Some of our parents were taught to give us water in our bottles, sometimes as early as just a few weeks.
One reasoning for this was “when you drink cows milk, it makes you thirsty! So the baby must need some water after drinking all that milk!”
Or perhaps they were taught to use water to “cure” colic or to make the baby burp.
But when we know better, we do better.
Human milk is not cows milk, nor does it have the same consistency.
Both breastmilk and formula are designed to both hydrate and provide nutrition to babies, all in one.
Generally, having water is a healthy way that we stay hydrated, so we might assume (especially given our parents experience) that giving our babies water is necessary.
However, for young infants, we now know that water isn't recommended for exclusively breastfed babies.
For formula-fed infants, caution needs to be exercised. Giving too much water to a young infant can even be dangerous or fatal.
Leading health organisations such as Australia’s National Health and Medical Research Council (NHMRC), the American Academy of Pediatrics and the World Health Organization all recommend exclusive breastfeeding for 6 months (or ‘around’ 6 months) and then for solids to be introduced while breastfeeding continues for at least one year.
Exclusive breastfeeding means no other liquid or solid food is given, not even water.
But are there any situations where a baby may need water?
Exclusively Breastfed Babies Don’t Need Water
Babies who are exclusively breastfed and are feeding well do not need any extra fluids such as water, even in hot and humid weather. Feeding a baby when she shows feeding cues helps ensure she gets all the breastmilk she needs which will keep her adequately hydrated.
During hot weather it is common for babies to want to have more frequent but shorter breastfeeds. In this way, she gets more of the thirst-quenching, lower-fat milk more often.
Giving an exclusively breastfed baby any additional fluids can reduce her appetite for breastmilk and hence potentially lower her mother’s milk supply.
What About After The Introduction Of Solids?
Giving a breastfed baby water after the introduction of solids is not absolutely necessary as long as she has an unrestricted number of breastfeeds (i.e. is fed according to her individual needs).
However, some mothers like their baby to get used to drinking from a cup. They may offer a small amount of water from a cup at the same time as solids are given. This might also help baby to associate meal times with drinking water as opposed to any other drinks. But if you prefer, you could also express breastmilk into a cup.
Formula Fed Babies May Need Water
According to the NHMRC, “For formula-fed infants, cooled boiled tap water may be used if additional fluids are needed.”
This may be necessary, for example, if a formula fed baby is constipated.
However, it is important to seek medical advice before giving a young baby any water. This is because it can be potentially dangerous to give a young infant water.
Why Giving Water Could Be Dangerous
Since a young baby’s kidneys are immature, they cannot handle water, and can quickly become over hydrated when given water or diluted formula. For this reason, young babies are susceptible to water intoxication if given water.
Be sure to check with a healthcare provider before offering water for constipation or any other concerns.
For more information on adding water to breastmilk or formula, see here.
What About Other Fluids?
Breastmilk or infant formula should be a baby’s main drink in the first 12 months.
While small amounts of cows’ milk may be given to a baby over the age of about 6 months (e.g. on cereal), it should not be given as a drink until after 12 months due to the risk of iron deficiency.
Fruit juices should not be given to babies under 12 months of age, and should not be considered as a replacement for fruit at any age. Sweetened drinks, such as fruit juices, contain a great deal of sugar, are associated with tooth decay.
For the first 6 months, exclusively breastfeeding or formula feeding is advised. If your baby is formula-fed, you can discuss small amounts of water with your healthcare provider if you believe it might be necessary. During the first 12 months, be sure to keep breastmilk or formula as their primary drink.
This ensures they are getting adequate nutrition and lessens their risk of iron deficiency.
Grandparents, aunts and even healthcare providers not up-to-date with current recommendations, might suggest offering water. It can be hard to navigate what seems like a constant flow of conflicting advice, but following evidenced based information can help you make informed choices that you are comfortable with. If you are exclusively breastfeeding and your baby is under six months, avoiding water is the current recommendation.