Take our word for it. If you have any concerns about your baby's health and feeding habits, don't hesitate to consult your child's paediatrician.

When to consult a doctor

Call your child's doctor for advice on how to keep your infant hydrated if he or she has diarrhoea and/or is vomiting. If your child exhibits any signs of dehydration, you should also phone the paediatrician.

Although friends and family may advise against giving babies water during the first few months of life, it is advisable to wait until your child begins solids to avoid any potential health issues. Before you know it, you'll be frequently serving the clear stuff!

ALSO READ: Extended breastfeeding: Is it for you and your toddler?

This article was first published in theAsianparent.