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

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.

Even between 6 months and 1 year of age, the amount of water you give your baby should be very limited. It’s more for them to get the taste and experience of water rather than for any real medical purpose like hydration. After all, formula and breast milk are very hydrating — and also give your little one what they need to grow and thrive.

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.

A dangerous equation

Remember: Tiny tummy + immature kidneys + developing brain = Avoid giving babies water until they are 6 months of age

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.

Should I give my child water from a bottle?

Many young mothers are interested in the question - is it necessary to give water to a newborn baby? In this case, the doctor gives a variety of advice - some argue that breastfed babies do not need additional water, others assure the opposite. To get an answer to this question, it is necessary to understand in more detail how and when the baby should be watered, and what water can be used for this.

Mother's breast milk, which the child receives from the first days of life, is both food and drink for him - it is known that on 90% it consists of water. Thus, the breastfed baby receives all the amount of fluid he needs. Thanks to special enzymes, mother's milk has a beneficial effect on the digestion process. In addition, the female body is able to independently adapt to the needs of the baby, regulating the composition of breast milk. When the baby needs more liquid, he begins to breastfeed more, thus receiving more foremilk (it is less saturated), which not only quenches thirst well, but also restores electrolyte balance.

If we take into account all of the above, we can decide that the baby does not need ordinary water as a drink at all. But in fact, sometimes it is necessary. However, giving water to a child who is not yet three months old is possible only on the recommendation of a pediatrician. Babies who are already 4 months old can drink water - this will not affect the breastfeeding process in any way. There are absolutely no contraindications to water if the baby drinks it with pleasure. On the contrary, you should be wary of a lack of fluids, which can cause much more harm to the child. We must not forget that newborns have a very fast metabolism, due to which the loss of moisture can be very significant.

Water for baby during breastfeeding

You can give your baby water from about 4-5 months. It is best to do this not during feeding, but between them. When the baby feels thirsty, he will gladly drink water from the bottle. As for the norm of fluid for a child, this is a very individual question. As a rule, pediatricians advise giving babies about 100 mg of liquid per 1 kg of body weight, while the liquid includes breast milk. Water in this case will be from 30 to 70 ml.

The baby can drink water from an ordinary bottle with a nipple, you can also use a spoon for this (it will help to accustom the child to complementary foods, which will be needed soon). However, the main rule to remember is that the baby must drink water voluntarily, in no case should he be forced to do so.

Mixed or formula-fed baby water

Artificial feeding has significant differences from natural feeding. The fact is that infant formula contains much more protein than mother's milk. A formula-fed baby has a special need for extra fluids. If you constantly give him a rich nutrient mixture, this can cause constipation. The additional water received by the baby will improve his well-being and contribute to the normal emptying of the intestines.

If the child is on mixed or artificial feeding, then you can start giving water to him a little earlier - already from 1 or 2 months of life. In this case, the water temperature should be cooler than the temperature of the nutrient mixture. Pediatricians assure that babies who are on artificial or mixed feeding definitely need water.

You can give your baby a drink immediately after eating. You can also drink it in between feedings. It is important to remember that babies have a very small stomach in volume, and they will not physically be able to drink a lot of water. It is enough to give him 2-3 teaspoons of water. Gradually, this dose can be slightly increased.

There are situations in which the need for additional liquid for the baby increases dramatically - for example, when the child has been in a room that is too dry for a long time, or has become slightly overheated. Some parents are too afraid of catching a cold while bathing, and maintain a high temperature in his room - because of this, the humidity in the room decreases, and the baby's body is dehydrated. To prevent this from happening, the air temperature in the baby's room should be maintained at 20 degrees, and the humidity should be between 50 and 70%.

If the air in the room is too dry, the child begins to breathe rapidly, swallowing becomes difficult and colic begins. With overheating, which most often occurs in summer, the baby sweats more, as a result of which the body loses moisture. Signs of dehydration can be signs such as dry skin and mucous membranes, as well as infrequent urination. Pediatricians agree that during illness, newborns need to be given water - for example, with colic, or at elevated temperature. The water in this case should be warm.

The child needs water in such cases:

• at a high temperature - you can give him a little drink from a spoon, and just moisten his lips with water;
• with diarrhea - you need to give the child a little drink, after which it is imperative to show it to the pediatrician;
• when there is fever without temperature - water can be given to the baby in a small amount;
• for constipation - the liquid will help to empty the intestines without discomfort for the child;
• when vomiting - water will prevent dehydration and cleanse the stomach;
• for hiccups - water will relieve spasm of the diaphragm, which happened from hypothermia, and also help to get rid of excess air in the stomach.

