Babies and drinking water

We all know we should drink at least eight glasses of water a day but what about babies and drinking water? For young children and babies drinking enough fluid is essential to health and well-being. A high proportion of their body weight is water – so it’s vital to keep youngsters properly hydrated. Read on to find out how much water your baby or toddler should be drinking and when.

Newborns

Regardless of whether your baby is breast or bottle fed, his milk contains all the nutrients and fluids that he needs so further drinks are not usually necessary.

Breastmilk includes foremilk and hindmilk at every feed. The foremilk is a thirst-quenching drink, high in lactose (milk sugar) but low in fat, while the hindmilk that follows on is higher in fat.

When to introduce other fluids

Currently, the Department of Health recommends that babies should be fed nothing but milk, either breast or bottle, up until six months of age, after which solids can be introduced into the diet.

In line with these guidelines, parents are advised that other fluids should be introduced at the same time although your baby’s main drink will still be his milk; around a pint a day, whether formula or breast.

This is also a good time to start thinking about using a cup for your baby. The School of Dentistry at the University of Birmingham say, “Encourage your baby to drink from a cup a soon as they can hold one and try to discourage bottle feeding by the age of one year.”

The reason for this is that most drinks other than water contain some form of sugar. Using a teat means there is prolonged contact with newly growing teeth increasing the risk of tooth decay. The use of teats can also inhibit speech development.

What to introduce

The ideal drink for your baby is milk or water. No other fluid is actually needed and introducing water as an alternative drink will help instill good habits for your child as well as help to prevent a sweet tooth in the future.

However, if you do want to introduce fruit juices it’s worth remembering some simple points:

1. Fresh fruit juice contains natural sugar, so dilute one part pure fruit juice to ten parts of cooled boiled water.

2. Drinks with artificial sweeteners such as saccharin should not be given to children under 3 years old.

3. Fruit squashes aimed at an older market should be avoided as they often contain artificial additives such as sweeteners and colourings which are not permitted in baby foods.

Ready-made baby drinks can also contain sugar so parents are advised to follow the instructions carefully.

Carbonated drinks are best avoided due to their high sugar and acid content which can erode tooth enamel and lead to tooth decay. In fact recent figures from the Office of National Statistics show that tooth decay has risen amongst pre-school children.

As well as other fluids, you may be thinking about introducing an alternative milk, such as follow-on milk (cows’ milk should not be introduced to your toddler’s diet before he is 1 year old). However, health visitor Debbie Honer says, “All baby milks are fortified with vitamins and iron. There is no real need to change milks if your baby is happy to stay on his usual formula milk and he is taking a good varied diet. Although milk is still a staple part of their diet, you need to concentrate more on the nutritional balance of solid foods.”

Follow-on milks are also available in soya infant formulas which are nutritionally similar to cows’ milk-based formulas but are suitable for babies with a cows’ milk allergy.

Child drinking from cup

Water babies – tap or bottled?

Dentists, health visitors and doctors all recommend that the best ‘between meal’ dink for children is water and the early introduction will encourage this good habit. But when it comes to water, is bottled your best option or should you opt for tap?

There are three different types of bottled water, Natural Mineral Water (NMW), Spring Water and Table Water.

Natural Mineral Water

This comes from a ground water source which is protected from all pollution and by law cannot be treated in any way. It undergoes two years of stringent analysis before it can be classed as an NMW. It is the purest form of water. However, NMWs contain high levels of minerals, some of which can be dangerous for your toddler. For example, the calcium levels in some mineral waters can be too high for a baby’s kidneys to cope with. Similarly, the sodium levels in many NMWs are much higher than the recommended 350mg a day for year old babies. Since December 2003, NMWs suitable for making up formula will be labelled as such.

Spring Water

Comes from a single non-polluted ground water source but unlike NMWs it can undergo some permitted treatments, although it must comply with the Drinking Water Regulations. Unlike NMWs, there is no legislation requiring the mineral content to be printed on the bottle and because of this it’s probably best avoided for your baby as there is no way of determining the sodium or mineral content.

Table Water

Is the trade name applied to other bottled drinking waters. It applies to water which may come from more than one source and may include the public water supply. You should treat this water in the same way that you would treat normal tap water if using it to prepare feeds for your baby.

Dr John Briffa, a doctor specialising in the nutritional management of health and disease, prefers bottled water over tap saying, “Mineral water is naturally free of the chemical contaminants used in the processing of tap water, and so I believe it really is better.”

Some of the chemicals used in tap water include chlorine and aluminium which have been linked to some forms of cancer. Dr Briffa suggests, “At the very least, I recommend filtering tap water through a jug or plumbed-in unit prior to drinking.”

However, the Drinking Water Inspectorate (DWI) insists that our tap water is safe, fresh and cheaper than bottled water. Ultimately, the choice is yours.

*All water, whether bottled or tap should be boiled and cooled prior to making up infant formulas or giving as a drink to babies under 6 months.

Drinks…too much?

According to a report by the American Academy of Paediatrics (AAP), supported by the British Nutrition Foundation, even fruit juice in too large quantities can be bad for your baby.

The AAP say, “A number of scientific studies have shown that infants who drink too much juice may become malnourished as a result of fruit juice replacing human milk or formula.”

Another main problem with drinking too much juice, is that it is filling and will decrease your child’s appetite for other more nutritious foods. The British Nutrition Foundation recommends keeping juices for mealtimes and only serving them in a cup.

…Or too little?

If your baby is drinking enough, he will have a wet nappy at nearly every change and he will be putting on weight. However, what should you look for if you think your baby is dehydrated?

  • Nappies – fewer than 6 wet nappies in 24 hours or no wet nappy for 6 hours
  • Urine – is consistently dark yellow
  • Fontanelle – the ‘soft spot’ on your baby’s head may be sunken
  • Mouth – and lips are dry and sticky.
  • Skin – may be less elastic

Some of the more usual causes for dehydration include tummy upsets, fever or sore mouth, gums or throat making drinking painful.

If you are worried your baby is becoming dehydrated, speak to your Health Visitor, GP or NHS Direct.

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