Updated: June 1, 2021
Originally Published: February 4, 2018
One sunny afternoon when my first child had just reached five months, I was out with my mother enjoying the warm weather. Despite knowing my baby was exclusively breastfed, she instinctively thought he might be thirsty and reached for her water bottle to offer him a sip. Reacting quickly, I exclaimed “NO!” and took the bottle away. My knowledge told me that breastfed infants do not require extra water; my ample milk supply and his wet diapers—even in the heat—made that clear. But was there a deeper rationale behind my hesitation?
Upon returning home, I did some research (as many parents do when faced with conflicting advice) and discovered that my instincts were correct. Babies who are not consuming solid foods should not be given water supplements, regardless of whether they are breastfed or formula-fed. According to the American Academy of Pediatrics, “Healthy babies do not need extra water. Breast milk or formula provide all the hydration they require.”
This advice is particularly crucial for younger infants, whose bodies are not designed to process any fluids other than milk. For breastfed infants, introducing any supplements can interfere with milk production. As the Academy of Breastfeeding Medicine explains, “Supplementation in the first few days can disrupt the normal frequency of breastfeedings. If the supplement is water, the infant is at increased risk for conditions such as elevated bilirubin levels, excessive weight loss, prolonged hospital stays, and potentially even water intoxication.”
For babies under four to six months who have not begun eating solids, caution is essential. While some pediatricians may suggest offering small amounts of water to formula-fed babies in hot weather, this should always be done sparingly. Why? Because too much water can be harmful. This condition, known as “water intoxication,” can occur if an infant consumes excessive amounts of water, leading to dangerous fluctuations in sodium levels. Dr. Samuel Harris, a pediatrician and former medical director at a children’s hospital, warns that for infants under one year, especially those under nine months, an overload of water may result in severe health issues, including seizures, coma, or even death.
If parents feel the need to provide extra water, it should be limited to two to three ounces and only given after the infant has breastfed or had formula. Interestingly, Dr. Harris also cautions against infants participating in swimming lessons, as repeated submersion can lead to gulping water, which has been linked to seizures at poolsides.
While it’s crucial for parents to remain vigilant regarding their baby’s water intake, it’s unnecessary to avoid all water exposure entirely. However, awareness of the risks associated with excessive water consumption is essential. Once babies begin eating solids, experts recommend introducing water (but not juice) during meals, as this can aid digestion and help replenish lost fluids as milk intake decreases.
In summary, for the first six months of life, breast milk or formula is all an infant needs, even during hot weather. So, the next time a family member tries to offer your baby water, feel confident in saying “No, thank you!”—after all, your baby truly does not require any additional hydration at this stage.
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