What kind of water should a baby drink?

Some parents are sure that only boiled water can be given to babies. Actually it is not. When water is boiled, not all bacteria die in it. And in the composition of such water there are chloride compounds that are extremely harmful to babies. Water obtained from open sources can be no less dangerous, as it contains bacteria from the soil and nitrates. In no case should children be given carbonated or mineral medicinal water with a complex chemical composition. Water purified by home filters is also not suitable for babies.

Where can you get water that will not harm the child? It is best to buy it in a pharmacy. Special water for babies is labeled on the bottle, it contains the optimal amount of minerals for the baby. Water from the pharmacy does not need to be boiled, but after opening it can be stored for no more than a day, and only in the refrigerator. It is best to immediately pour such water into a glass container with a tight-fitting lid.

Which water purification methods can be used for a baby?

The most economical and easiest option to provide your baby with high-quality drinking water is to buy a special "children's" water filter. This can be a jug-type device - it is inexpensive, it is very easy to use such a filter, and the degree of water purification is very high - the device effectively removes chlorine, bacteria, pesticides and particles of mechanical impurities from ordinary tap water. For the manufacture of such filters, only high-quality safe plastic is used, which is approved by pediatricians. Water purified in this way can be used not only for feeding the baby, but also for preparing various decoctions and infant formulas.

Can I give my baby water during hiccups?

What is hiccups? This is an involuntary contraction of the muscles of the diaphragm and larynx. Babies are especially susceptible to hiccups, since their diaphragm muscles are characterized by increased excitability. Hypothermia, air entering the stomach, nervous overexcitation and accumulation of gases in the intestines often lead to hiccups.

As soon as a child has hiccups, you need to immediately eliminate its cause. If the baby is cold, it needs to be warmed up. In order for air to come out of the stomach, the baby should be held in a “column”. A few sips of warm water will also help to cope with hiccups.

It is necessary to give water to a child with hiccups, as this measure will quickly eliminate the cause of discomfort.

If you do everything right and give water to the baby only when he really needs it, then there will be no harm - on the contrary, the child will receive the necessary amount of fluid for the normal functioning of the body.

Information about higher organizations

Ministry of Health of the Russian FederationOfficial portal of the Mayor and the Government of MoscowDepartment of labor and social protection of the population of the city of Moscow: on Mondays from 15. 00 to 18.00Department of health of MoscowDepartment of RosZdravNadzor for the city of Moscow and the Moscow region: Mon - Thu: 9:00 - 17:45, Fri: 9:00 - 16:30, Sat - Sun: days off Office of Rospotrebnadzor for the city of MoscowFKU Main Bureau of Medical and Social Expertise for the city of Moscow: Monday, Tuesday, Wednesday, Thursday, Friday from 8.30 to 17.30 .Directorate for coordinating the activities of medical organizations DZMMosvolunter. Responsible person for cooperation with volunteer organizations: Adylov Seyran Midatovich, tel. +7 499-250-01-75

Information for the public

Assessment of the quality of servicesIndependent assessment of the quality of services provided by medical organizationsQuestionnaire for assessing the quality of services provided by medical organizations on an outpatient basisDrugsCrowdsourcing projects of the Government of MoscowAmbulance and Emergency Medical Service in the City of MoscowAssistance Center for Medical WorkersMoscow City Compulsory Medical Insurance FundInsurance companiesFederal budgetary healthcare institution " Center for Hygiene and Epidemiology in Moscow "Official resource of the Healthy Russia program. " Order of the Ministry of Health of the Russian Federation dated August 10, 2017 N 514n "List of studies during preventive medical examinations of minors" List of drugs dispensed free of charge and with a 50% discount List of categories of citizens persons entitled to receive state social assistanceOn the list of documents required for issuing prescriptionsOn the list of pharmacy organizations for the disabled

Ask a question to the Chief Physician!

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whether to supplement the baby with breastfeeding and artificial feeding, how much water a child can drink

The birth of a baby always involves a lot of questions from parents. Some of them are, of course, related to proper nutrition. And almost always, the first thing moms ask is whether it is necessary to give water during breastfeeding. Will it harm digestion and stool? And if supplemented, then with what water, how often and from what? Let's take a look at all the nuances in order.

