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Drinking water can be harmful to smallest babies

By Anne Harding

NEW YORK | Wed May 21, 2008 2:42pm EDT

(Reuters Health) - Babies younger than six months old should never be given water to drink, physicians at Johns Hopkins Children's Center in Baltimore remind parents. Consuming too much water can put babies at risk of a potentially life-threatening condition known as water intoxication.

"Even when they're very tiny, they have an intact thirst reflex or a drive to drink," Dr. Jennifer Anders, a pediatric emergency physician at the center, told Reuters Health. "When they have that thirst and they want to drink, the fluid they need to drink more of is their breast milk or formula."

Because babies' kidneys aren't yet mature, giving them too much water causes their bodies to release sodium along with excess water, Anders said. Losing sodium can affect brain activity, so early symptoms of water intoxication can include irritability, drowsiness and other mental changes. Other symptoms include low body temperature (generally 97 degrees or less), puffiness or swelling in the face, and seizures.

"It's a sneaky kind of a condition," Anders said. Early symptoms are subtle, so seizures may be the first symptom a parent notices. But if a child gets prompt medical attention, the seizures will probably not have lasting consequences, she added.

Water as a beverage should be completely off limits to babies six months old and younger, Anders and her colleagues say. Parents should also avoid using over-diluted formula, or pediatric drinks containing electrolytes.

Anders said it may be appropriate in some cases to give older infants a small amount of water; for example to help with constipation or in very hot weather, but parents should always check with their pediatrician before doing so, and should only give the baby an ounce or two of water at a time.

If a parent thinks their child may have water intoxication, or if an infant as a seizure, they should seek medical attention immediately, she advised.

Drinking Water for infants & babies

As written by the free drinking water website… Newborn babies do just fine with formula or breast milk; drinking water is not recommended until about 6-12 months (too much water can cause jaundice or intoxication). For children under 1 years old drinking too much water may be a dangerous practice because it dilutes a baby’s normal sodium levels. Breast milk or formula provides all the fluid healthy babies need. Keep in mind that breastmilk is 88% water. 

For newborns (especially under 4-5 weeks), water supplements can be risky
• Babies under two months old should not be given supplemental water
• Too much water can lead to oral water intoxication
• Babies who get water supplements are less interested in nursing. If baby is not nursing as often as they should it will take longer for the mom’s milk to come in
• Water supplements fill the baby without adding calories. This can result in insufficient weight gain or weight loss

For babies past the newborn stage
• Too much water can interfere with breastfeeding because it fills the baby up so he nurses less. Water does not give the baby the nutrition it needs to grow.
• When your baby is beginning to learn a cup, giving him a few sips of water a couple times a day is okay.
• Once your baby starts eating solids you may give him a few sips of water to help prevent constipation. 

While most of the medical world pushes breast feeding, many moms opt for formula or in fact, must use the substitute for health reasons. Whatever the reason behind not using breast milk, attention must be focused on one crucial ingredient to formula: water. The World Health Organization states, "...concentrations of nutrient minerals in drinking water may contribute significantly to the total trace element and mineral intake of infants and young children...especially applicable to formula-fed infants during the first months of life, who may be the most vulnerable group affected by excessive concentrations of nutrients or contaminants in drinking water."

Formula can come ready to drink, which parents can be assured is safe. Formula also comes in powder mixture, which water is mixed with. Because the latter infants will be in taking so much water through formula, the safety of that water should be the parents' focus. In an astonishing statistic, infants receive 40-60% of the lead they are exposed to through drinking water, which can cause damages including mental retardation. Nitrate, chlorine, aluminum and fluoride are other worries for babies drinking formula made with tap water. For this reason, most formula companies recommend bottled water or boiled tap water. Also, homes with water purification systems will be on the safer side. Contamination of water needs to limited.

What about hot weather?
In very hot weather, your baby may be losing extra water without urinating, so in these special cases it may be okay to offer a baby 1-2 ounces of water between feedings. Most babies will do well with just a little bit of extra formula so there is no need to force this. Breast fed babies are even less likely to need extra water. A newborn baby should pee at least once in 24 hours, twice in the second 24 hours, and three times every day thereafter. If you are concerned your baby is dehydrated contact your health care provider.

For toddlers, pure drinking water can also aid in healthy teeth and gums. Many toddlers need a bottle to go to sleep with or they get antsy. But, giving a bottle of juice or milk can cause tooth decay. A bottle of water is suggested instead.

According to TodaysParent.com, until babies begin to eat food, they will get all of the nutrition they need from breast milk and formula. But, the site also says once a baby is older and drinking from a cup, water is preferred over juice as it satisfies thirst. (Plus, it will start a healthy water habit early!) Being a parent is far from easy but watching your kids grow healthy one step at a time is truly worth all the effort.