Healthy Children - May 2014

Should I Give My Baby Extra Water?

Temperatures outside are heating up, and the fact that we are perspiring tells us we are losing body fluids. Many adults find themselves drinking more water to stay hydrated, but what about our children? In particular, what about babies? Should we all be drinking more water?
We lose body fluids continuously from perspiration, breathing, urine and stool and we must rehydrate to stay energized. We are often encouraged to drink water to stay healthy, and water provides many health benefits. In hot weather, our bodies require extra water to energize muscles and to keep adequate fluids moving things along in our digestive tract. While drinking extra water on a hot day is recommended for adults and children over a year old, it is not helpful to babies.

In fact, extra water for infants younger than 6 months of age could lead to water intoxication, which is a cause of infant seizures in otherwise healthy babies.
It is all about balance-fluid balance.  Extra water dilutes the sodium in a baby's blood and flushes it out of the baby's body. That reduces the amount of electrolytes in the body, altering brain activity, which can cause seizures.

Between 1975 and 1990, James Keating, MD, then a Washington University pediatric gastroenterologist at St Louis Children's Hospital, noticed a total of 34 infants treated in the emergency room with water intoxication. Thirty-one of the babies had too much water given to them by caretakers because they had run out of formula. As a result, Dr. Keating worked to modify the Special Supplemental Nutrition Program for Women, Infants, and Children to provide sufficient formula for growing infants. He also published research to educate mothers about the hazards of excessive water ingestion in order to reduce the incidence of this preventable, life-threatening condition.

Parents should also avoid infant Swimming lessons prior to age 1. "Repeated dunking of infants can cause them to gulp water and has caused seizures in infants at the poolside," Dr. Keating says. The symptoms of drinking too much water are subtle for an infant but may include twitching, irritability that leads to inconsolable crying and difficulty breathing leading to seizures. If you notice any of these symptoms, seek immediate medical attention.

The bottom line is this, breastfeeding is best for your infant. Breast milk offers immunity protection and many neurodevelopment advantages.  On extra hot days breastfeed your baby more frequently. If unable to breastfeed, offer formula more frequently.

1 Keating James, Shears Greg, Dodge Philip. Oral Water Intoxication in Infants, An American Epidemic, Am J. Dis Child 1991-sep: 145(9);985-90
2. American Academy of Pediatrics. Breastfeeding and the Use of Human Milk, Pediatrics Vol  115 No  2 February  1. 2005 pp.496-506

This article was written by Sue Griffard. RN. a nurse on The Answer Line at St  Louis Children's Hospital. For more information call The Answer Line at 314.454.KIDS (5437).