Contents: Hide

1. When a baby needs water
2. What are the dangers of drinking water early
3. General advice on supplementation

When a baby needs water

he is breastfed, with normal assimilation of mother's milk and regular weight gain, water is not required. Mother's milk quenches thirst and protects against dehydration. However, there are doctors who express a different opinion from this. So, when should you supplement your newborn?

• With artificial and mixed feeding. Mixtures, even as close as possible in composition to mother's milk, are absorbed longer, and water helps their absorption. Therefore, the use of water in this case is mandatory.

• When breastfeeding with insufficient lactation. Unfortunately, it happens that the mother's milk is not enough for the baby. If the baby cries often, does not gain weight, supplement the baby with water and immediately contact the pediatrician about mixed feeding or a complete transition to the mixture.

• In hot weather. When it's hot, fluid leaves the body much faster, and feeding a child with milk all the time means forcing him to overeat. Water in this case is your salvation.

• For hiccups. As you know, water helps to cope with hiccups. This is true not only for an adult, but also for a baby.

• For vomiting and diarrhea. They wash fluid out of the child's body, which threatens with dehydration. If you experience these problems, give your baby as much water as possible.

• To bring down high temperatures. If the baby is sick, his temperature has jumped, then the first advice given by all doctors, without exception, is to drink as much as possible. Milk at a high temperature is contraindicated, only fermented milk products are allowed. Therefore, the best way out for mommy will be to give the child some water.

• When the child is older than two months. If a newborn can only get by with mother's milk, then the baby is a little older - no longer. The body grows, as do its needs. Many pediatricians from 2.5 months already recommend to supplement the baby not only with water, but also with dried fruit compotes.

IMPORTANT! Irina Vostrikova, a pediatrician at the MEDSI clinic, believes that babies do not need additional water, because breast milk is already 90% water. However, this may be necessary if the mother herself does not drink enough fluids. So, a nursing mother should drink at least 2 liters of ordinary non-carbonated water per day.

In hot weather, the baby can be offered water between feedings in a volume of 10-15 ml: if the baby refuses, then now he does not need additional liquid. The same recommendations are valid for artificial feeding. It is better to give water to the child with a spoon, and not from a bottle. Because when feeding from a bottle, the baby has a "sucking confusion", and he begins to take the breast incorrectly - because of this, the effectiveness of stimulating milk production is reduced, and the nipples are injured.

What dangers can be with early water intake

Many mothers are surprised when they hear about the ban on giving water to their babies. What problems in a newborn can cause frequent water intake?

• Malnutrition. If you give your baby water shortly before feeding, the liquid will take place in the baby's stomach, and he will eat less milk. As a result, the baby will remain hungry, his body will receive fewer nutrients, and the mother will not empty the mammary glands, which threatens to stagnate milk and reduce lactation.

• Violation of the intestinal microflora. The use of water leads to the appearance in the body of a newborn of the first bacteria, which are not always beneficial. This is a load on the intestines, the likelihood of developing dysbacteriosis.

• Load on the kidneys. The introduction of water into the diet makes the kidneys work more intensively, and the body of a newborn baby may not be ready for this.

IMPORTANT! Elena Shmakova, consultant on breastfeeding and baby care at the Lada Center, teacher of the WHO/UNICEF course "Counseling on Breastfeeding", adds that there is a risk to breastfeeding itself when supplementing. The fact is that milk is produced in response to sucking, and its amount directly depends on the frequency of breast stimulation. If you give your baby water to drink, he will suckle less often and less, which means that the stimulation of the mammary glands will decrease.

She is sure that the baby should be supplemented only when breastfeeding does not help with the dehydration of the baby due to malaise. Dehydration can be detected, for example, when the number of urination is less than 6 per day, while the urine is concentrated, dark, it is less than usual.

Read also: Is it possible to give children mineral water

General recommendations for supplementation

baby.

• Only purified water should be given. The best option would be to buy bottled water. Today in stores you can find bottles of water intended for children: it has gone through all possible purifications and is devoid of harmful bacteria. It is also possible to use well water at home, which has passed through special children's filters. Avoid using tap water, even filtered.

• Use only boiled water. By doing this, you significantly reduce the risk of crumbs of harmful bacteria entering the body (almost all of them die when boiled).

• If possible, use silverware.

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