Water is not recommended for babies under 6 months. You can start giving the baby water when he/she starts eating solid foods. Before the six months mark, your baby will get all the water that he/she needs from breast milk (which is 80 % water) or formula. After the baby turns 6 months old, you can start offering a little water. Assuming that your child is feeding well, either through breast milk, formula, or both, their hydration status should not be a cause of concern.
Why babies under 6 months should not be given water
The following are reasons why it is not recommended to give babies under 6 months water:
Water feedings tend to fill up your baby, making them less interested in nursing. This could contribute to weight loss and elevated bilirubin levels.
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.
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.
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 under the age of 6 months who is given water 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. Treatment may include intravenous electrolytes or medications. Contact your healthcare provider if you notice any of the symptoms listed above, or if you have any concerns about water intoxication.
How much water can my baby drink?
From about 6 months on, babies need 0.5-1 cups of water daily. But ask your pediatrician about how much your baby needs before your baby starts drinking water.
How and when to introduce water to your baby
The best way to introduce water to your baby (who is 6 months or older) is to give him/her a small amount in a sippy cup.
Do not force your baby to drink water if he/she rejects it. By gradually giving your baby water, you give him/her a chance to get used to water’s plain flavour.
Drinking water will help your child develop healthy habits. It is not recommended to give your baby juice because it can cause cravings for sweetened drinks, which can lead to obesity later.
Benefits of giving your baby water
Water benefits babies (6 months and up) by helping them stay hydrated, which:
transports nutrients and oxygen to cells while helping remove waste;
keeps joints and tissue lubricated;
maintains blood volume; and
eliminates the need for fruit juice (which pediatricians suggest avoiding before the age of 1 — and then only offering it in very limited quantities, if at all).
Should babies drink water when it is hot outside?
Many doctors recommend that babies drink small sips of water when it is very hot outside to reduce the risk of dehydration, but ask your pediatrician first.
Signs of dehydration in babies
If you are concerned that your child is not getting enough fluids, watch out for these signs of dehydration in babies:
fewer than six wet diapers in 24 hours
dark yellow urine
cracked lips
tearless crying (crying with few or no tears)
dry skin that doesn’t bounce back when gently pressed
sunken eyes
listlessness
sunken fontanelle (the "soft spot" on the top of her head)
extreme fussiness
unusual sleepiness
cold hands and feet
If the baby is under 6months, give breastmilk and /or formula and if the baby is above 6 months, give water in sips and not a large quantity at once. Dehydration is a very serious condition in children. It is important to seek medical help in the event that you see any of the above mentioned signs and symptoms.
Take Home Message
It is advisable to start giving babies water at the age of 6 months. This is because babies under 6 months get sufficient water from breastmilk and formula. Once you start giving your baby water, watch out for water intoxication and dehydration.
This article is written by Dr. Itumeleng Buti (MBChB)
References
1. Anita Mirchandani. When Should My Baby Drink Water? [Internet] Healthline Media. [ Updated 2018 November 1; Cited 2022 April 13] Available from: https://www.healthline.com/health/parenting/babies-drink-water#tips-to-ensure-adequate-hydration.
2. Colleen de Bellefonds. Can Babies Drink Water? [Internet] What to Expect. [2020 May 1; Cited 2022 April 13] Available from: https://www.whattoexpect.com/first-year/feeding-your-baby/giving-water-to-baby.aspx
3. Pampers. Giving Your Baby Water: How and When to Start. [Internet] [ Updated 2020 February 20; Cited 2022 April 13] Available from: https://www.pampers.com/en-us/baby/feeding/article/when-can-babies-drink-water.
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