Supplemental Water in Breastfed Infants

Q. My son is 3 months and gets nothing but breastmilk. He is still eating every two hours and is very healthy, My husband’s mother is always trying to get me to give my son water, but she bottle fed all her children. Does anyone give their child water and why is it needed?

A. First, no, water is definitely not needed for breastfeeding babies. There have been a few wonderful research papers published about this very topic. In very hot climates, a well-hydrated mother produces more than enough milk for her baby. I am talking about 105 degrees F or more! These studies have been done more than once. In other words, moms need extra water and babies don’t.

In the newborn nursery, giving water to babies leads to¬†more weight loss andincreased jaundice. This makes sense when one realizes that colostrum and breastmilk are fuel and get digested for that purpose. Water tends to just “flow through” the baby and contains zero calories for metabolic energy, zero protein and so on. The weight loss and jaundice research was done many years ago and is ignored in the majority of hospitals throughout the country. The truly dangerous aspect of this antiquated practice is that bottles of water in the nursery can delay mom’s milk coming in since it takes away from the time that baby is at the breast. She could then get home and find herself with less milk and no water and a very confusing situation.

When do I recommend water for babies? Starting after six or seven months of age it may be convenient to grab a small cup or bottle of H2O in a hurry, but there is still no “need” for water in a breastfeeding baby in the first year of life.

References:

DeCarvalho, 1981
DeCarvalho M, Hall M, and Harvey D. Effects of water supplementation on physiological jaundice in breast-fed babies. Arch Dis Child. 1981: 56: 568-569.

DeCarvalho, 1982
DeCarvalho M, Klaus MH, and Merkatz RB. Frequency of breast-feeding and serum bilirubin concentration. Am J Dis Child. 1982: 136: 737-738.

DeCarvalho, 1983
DeCarvalho M, Robertson S, Friedman A, and Klaus M. Effect of frequent breast-feeding on early milk production and infant weight gain. Pediatrics. 1983: 72; 307-311.

DeCarvalho, 1985
DeCarvalho M, Robertson S. And Klaus M. Fecal bilirubin excretion and serum bilirubin concentrations in breast-fed and bottle fed infants. J of Pediatrics. 1985: 107(5), 786-790.