Why Would You Give a Tiny Baby Water

There are many opinions on water consumption for infants, babies, and toddlers. However, most medical institutions agree that water should not be offered before 6 months of age. Too much water can displace valuable nutrition from breast milk or formula and imbalance an infant's electrolytes. Furthermore, most health care professionals agree that water isn't necessary for the first year of life as breast milk and formula are comprised mostly of water.

When water is introduced, it should only be offered in an open cup or straw cup (never a bottle). Have a water bottle yourself? It's fine to offer baby sips from time to time. Just keep tabs on how much your child is consuming before 12 months of age, when water intake needs to be more carefully monitored.

When can babies drink water?

Water may be introduced in small amounts after 6 months of age. When infants less than 6 months of age consume water, it puts them at risk of life-threatening electrolyte imbalance and inadequate intake of calories, protein, and essential nutrients. ^{1 2 3} Per the American Academy of Pediatrics, small amounts of water can be offered starting around 6 months as long as baby is growing and gaining appropriately, but water is optional before 12 months of age.

It's worth noting that water consumption recommendations for babies vary across the globe. Check with your health department for specific recommendations in your country or region.

How much water can babies have?

The American Academy of Pediatrics suggests offering up to 8 ounces (227ml) of water per day starting at 6 months old; however, it is our strong opinion that water should be limited to less than 2-4 ounces (59-118 ml) a day to avoid displacing valuable nutrition from breast milk or formula. ⁴ If you're concerned about baby's hydration status, monitor the number of wet diapers and energy levels, and contact your pediatrician. Generally speaking, babies should have 4-6 good, wet diapers every 24 hours.

How should water be offered?

Offer water in an open cup or straw cup to help baby develop cup-drinking skills.

Believe it or not, water is actually one of the hardest liquids to learn how to drink. Water is thin and flows quickly, which requires the tongue and swallow muscles to work very fast. Don't be worried if your little one coughs when first learning to drink water. The oral motor skills required to drink from a cup or straw are very different than the movements required for breast or bottle feeding. Often, a baby coughs and sputters when the liquid is not well-contained in the mouth. As baby's skills improve with cup and straw drinking, this coughing and sputtering should subside. If your baby continues to cough with water drinking after ample practice time (a few months), speak with your pediatrician.

Avoid offering water in a bottle. Drinking water from a bottle may result in consuming too much water and does not benefit the development of oral-motor skills. Remember, bottle feeding isn't a skill our babies need for life, so learning to drink water from a cup or straw is the way to go!

Offering small sips of water from an open cup or straw cup is an excellent way to teach your infant how to swallow water safely and adequately. Learn how to teach baby to drink from a cup.

When choosing an open cup, select a small cup that's easy for baby hands to hold. Since you'll be dealing with many, many spills, look for a cup that holds no more than 1-3 ounces. A small cup also makes it less likely that your baby will flood themselves with liquid. There are many cups on the market that fit this description, but a shot glass or small glass yogurt cup will do just fine, too!

Before choosing a straw cup, we recommend first teaching your baby the skills of using a straw by itself. Once your baby has the basic idea of the straw itself, you can choose any straw cup you prefer, knowing your baby can use it.

Learn more about cups and why we recommend against sippy cups on our Cup Drinking page or by watching our video on cups and straws here.

Amelia, 7 months, drinks water out of an open cup.

Kalani, 9 months, drinks water out of an open cup.

What kind of water can babies drink?

Babies can drink the same water as the rest of the family. You do not need to purchase special water for babies. That said, always check the water quality in your area to ensure it's safe for drinking; this information is available through your local health department.

Can babies drink sparkling water?

A sip of sparkling water here or there is probably fine, but consumption of carbonated beverages can also lead to painful bloating, gas, and reflux. Many carbonated beverages and sparkling waters have added sodium, as well.

If I am breastfeeding, does my baby need water?

If your baby is younger than 12 months of age, no. Breast milk is comprised 87% of water and water is optional before one year of age. ⁵

If your child is 12 months or older, water is necessary. The minimum water intake for children 12-24 months is around 8 ounces (237mL) a day. While breast milk can "count" as water for a toddler, the ideal is 8 ounces of waterin additionto breast milk or milk.

For a 12-month-old drinking less than 8 ounces of water per day, we advise offering water throughout the day and slowly work toward that 8 ounces minimum. Around 12 months, babies eat more solids, drink less breast milk, and need more water.

How do I know if my child is getting enough water?

First, remember that almost 90% of breast milk and infant formula (standard mixing) is water! Children less than 12 months of age do not necessarily need extra water, but practicing cup drinking at this age is developmentally beneficial and can help acclimate your child to the taste of liquids other than breast milk or formula.

In general, babies who make at least 4-6 good wet diapers per 24-hour period are usually adequately hydrated. Signs of possible dehydration include:

• chapped lips
• few to no tears when crying
• sunken eyes
• dark urine color
• sunken soft spot (anterior fontanelle) on top of the head
• fussy
• excessively sleepy

If you are ever concerned about dehydration, contact your child's health care provider right away. Do not wait.

My doctor said I could start giving my baby water at 3 months / 4 months / 5 months. Is that wrong?

The American Academy of Pediatrics recommends waiting until at least 6 months before offering water to your child. Water given before 6 months of age can reduce nutrient intake and cause life-threatening electrolyte imbalances. ^{6 7 8} The only liquids a baby should be consuming prior to 6 months of age is breast milk or formula. ^{9 10}

My baby/toddler won't drink water! How can I get my child to drink water?

The best way to encourage water drinking is to model the activity yourself. In other words, show them how it's done!

