HYPONATREMIA in Infants: Why babies shouldn’t have water

America is experiencing a record-breaking heat wave, so parents are making sure their children are staying hydrated. The first parental instinct is to reach for water as a hydration source, but did you know that babies under 6 months old shouldn’t have regular water? This is because their kidneys are not mature enough to handle the processing of water. Giving water to a baby younger than 6 months old can cause electrolyte imbalances and other problems. 

One of the potential risks is hyponatremia, a condition that can occur when babies consume too much water. Understanding hyponatremia and the importance of age-appropriate hydration can help you keep your little one safe and healthy.

What is Hyponatremia?

Hyponatremia is an electrolyte imbalance characterized by low sodium levels in the blood. Sodium is a vital electrolyte that helps regulate water balance in and around cells, plays a crucial role in nerve function, and is essential for muscle contractions. In infants, hyponatremia can occur if they consume too much water, which dilutes the sodium in their bloodstream, leading to potentially serious health issues.

The symptoms of hyponatremia vary depending on the sodium level. Mild symptoms include vomiting, fussiness, and weakness. More severe symptoms include lethargy, seizures and coma. 

Why Babies Shouldn't Have Regular Water

1. Immature Kidneys: Infants' kidneys are not fully developed, making them less efficient at filtering excess water and sodium. When babies drink too much water, their kidneys may struggle to excrete the excess, leading to water retention and diluted sodium levels.
2. Nutritional Needs: Infants primarily get their hydration and nutrition from breast milk or formula, both of which contain the necessary balance of electrolytes and nutrients required for healthy growth and development. Introducing regular water can fill up their tiny stomachs, potentially leading to decreased intake of breast milk or formula and, subsequently, insufficient nutrition.

Safe Hydration Tips for Babies

1. Breast Milk or Formula: Exclusively breastfeed or provide formula to infants under six months old, as these provide all the hydration and nutrients they need. Breast milk and formula contain the right balance of water, electrolytes, and nutrients essential for growth.
2. Avoid Adding Water to Formula: Never dilute formula with extra water. Always follow the manufacturer's instructions when preparing formula to ensure the correct balance of nutrients and electrolytes.
3. Introduce Water at the Right Age: After six months, when solid foods are introduced, you can begin offering small amounts of water. This should be done gradually, and water should complement, not replace, breast milk or formula feedings. The American Academy of Pediatrics recommends, if desired, no more than 4-8 ounces of water per day served at mealtimes starting at 6 months old. 
4. Monitor for Signs of Dehydration or Hyponatremia: Stay vigilant for signs of dehydration, such as dry mouth, fewer wet diapers, or lethargy, as well as signs of hyponatremia, such as irritability or seizures. Always consult a pediatrician if you have concerns about your baby's hydration status.

While water is vital for life, infants have unique nutritional and hydration needs that differ from adults. Understanding the risks of hyponatremia and adhering to appropriate feeding practices ensures your baby receives the proper nutrition and hydration necessary for healthy growth and development. Always consult with your pediatrician for personalized advice tailored to your baby's specific needs, and feel confident knowing you're giving your little one the best start possible.

By keeping these guidelines in mind, you can help protect your baby from the risks associated with hyponatremia and ensure their first months are as healthy and happy as possible.