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When and How to Serve Water to Babies and Toddlers

There are many opinions on water consumption for infants, babies, and toddlers. However, most medical institutions agree that water should not be offered before 6 months of age. Too much water can displace valuable nutrition from breast milk or formula and imbalance an infant’s electrolytes. Furthermore, most health care professionals agree that water isn’t necessary for the first year of life as breast milk and formula are comprised mostly of water.

When water is introduced, it should only be offered in an open cup or straw cup (never a bottle). Have a water bottle yourself? It’s fine to offer baby sips from time to time. Just keep tabs on how much your child is consuming before 12 months of age, when water intake needs to be more carefully monitored.

Get guidance on cup drinking and much more in our Starting Solids Virtual Course.

Water may be introduced in small amounts after 6 months of age. When infants less than 6 months of age consume water, it puts them at risk of life-threatening electrolyte imbalance and inadequate intake of calories, protein, and essential nutrients.^{1 2 3} Per the American Academy of Pediatrics, small amounts of water can be offered starting around 6 months as long as baby is growing and gaining appropriately, but water is optional before 12 months of age.

It’s worth noting that water consumption recommendations for babies vary across the globe. Check with your health department for specific recommendations in your country or region. 

The American Academy of Pediatrics suggests offering up to 8 ounces (227ml) of water per day starting at 6 months old; however, it is our strong opinion that water should be limited to less than 2-4 ounces (59-118 ml) a day to avoid displacing valuable nutrition from breast milk or formula.⁴ If you’re concerned about baby’s hydration status, monitor the number of wet diapers and energy levels, and contact your pediatrician. Generally speaking, babies should have 4-6 good, wet diapers every 24 hours.

Offer water in an open cup or straw cup to help baby develop cup-drinking skills. 

Believe it or not, water is actually one of the hardest liquids to learn how to drink. Water is thin and flows quickly, which requires the tongue and swallow muscles to work very fast. Don’t be worried if your little one coughs when first learning to drink water. The oral motor skills required to drink from a cup or straw are very different than the movements required for breast or bottle feeding. Often, a baby coughs and sputters when the liquid is not well-contained in the mouth. As baby’s skills improve with cup and straw drinking, this coughing and sputtering should subside. If your baby continues to cough with water drinking after ample practice time (a few months), speak with your pediatrician. 

Avoid offering water in a bottle. Drinking water from a bottle may result in consuming too much water and does not benefit the development of oral-motor skills. Remember, bottle feeding isn’t a skill our babies need for life, so learning to drink water from a cup or straw is the way to go!

Offering small sips of water from an open cup or straw cup is an excellent way to teach your infant how to swallow water safely and adequately. Learn how to teach baby to drink from a cup.

When choosing an open cup, select a small cup that’s easy for baby hands to hold. Since you’ll be dealing with many, many spills, look for a cup that holds no more than 1-3 ounces. A small cup also makes it less likely that your baby will flood themselves with liquid. There are many cups on the market that fit this description, but a shot glass or small glass yogurt cup will do just fine, too!

Before choosing a straw cup, we recommend first teaching your baby the skills of using a straw by itself. Once your baby has the basic idea of the straw itself, you can choose any straw cup you prefer, knowing your baby can use it. 

Learn more about cups and why we recommend against sippy cups on our Cup Drinking page or by watching our video on cups and straws here.

Babies can drink the same water as the rest of the family. You do not need to purchase special water for babies. That said, always check the water quality in your area to ensure it’s safe for drinking; this information is available through your local health department.

A sip of sparkling water here or there is probably fine, but consumption of carbonated beverages can also lead to painful bloating, gas, and reflux. Many carbonated beverages and sparkling waters have added sodium, as well.

If your baby is younger than 12 months of age, no. Breast milk is comprised 87% of water and water is optional before one year of age.⁵

If your child is 12 months or older, water is necessary. The minimum water intake for children 12-24 months is around 8 ounces (237mL) a day. While breast milk can “count” as water for a toddler, the ideal is 8 ounces of water in addition to breast milk or milk. 

For a 12-month-old drinking less than 8 ounces of water per day, we advise offering water throughout the day and slowly work toward that 8 ounces minimum. Around 12 months, babies eat more solids, drink less breast milk, and need more water.

First, remember that almost 90% of breast milk and infant formula (standard mixing) is water! Children less than 12 months of age do not necessarily need extra water, but practicing cup drinking at this age is developmentally beneficial and can help acclimate your child to the taste of liquids other than breast milk or formula.  

