As an international feeding specialist, I teach families across the globe. And no matter what country the parent is from, one of the biggest concerns I hear about is water consumption for their baby. Here are some of the common water questions I get asked plus how I respond.

Can I use water when teaching open cup drinking to my baby?

Babies under six months should not drink water due to the medical risk of water intoxication (the kidneys are too immature to filter water). Developmentally, we teach open-cup drinking between 4-6 months of age. During this stage, babies should learn to drink from an open-cup (held by an adult) filled with breast milk or formula – not water.

Can I give my baby water to help with hydration?

Breastfed babies do not require additional water because breastmilk is 80% water, which meets their hydration needs. Likewise, no extra water is required for formula-fed babies; formula also maintains their hydration needs. In addition to breast milk / formula I like to offer babies (that are six months or older) first foods that are naturally high in hydration. Some of my favorites are overripe watermelon, cantaloupe, peaches and strawberry spears (or purees).

Should I stop breastfeeding and replace breastmilk with water when I start baby-led weaning?

Although the name is similar (and it can be confusing), weaning your baby from a breast or bottle is different than baby-led weaning (BLW). BLW is a feeding method for introducing your baby to solid food, and it starts around 6 months of age. Weaning from a breast occurs when you (and your baby) choose to make that transition. The preferred liquid the American Academy of Pediatrics (AAP) recommends for the first 6 months of life is breast milk (or formula), not water. After 6 months, the AAP continues to recommend breast milk / formula as well as solid foods for baby’s nutritional and hydration needs. This recommendation holds until the baby is 12 months old.

 Can water affect my baby’s hunger and fullness cues?

Yes, water can make a baby feel full and interrupt their hunger and fullness cues. This can, in turn, affect their consumption of solids. If you want to offer a developmentally appropriate liquid before (or during) a meal to help with swallowing, to clear your baby’s mouth of pocketed food, or to help satiate their appetite, breast milk or formula is best.

When should we safely introduce water?

I like to introduce water from an open cup around 10 months of age. By this age, their kidneys are fully developed and they have had success drinking thicker liquids from an open cup (e.g., breast milk, formula, fresh smoothies and thin or thick purees). This practice with thick (and slower) liquids improves their ability to maintain a safe head and neck posture for drinking a thinner (and faster) liquid like water. I find that if water is introduced too early (and the liquid ‘goes down the wrong way’) babies refuse to drink from a cup, which may cause nutritional or developmental delays.

*I should also mention several pediatricians, gastroenterologists and dieticians I have had the pleasure of working with over the years recommend waiting until 12 months of age to introduce water.

Should my older baby learn to like the taste of water?

Yes. Ten months of age is a good time to introduce the ‘taste’ of water, and you can do so from an open-cup or a straw cup. Developmentally, babies can be introduced to a straw cup around nine months of age with thick liquids. With time and practice, they can graduate to thin liquids like water (between ten and twelve months of age). Just remember; even a few hesitant sips are a great start when introducing water! This is part of the process in helping babies become toddlers that enjoy drinking water and can do so safely.

Getting your baby to be safe and successful with drinking water takes patience. But practicing open cup and straw cup drinking with breast milk (or formula) can prepare you baby to take this next step in their swallowing development. Tag us in your cup drinking adventures by using our hashtag #ezpzfun.

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