Summer breastfeeding - why water could be unsafe

It's stinking hot. You are sweaty and so is your baby. He or she keeps grizzling and signalling for more ‘boobie'. Obviously thirsty, you wonder if you should give your little one a drink of water.

Not only do you not need to offer your baby water in hot weather, but it can be unsafe: giving water to newborns can affect your milk supply, and your baby's weight gains. For all babies under six months, giving water can dilute the sodium in the baby's bloodstream - and a condition known as oral water intoxication may develop. This condition can lead to symptoms like low body temperature, bloating, and seizures.

If you have a newborn, giving water fills your baby's tummy, which means he or she will drink less milk. This can affect your baby's weight gains or they may even lose weight. It can also have a negative impact on establishing your milk supply. In the early weeks after giving birth, you need to feed your baby often to calibrate your milk-making potential - if you can get your supply up now, while your post-birth hormones are influencing milk production (along with emptying your breasts), you will have a better long-term supply and an easier time when these hormones are no longer supporting your milk production to the same extent.

According to physicians at Johns Hopkins Children's Center in Baltimore, babies younger than six months old should never be given water to drink. “Even when they're very tiny, babies have an in tact thirst reflex or a drive to drink,” Dr. Jennifer Anders, a pediatric emergency physician at the centre told Reuters Health. “When they have that thirst and they want to drink, the fluid they need to drink more of is their breast milk or formula.”

Because babies' kidneys aren't yet mature, giving them too much water causes their bodies to release sodium along with excess water, Anders said. Losing sodium can affect brain activity, so early symptoms of water intoxication can include irritability, drowsiness and other mental changes. Other symptoms include low body temperature (generally 97 degrees or less), puffiness or swelling in the face, and seizures.

“It's a sneaky kind of a condition,” Anders said. Early symptoms are subtle, so seizures may be the first symptom a parent notices. But if a child gets prompt medical attention, the seizures will probably not have lasting consequences, she added.

Beyond the newborn stage, your baby still needs the calories and nutrition in milk for growth and development. Water has none of these and again, it will fill their tummy, possibly reducing ood intake and may affect your milk supply. Or if your baby has been drinking lots of water during the day, he or she may wake more at night to catch up on milk feeds because they're hungry.

Water as a beverage should be completely off limits to babies six months old and younger, Anders and her colleagues say. Parents should also avoid using over-diluted formula, teas or pediatric drinks containing electrolytes.

So what can you do to keep your baby hydrated in hot weather?

Most importantly, respond to your baby's feeding cues (smacking or licking lips, opening and closing the mouth, sucking on lips, tongue, hands or fingers and ‘rooting' at your chest). Allow your baby to breastfeed as much as they need to quench their thirst.

Breastmilk is composed of 90% water, and that provides all that your breastfed baby needs, even in hot weather. If your baby is thirsty, they will regulate the amount and consistency of your breastmilk by feeding more often and taking in enough of the watery foremilk to satisfy thirst, but not so much of the creamier hind milk if they are thirsty but not hungry - you can't ‘overfeed' your breastfed baby. This means that your baby may seem to ‘snack' as they feed frequently, but for just a short time on hot days.

When your baby is around six months and ready to try other foods, he or she may enjoy a few sips of water from a sippy cup. As they eat more family foods, a little water may help if they seem constipated. If your older baby doesn't want to try water yet though, don't worry, an extra breastfeed or several will give them all the water they need - you can also offer breast milk ‘icypoles' if they seems too hot to snuggle close and breastfeed.

Meanwhile, make sure you maintain your milk supply by drinking plenty of fluids yourself - respect your own hunger and thirst signals and consider that tiredness can be an early sign of dehydration. So, watch your baby, not the clock, and make sure you drink water so your baby gets plenty to drink on these hot days.

Pinky McKay is an internationally certified lactation consultant and best selling baby care author of Sleeping Like a Baby, Parenting by Heart, 100 Ways to Calm the Crying and Toddler Tactics.

See Pinky's Books (also available as audio) at her website at www.pinkymckay.com