Water, milk & juice

Water, milk and juice
When can I give my baby water? Does my baby need extra water? Does my baby need extra water during the hot months?

The answer depends on how your baby is fed. Dr. Sears explains on his website that babies who are breastfed do not require extra water, but formula-fed babies may. Formula contains higher concentrations of salts and minerals than breast milk, so extra water is often necessary to help a baby’s kidneys to excrete the extra salt. He also states that “because of less efficient metabolism, formula-fed infants lose more water”.

The general consensus appears to be that you should use your discretion when deciding whether to give formula-fed babies extra water, but otherwise you should wait until your baby is eating solid food before introducing water to a baby. If unsure, always ask your pediatritian for advice.

When offering infants extra water, use caution, especially during the first nine months of life. Too much water can dilute a baby’s normal sodium levels and can lead to water intoxication (in severe cases leading to seizures, coma, brain damage and death). According to pedatrician James P. Keating, MD, medical director of the St. Louis Children’s Hospital Diagnostic Center, additional water for infants should be limited to two to three ounces at a time and should be offered only after the baby has satisfied his hunger with breastfeeding or formula.

Parents who are having their infants under the age of 12 months old take swimming lessons should be cautious of the amount of water that their babies may inadvertently swallow, as water intoxication may also occur due to a baby swallowing too much water when swimming.

Recommendations for each country seem so different. For how long should I breastfeed? If I stop, do I need to give formula?

The World Health Organisation (WHO) recommends that babies are breastfed, ideally for the first two years of their lives. This recommendation is often described as more important in the third world, but there are many studies which show that your child will continue to benefit from increased immunity/protection from antibodies in your breast milk for as long as he or she is breastfed.

If you breastfeed and decide to stop before 6 months are up, the universal recommendation is to switch to formula to ensure that your baby gets the nutrients he or she requires. After 6 months, the advice changes depending on your location.

The UK, the US and many other countries recommmend that you continue to give bottled formula milk until at least the age of one year, when it is safe to switch to cows milk (see below for why to wait). Scandinavian countries do not recommend formula for babies over 6 months, but instead recommend Välling, a heavier milk substitute which also contains cereals and/or ensuring that your baby is receiving the appropriate nutrients (most importantly calcium) from other sources, such as broccoli, leafy green vegetables and whole milk yogurt.

Can I give my baby juice?

We do not recommend juice for babies or toddlers, but many do. If you wish to give juice, you should wait until the age of one. There are several reasons not to give your baby juice. Firstly, most juice, even freshly squeezed, is very sweet and has most if not all of the fibre removed, making it a very concentrated form of fructose. Despite the health benefits of Vitamin C, this is not good for a baby’s developing teeth, nor his sensitive taste buds. If you get your baby used to drinking sweet juice now, you will most likely have trouble persuading him to drink plain water later. It is generally better to give a slice of fruit for Vitamin C and a glass of water, than a glass of juice.