In general, babies who make at least 4-6 good wet diapers per 24-hour period are usually adequately hydrated. Signs of possible dehydration include: 

• chapped lips
• few to no tears when crying
• sunken eyes
• dark urine color
• sunken soft spot (anterior fontanelle) on top of the head 
• fussy
• excessively sleepy

If you are ever concerned about dehydration, contact your child’s health care provider right away. Do not wait.

The American Academy of Pediatrics recommends waiting until at least 6 months before offering water to your child. Water given before 6 months of age can reduce nutrient intake and cause life-threatening electrolyte imbalances.^{6 7 8} The only liquids a baby should be consuming prior to 6 months of age is breast milk or formula.^{9 10} 

The best way to encourage water drinking is to model the activity yourself. In other words, show them how it’s done! 

If baby is truly not interested in learning to drink water from a cup: 

1. Try pouring water into an open cup in front of baby.
2. Tap the table to get baby’s attention.
3. Drink the water from baby’s cup yourself. 
4. Hand the cup to baby in the air and see if baby reaches for it or leans in. 

To help incentivize older toddlers, try teaching them how to pour water from a jug into their cup and let them pour their own water. The more you hand over control, the more your child will explore, touch, and, hopefully, drink. You can also try floating mint leaves or pieces of fruit in the water to add a pop of flavor and make it more exciting. Finally, offer them your straw! Many times it’s much easier to get a toddler to drink out of “daddy’s straw” or “momma’s straw” to try some water. 

Generally, you want to offer 1-2 ounces of water in a small open cup that babies can manipulate with minimal assistance. Bring the cup to baby but stop before it gets too close and give them a chance to reach and grab the cup themselves. Encourage this independence from the start and expect that it will be messy for a while and take some time.

Need help with cup or straw drinking? Check out our Cup Drinking page >>

It is best to refrain from offering water in a bottle. When water is first introduced around 6 to 9 months of age, the focus is more on skill-building than consumption. For this reason, it’s best to offer water in an open cup. 

Additionally, it’s much easier to consume too much water through a bottle, which can displace essential nutrients and lead to water intoxication.¹¹ Remember: we want to make every sip, gulp, and bite count for babies, and consuming too much water takes away from other forms of nutrition that can be offered instead. 

Introduce both an open cup and straw cup as early as 6 months of age with meals. Alternating between an open cup and straw cup (e.g., offering an open cup with breakfast and a straw cup at lunch) can be helpful so one skill doesn’t become too dominant. Check out our cup drinking page for more information on teaching a baby to drink from a cup and why you may want to avoid sippy cups entirely.

Yes! But aim for less than 4 ounces in infants 6-9 months of age and less than 8 ounces in infants 9-12 months of age. Also, consider serving avocado, beans, berries, chia seeds, ground flaxseed, or the “P” fruits: papaya, peaches, pears, plums, and prunes. And never hesitate to touch base with your child’s healthcare provider.

No. It is never recommended to dilute formula without discussing it with your child’s primary health care provider. Formula dilution can be extremely dangerous and lead to water intoxication. ¹²

We don’t recommend them. Our feeding and swallowing specialists strongly recommend using open cups or straw cups rather than sippy or 360 cups. Sippy cups and 360 cups do not encourage oral-motor skills development. Drinking from an open cup or straw is a lifelong skill. For more information, visit our cup drinking page. 

After 12 months of age, should I have water available throughout the day?

Absolutely. Having water easily accessible throughout the day in addition to mealtimes is a great way to foster independence in your child while also maintaining hydration. Like in adults, toddlers’ thirst varies depending on their activity level and health status, as well as the weather.  As caregivers, we can model drinking water throughout the day to help children build healthy habits early on. 

For some children, water is instantly accepted. For children younger than 12 months old, monitor how much water is consumed in a day. If it’s more than 8 ounces, it’s likely too much. For younger infants, in particular, drinking too much water can result in water intoxication characterized by electrolyte imbalance and even seizures.¹³

Signs of overhydration or water intoxication include:¹⁴

• Nausea
• Fatigue
• Vomiting
• Excessive number of wet diapers (more than 8 per day)
• Confusion
• Change in behavior

If you feel like your child is excessively thirsty, this can also be a sign of an underlying problem. Please don’t hesitate to reach out to your child’s health care provider. 