If baby is truly not interested in learning to drink water from a cup:

1. Try pouring water into an open cup in front of baby.
2. Tap the table to get baby's attention.
3. Drink the water from baby's cup yourself.
4. Hand the cup to baby in the air and see if baby reaches for it or leans in.

To help incentivize older toddlers, try teaching them how to pour water from a jug into their cup and let them pour their own water. The more you hand over control, the more your child will explore, touch, and, hopefully, drink. You can also try floating mint leaves or pieces of fruit in the water to add a pop of flavor and make it more exciting. Finally, offer themyour straw! Many times it's much easier to get a toddler to drink out of "daddy's straw" or "momma's straw" to try some water.

Generally, you want to offer 1-2 ounces of water in a small open cup that babies can manipulate with minimal assistance. Bring the cup to baby but stop before it gets too close and give them a chance to reach and grab the cup themselves. Encourage this independence from the start and expect that it will be messy for a while and take some time.

Need help with cup or straw drinking? Check out our Cup Drinking page >>

Can I give my baby water from a bottle?

It is best to refrain from offering water in a bottle. When water is first introduced around 6 to 9 months of age, the focus is more on skill-building than consumption. For this reason, it's best to offer water in an open cup.

Additionally, it's much easier to consume too much water through a bottle, which can displace essential nutrients and lead to water intoxication. ¹¹ Remember: we want to make every sip, gulp, and bite count for babies, and consuming too much water takes away from other forms of nutrition that can be offered instead.

At what age should I introduce a cup?

Introduce both an open cup and straw cup as early as 6 months of age with meals. Alternating between an open cup and straw cup (e.g., offering an open cup with breakfast and a straw cup at lunch) can be helpful so one skill doesn't become too dominant. Check out our cup drinking page for more information on teaching a baby to drink from a cup and why you may want to avoid sippy cups entirely.

Is it okay to give water to a constipated baby?

Yes! But aim for less than 4 ounces in infants 6-9 months of age and less than 8 ounces in infants 9-12 months of age. Also, consider serving avocado, beans, berries, chia seeds, ground flaxseed, or the "P" fruits: papaya, peaches, pears, plums, and prunes. And never hesitate to touch base with your child's healthcare provider.

Is it okay to dilute formula if my baby is constipated?

No. It is never recommended to dilute formula without discussing it with your child's primary health care provider. Formula dilution can be extremely dangerous and lead to water intoxication. ¹²

Are sippy cups okay? And what about 360 cups?

We don't recommend them. Our feeding and swallowing specialists strongly recommend using open cups or straw cups rather than sippy or 360 cups. Sippy cups and 360 cups do not encourage oral-motor skills development. Drinking from an open cup or straw is a lifelong skill. For more information, visit our cup drinking page.

My child is obsessed with water. How do I know if they are drinking too much water?

For some children, water is instantly accepted. For children younger than 12 months old, monitor how much water is consumed in a day. If it's more than 8 ounces, it's likely too much. For younger infants, in particular, drinking too much water can result in water intoxication characterized by electrolyte imbalance and even seizures. ¹³

Signs of overhydration or water intoxication include: ¹⁴

• Nausea
• Fatigue
• Vomiting
• Excessive number of wet diapers (more than 8 per day)
• Confusion
• Change in behavior

If you feel like your child is excessively thirsty, this can also be a sign of an underlying problem. Please don't hesitate to reach out to your child's health care provider.

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Reviewed by:

Natalia Stasenko, MS, RD

Jennifer H. Min, MSN, RN, CPNP-PC, PhD(c)

Kimberly Grenawitzke, OTD, OTR/L, SCFES, IBCLC, CNT

Rachel Ruiz, MD, FAAP. Board-Certified General Pediatrician & Pediatric Gastroenterologist

1. Houck, J., Ganti, L., & Vera, A. E. (2019). A Case of Hyponatremia-induced Seizures in an Infant Secondary to Water Intoxication from the Use of Almond Milk.Cureus, na.
2. Becker, G. E., & Remmington, T. (2014). Early additional food and fluids for healthy breastfed full-term infants.Cochrane Database of Systematic Reviews, na.
3. Cohen, R. J., Brown, K. H., Rivera, L. L., & Dewey, K. G. (2007). Exclusively breastfed, low birthweight term infants do not need supplemental water.Acta Paediatrica,89(5), 550–552.
4. Martin, C. R., Ling, P. R., & Blackburn, G. L. (2016). Review of Infant Feeding: Key Features of Breast Milk and Infant Formula. Nutrients, 8(5), 279.
5. Martin, C. R., Ling, P. R., & Blackburn, G. L. (2016). Review of Infant Feeding: Key Features of Breast Milk and Infant Formula. Nutrients, 8(5), 279.
6. Houck, J., Ganti, L., & Vera, A. E. (2019). A Case of Hyponatremia-induced Seizures in an Infant Secondary to Water Intoxication from the Use of Almond Milk.Cureus, na.
7. Becker, G. E., & Remmington, T. (2014). Early additional food and fluids for healthy breastfed full-term infants.Cochrane Database of Systematic Reviews, na.
8. Cohen, R. J., Brown, K. H., Rivera, L. L., & Dewey, K. G. (2007). Exclusively breastfed, low birthweight term infants do not need supplemental water.Acta Paediatrica,89(5), 550–552.
9. American Academy of Pediatrics. (2021).Infant Food and Feeding.
10. World Health Organization. (2020).Infant and young child feeding.
11. Encyclopedia of Children's Health. (2021).Overhydration.
12. Healthy Children. (2018). How to Safely Prepare Formula with Water.
13. Encyclopedia of Children's Health. (2021).Overhydration.
14. Encyclopedia of Children's Health. (2021).Overhydration.

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Why Would You Give a Tiny Baby Water

Source: https://solidstarts.com/starting-solids/water/

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