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Exclusively breastfed babies do not need additional water – breastmilk is 88% water and supplies all the fluids that your baby needs.
Even in the first few days after birth, before mom’s milk has “come in”, colostrum is all that is needed to keep baby well hydrated (assuming baby is nursing effectively).
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Exclusively breastfed babies do not require additional water even when it is very hot outside, as long as baby is allowed to nurse as needed.
Even in extremely hot, dry weather your baby can get all the liquids needed via breastmilk.
A number of research studies investigating the need for water in exclusively breastfed babies were done in various locations (both humid and dry) at temperatures ranging from 22-41°C (71.6-105.8°F) and 9-96% relative humidity [see references below]; these studies concluded that exclusive breastfeeding provides all the fluids needed.
Formula fed babies also do not routinely need extra water.
Some sources do suggest offering water to a formula fed baby when it is very hot outside (though baby may prefer to get extra water from more frequent feeding), or when baby is sick with a fever (consult baby’s doctor for guidelines).
The Academy of Breastfeeding Medicine advises, “Supplementation in the first few days interferes with the normal frequency of breastfeedings.
If the supplement is water or glucose water, the infant is at increased risk for increased bilirubin, excess weight loss, longer hospital stay, and potential water intoxication.”
Per the American Academy of Pediatrics, “Supplements (water, glucose water, formula, and other fluids) should not be given to breastfeeding newborn infants unless ordered by a physician when a medical indication exists
During the first 6 months of age, even in hot climates, water and juice are unnecessary for breastfed infants and may introduce contaminants or allergens.”
For newborns (especially under 4-5 weeks), water supplements can be risky
Babies under two months should not be given supplemental water.
Water supplements are associated with increased bilirubin levels (jaundice), excess weight loss, and longer hospital stays for newborns.
Too much water can lead to a serious condition called oral water intoxication.
Water supplements fill baby up without adding calories, so water supplements can result in weight loss (or insufficient weight gain) for the baby.
Babies who get water supplements are less interested in nursing.
If baby is not nursing as often as he should, it will take longer for mom’s milk to come in and can delay or prevent mom from establishing an optimum milk supply.
For babies past the newborn stage
Too much water can interfere with breastfeeding because it fills baby up so that he nurses less.
Babies need the nutrition and calories in breastmilk to grow – water has none of these.
Breastmilk has all the water your baby needs, even in very hot weather.
When your 4-6 month old baby is learning to use a cup, giving him a few sips of water a couple of times a day (no more than 2 ounces per 24 hours) is fine and fun.
Once baby starts solids, you might want to give him a few sips of expressed milk or water with his solids – some babies need this to prevent constipation.
For older babies & toddlers, continue to breastfeed and offer water in moderation.
Breastmilk supplies plenty of fluids, so many older babies or toddlers who breastfeed without restriction can get the fluids they need through breastfeeding.
Others may need a little water with solids to prevent constipation. No need for a bottle – just offer a cup.
Most older babies and toddlers particularly like to drink water from a parent’s cup or straw.
In our family, we usually offer a cup of water at mealtime, or when someone else is getting a drink, and let the child choose whether or not to drink.
Should I Give Bottles of Water to My Baby?
My one-month-old doesn’t seem satisfied after feeding.
Should I give her a bottle of water?
Babies who latch on and suck well, and who breastfeed frequently throughout the day and night will get all the nourishment they need from the breast.
Checking the signs listed under Getting Enough Milk? can reassure you that you have enough milk and baby is well-fed.
Even during the first days of breastfeeding, when your milk has not yet come in and your baby is receiving colostrum, there is usually no need to offer supplements of water, sugar water, or formula.
Supplemental Bottles of Water and Formula
Supplemental bottles of water and formula are not only unnecessary, they can sabotage breastfeeding.
Here’s why breastfed babies should not get routine supplementary bottles:
Supplemental Bottles Will Interferes With Supply and Demand.
Water and formula quench babies’ thirst and fill their tummies, so that giving babies bottles containing either one will make them want to nurse less.
While it seems as if a bottle might be “insurance” that baby is getting enough milk, giving formula supplements interferes with the balance between mother’s milk supply and baby’s demand.
Baby may fill up on formula and therefore not nurse as well at the next feeding.
Mother’s breasts get the message that they should make less milk.
Soon baby is getting two or three bottles a day, either because mother doesn’t feel she has enough milk or because she’s off doing other things instead of focusing on her baby.
The trend continues.
Mother’s milk supply fades, along with her confidence, and baby soon is completely weaned to bottles and formula.
Bottles Can Risk Nipple Confusion
In the first weeks after birth, offering artificial nipples may cause nipple confusion.
Getting milk from a bottle requires different movements of the mouth and tongue.
When baby is offered the breast, he may have difficulty latching-on and sucking correctly.
Nipple confusion is less of a problem after 4-6 weeks of age, but even older babies may protest when put to the breast if they have become accustomed to the faster milk flow of the bottle.
Supplemental Bottles Affects Long-Term Breastfeeding
Studies have shown that supplementation, especially in the first few days after birth, negatively influences the duration of breastfeeding.
Frequent feeding during the first few weeks postpartum is crucial to having a plentiful milk supply down the road.
Bottles May Messes With Mom’s Mind
The words “in case you don’t have enough milk” plant the seeds of doubt in mother’s mind, and one way or another, they can keep a mother from making enough milk.
When people suggest that your milk supply is inadequate, you may be quick to conclude that baby’s fussiness, wakefulness or sleepiness (or anything else your baby is doing) means baby is not getting enough milk.
Doubt produces confusion about how to interpret baby’s cues and worries about him being hungry.
Supplementary bottles look like the solution to your dilemma, but depending on supplements will make it impossible for you to learn to read your baby’s breastfeeding cues.
You’ll nurse your baby less, and eventually, you won’t have enough milk.
Giving Baby Bottles Keeps You From Trying Better Breastfeeding Solutions
If you have concerns about your milk supply, clicking into the bottle mindset keeps you from experimenting with techniques that will help your body make more milk.
Go to Increasing Your Milk Supply for options that work with your biology, not against it.
Occasionally, because of medical complications or because baby is having difficulty learning to latch on and suck efficiently, supplements are necessary.
This is usually a temporary situation. Supplements can be given using alternatives to bottles.
The best supplement is mother’s own milk, obtained with a breast pump or by hand expression.