Reviewed by:

Natalia Stasenko, MS, RD

Jennifer H. Min, MSN, RN, CPNP-PC, PhD(c) 

Kimberly Grenawitzke, OTD, OTR/L, SCFES, IBCLC, CNT

Rachel Ruiz, MD, FAAP. Board-Certified General Pediatrician & Pediatric Gastroenterologist

1. Houck, J. , Ganti, L., & Vera, A. E. (2019). A Case of Hyponatremia-induced Seizures in an Infant Secondary to Water Intoxication from the Use of Almond Milk. Cureus, na.
2. Becker, G. E., & Remmington, T. (2014). Early additional food and fluids for healthy breastfed full-term infants. Cochrane Database of Systematic Reviews, na.
3. Cohen, R. J., Brown, K. H., Rivera, L. L., & Dewey, K. G. (2007). Exclusively breastfed, low birthweight term infants do not need supplemental water. Acta Paediatrica, 89(5), 550–552.
4. Martin, C. R., Ling, P. R., & Blackburn, G. L. (2016). Review of Infant Feeding: Key Features of Breast Milk and Infant Formula. Nutrients, 8(5), 279.
5. Martin, C. R., Ling, P. R., & Blackburn, G. L. (2016). Review of Infant Feeding: Key Features of Breast Milk and Infant Formula. Nutrients, 8(5), 279.
6. Houck, J., Ganti, L., & Vera, A. E. (2019). A Case of Hyponatremia-induced Seizures in an Infant Secondary to Water Intoxication from the Use of Almond Milk.  Cureus, na.
7. Becker, G. E., & Remmington, T. (2014). Early additional food and fluids for healthy breastfed full-term infants. Cochrane Database of Systematic Reviews, na.
8. Cohen, R. J., Brown, K. H., Rivera, L. L., & Dewey, K. G. (2007). Exclusively breastfed, low birthweight term infants do not need supplemental water. Acta Paediatrica, 89(5), 550–552.
9. American Academy of Pediatrics. (2021). Infant Food and Feeding.
10. World Health Organization. (2020). Infant and young child feeding.
11. Encyclopedia of Children’s Health. (2021). Overhydration.
12. Healthy Children. (2018). How to Safely Prepare Formula with Water.
13. Encyclopedia of Children’s Health. (2021). Overhydration.
14. Encyclopedia of Children’s Health. (2021). Overhydration.

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 age. 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

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when, how much and what kind of water should be given to a newborn and children during breastfeeding and artificial feeding?

Does a newborn baby need water? This question worries many young mothers, while the recommendations of doctors differ: some believe that the baby does not need any additional fluid, while others argue that the child needs water. Let's try to figure out how and when to give your baby water and how water for newborns differs from ordinary drinking water.

Breast milk is both food and drink for the baby, since it consists of 90% water and in the first weeks of life it is able to maintain the fluid balance at the required level. Mother's milk helps the process of digestion, as it contains all the enzymes necessary for this. Moreover, the mother's body is able to very accurately adapt to the needs of the child, adjusting the composition of milk depending on the situation. For example, if a baby needs more fluid, he will breastfeed more often and, as a result, receive more unsaturated foremilk, which quenches thirst and restores electrolyte balance.

It may seem that the child does not need water, but this is not so: there are situations when it is indispensable. Indeed, up to three months, babies should be given water only on the recommendation of a doctor. Babies older than four months can be fed quite calmly - contrary to popular belief, this does not lead to the child's refusal to breastfeed, and even more so to his exhaustion. If the baby drinks water with pleasure, there are no contraindications for this. But the lack of fluid for the baby is very dangerous - adults should not forget that the metabolic rate in newborns is very high and moisture loss is also significant.

However, parents need to know when and how much water should be given to newborns and how the type of feeding affects fluid requirements.

Water while breastfeeding

Newborns can drink water from four to five months. It is better to do this between feedings - if the baby feels thirsty, he drinks water with pleasure. How much water can you give a newborn? Here, as in adults, everything is individual. Usually, pediatricians advise giving a certain amount of liquid per day with a calculation of no more than 100 ml per kg of weight, but this also includes breast milk. So the water, in fact, remains 30-70 ml.

You can feed your newborn from a bottle with a nipple or even from a spoon - this will make it easier to introduce complementary foods later, because the baby will already know how to use a spoon. But the most important rule is voluntariness: if the child is naughty and does not want to drink, you should not insist.

