Does My Baby Need Water?

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We’ve all heard that we should drink more water to stay healthy, but the same isn’t true for infants.

According to the American Academy of Pediatrics, healthy babies younger than age 6 months usually don’t need extra water in addition to formula or breast milk. Even in cases of very hot weather, check with your pediatrician before giving water to your baby, and ask how much is safe.

The Hazards of Hydrating

Parents on a budget sometimes try to “stretch” formula or breast milk by diluting it with water. However, this practice can be dangerous, and even deadly for your baby. It reduces the amount of nutrients in each serving, while increasing the potential for a condition known as water intoxication.

Symptoms and Complications

Water intoxication sometimes occurs when the body ingests too much water. While it’s rare in adults, children are more vulnerable because babies are born with the urge to suckle so it’s easy for them to ingest more water than is healthy. Signs of water intoxication in infants can include facial swelling, a temperature below 97 degrees Fahrenheit, clear urine and more than six to eight wet diapers in a day.

Too much water can cause an imbalance in the amount of sodium naturally present, a condition known as hyponatremia, which can occur as a sudden or chronic condition. Chronic hyponatremia can lead to developmental delays and a lack of growth, but acute hyponatremia, occurring in less than 48 hours, is more dangerous. In these cases, coma and death are possible. Common signs of hyponatremia in infants include convulsions, seizures and muscle spasms.

Proper Formula Preparation

Diluting formula with too much water can be bad for your baby, but not adding enough has its own risks. Formula that’s too strong can put extra strain on your baby’s digestive system and kidneys.

  • Measuring: Use only the scoop that came with the formula you’re using. Don’t assume two different brands are exactly the same.
  • Follow directions: Although mixing one level scoop of formula per two ounces of water is a general rule of thumb, follow the manufacturer’s instructions.
  • Heating: If your baby prefers a warm bottle, avoid using a microwave, which can cause uneven heat and hot spots.

Did You Know?

> Mixed formula has a short life. Refrigerate it if not used immediately, and throw it away after 24 hours, even if refrigerated.

> Don’t freeze prepared formula or powder, and store cans of formula at room temperature.

> Throw away formula left over following a feeding, since the mixture of formula and saliva can allow bacteria growth.

Schedule doctor visits for your child online at! Day or night, schedule appointments for next day and beyond with pediatricians Alan Brown, M.D., or Bird Gilmartin, M.D., here.

Drs. Brown and Gilmartin are members of the medical staff at Evanston Regional Hospital.