Water with formula or formula feeding

Formula feeding differs markedly from natural feeding - infant formula contains much more protein than mother's milk, so the baby needs additional fluids. Lack of water, especially when feeding too rich formula, can lead to constipation in children. The extra water will help empty the bowels and make your baby feel better.

With artificial or mixed feeding, water can be given earlier than with breastfeeding. Unlike formulas, which should be 36-37°C, the water can be slightly cooler: 26-30°C in the first one or two months of life, and at an older age - about 20°C.

All paediatricians agree that with the introduction of complementary foods, water becomes essential. Usually, babies who received only milk or formula before the introduction of complementary foods begin to drink solid food only after one to two months. And babies, accustomed to water, are not capricious and drink it with pleasure after each feeding.

When is water given to newborns?

Babies should be given water some time after meals and between feedings. Do not forget that the volume of the child's stomach is very small, which means that he simply cannot drink a large amount of water at once - a few teaspoons will suffice for a start.

In some situations, the need for fluid increases. Most often, overheating and very dry indoor air leads to a lack of moisture. Many parents are so afraid of colds in a child that they wrap him in clothes and do not observe the temperature regime in the children's room, which leads to a decrease in air humidity and dehydration of the baby's body. The optimal temperature for a nursery is 20 ° C, and humidity is 50–70%. Dry air leads to increased breathing, a decrease in the protective functions of the body, difficulty swallowing and colic. And in summer, in hot weather, overheating is added to all these problems, because of which the child sweats and loses precious moisture. It is easy to determine the first signs of dehydration: this is rare urination (normally - about 20 times a day), dryness of the mucous membranes, skin, tongue. In such a situation, water is simply necessary.

Many pediatricians recommend giving newborns water to drink even when they are sick, with fever or colic, which can be easily recognized by tucked up legs, a tense tummy and restlessness of the child. A few sips of warm water can also help with hiccups.

What kind of water should I give my baby?

Boiled water and water from open sources

Many parents believe that children should drink boiled water, but this is a misconception. Boiling leads to the destruction of only part of the bacteria, in addition, such water contains in excess chloride compounds that are very harmful to young children. Water from open sources is also dangerous - it may contain a high content of nitrates and bacteria from the soil and other harmful impurities. And, of course, babies should not be given healing mineral or sparkling water.

In addition, water from ordinary filter jugs designed to purify water for adults is not suitable for infants.

Bottled water

Baby water is sold in pharmacies and supermarkets. As a rule, on the bottle it has a special marking and information that this product has been tested by the Russian Academy of Medical Sciences. Water for a baby is different from the usual "adult" drinking water. In particular, other requirements for the content of minerals are imposed on it:

• total minerals less than 200–300 mg/l;
• calcium - less than 60 mg/l;
• potassium less than 5–20 mg/l;
• sodium less than 20 mg/l;
• magnesium - less than 10-35 mg/l.

Boiling such water is not required, but it can be stored only for a day from the moment of opening and always in the refrigerator. The best container for bottled baby water is a glass bottle or polycarbonate container (bottles made of this material are marked with the number seven on the bottom).

Specially filtered water

Regardless of the brand of bottled baby water and cost, it is impossible to be completely sure of its quality. Alas, there are also unscrupulous manufacturers, in addition, product quality may suffer during improper transportation or poor storage conditions.

Many parents, striving to give their children the best from the first days of their lives, “prepare” children's water on their own. Purifying water with quality home filters allows them to be sure that the filtered water does not contain harmful chemicals and bacteria. Moreover, advanced filters enrich the water with the necessary microelements that a growing child's body needs so much. Using water purification systems, parents themselves control its quality - this gives them the opportunity not to doubt the result. Filtering water at home is somewhat similar to making fresh juice: in both cases, the consumer can follow the process and get a natural and fresh drink. Meanwhile, it is impossible to control the technological process in large-scale production, and it is not known exactly how useful such a product is.

Another advantage of using home filters is their cost-effectiveness. Water obtained by home filtration is ten times cheaper, although it is not inferior in quality to water from a supermarket, and often even surpasses it. It is suitable both for feeding the baby, and for preparing milk mixtures and cereals for him. For its natural taste and crystal purity, older children will also love it, for whom water filtered according to all the rules will also be very useful.

Water should be included in a child's diet from birth. It is vital that it undergoes thorough mechanical and biological purification and has a balanced composition of useful substances. When using bottled water, it is useful to carefully read the information on the label. As with any other product, it is advisable to take a bottle with a fresh production date.

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