Is It Ok To Give My Baby Water?

Choosing suitable water to prepare powdered infant formula is important.

Non bottled water

The 3 most common supplies of non-bottled water are...  

• Municipal water supplies
• Private wells or bore water
• Rainwater tanks

1. Municipal water supplies

Like any water supply (including that used by bottle water manufacturers), municipal water supplies are vulnerable to contamination from the environment. To reduce the level of contaminants and improve its quality, the water is pumped through a series of filters and disinfected at water treatment plants.

There are concerns that the water treatment process may create potential health problems. Municipal water is treated with chlorine to eliminate harmful micro-organisms. Chorine reacts with naturally occurring organic matter to produce a toxic bi-product called trihalomethanes. Also some municipal water supplies add fluoride to the water. Fluoridated water is viewed as a health benefit by many and a health hazard by others.

According to the National Resource Defence Council, water quality varies from one water supplier to another, even within the same country. While tap water from some water suppliers is considered of good or even excellent quality, other suppliers provide water that is considered to be of poor quality.

Lead can get into your water supply AFTER it has left the treatment plant. (Lead is a toxic metal that can pose a long-term health risk for infants and small children.) Lead may be a concern in older homes with lead pipes

How to be sure your water is safe?

Municipal water is tested daily to ensure it meets federal and state health standards. 

To check the water quality in your area, ask your water supplier for a copy of their annual report. Also ask if tests indicate that lead may be a problem in your area, if so, get your water tested; this way you can determine what you house plumbing is contributing to your water supply.

2. Private well or bore water

Water from SOME private wells is NOT safe for infants and pregnant women.

Shallow well water may contain the byproducts of farm fertilizers; particularly nitrates, lead or arsenic selenium. High levels of nitrates in drinking water can reduce the ability of a baby's blood to carry oxygen, resulting in a serious condition called methaemoglobinaemia.

If you are on a spring or wall, with NO chlorine, then you are very vulnerable to bacteria contamination.

How to be sure your well water is safe?

Your local health department can tell you which contaminants are typically found in your area. It can also supply a list of certified labs to test the water for you. Be aware that any water system can be affected by temporarily by spills, agricultural runoff, including pesticides and insecticides. 

3. Rainwater tanks

Once upon a time rainwater was a pure as you can get. Today this is not the case. Rainwater is polluted from fossil fuel burning, airplane emissions and pesticide and insecticide spraying from farming. 

Anything that happens to fall on your roof or collect in your gutter will also collect in your rainwater tank. Bacterial and viral contamination in tank water is very common and elimination cannot be guaranteed, even with the use of chlorination or other methods of sterilization. 

How to be sure your rainwater is safe?

Bacteriological tests are available to determine if water is safe for human consumption. Contact your local health department for information on how and where these tests are performed. Regular testing is recommended.

Why is water important for babies? 

Water is the most abundant substance in the human body. Every cell in our body contains water. Body water of infants and children contributes to around 65% - 75% of their total body weight, for adults the figure is around 60%.

Water is necessary for ALL biochemical processes that occur in our body. Our body uses water for digestion, absorption, circulation, transporting nutrients, building tissues, carrying away waste and maintaining body temperature. 

Our survival is dependant on water. We can survive many weeks without food but only a few days without water. A lack of body water results in dehydration, a serious life threatening condition.

Home filtration systems

Home water filtration systems are also rapidly increasing in popularity. The different types of filtration systems vary significantly in their effectiveness in removing different contaminants i.e. heavy metals, bacteria, parasites in water. Correspondingly, they can also vary significantly in cost.

Before purchasing expensive filtration systems, have your tap water analyzed . Water analysis is usually inexpensive and will help to identify any potential problems. Test results will help you to determine if your water needs to be treated and, if so, the best option to use. 

The 3 most popular filtration devices are...

• Carbon filters
• Reverse osmosis filters
• Distillers

1. Carbon filters

When water flows through carbon filters, contaminants absorb or stick to the surface of the carbon filter. 

• Carbon filters treat general taste and odor problems, including chlorine residue.
• Carbon filters are reported to be the best method available for removing specific organic chemicals, including some pesticide residues.
• Carbon filters are the least expensive of the 3 main water treatment methods.

DISADVANTAGES

• Carbon filters are NOT effective at removing micro-organisms, lead or other heavy metals, nitrates, sodium, fluoride or minerals that produce hardness.
• The effectiveness of carbon filters declines over the period of use. Filters need to be cleaned or changed regularly. If the filter becomes clogged or wears out before it is replaced it can become a breeding ground for bacterial growth. 

SUITABLE FOR INFANTS provided the filter is changed regularly. Boil water before use.

2. Reverse osmosis filters

A reverse osmosis filter works by passing water, under pressure, through a special semipermeable membrane that traps lead, mercury, iron and many other contaminants, including micro-organisms. These systems are more powerful than carbon filters and are also more expensive.

ADVANTAGES

• Reverse osmosis is effective at removing non organic contaminants such as dissolved salts, fluoride, nitrate, lead and other organic contaminants.
• Reverse osmosis systems do not use electricity, and the cost per gallon of treated water is less than distillation.

DISADVANTAGES

• Reverse osmosis is NOT effective against high levels of minerals
• Reverse osmosis systems waste a lot of water. Only 10 - 25% of the water passing through the unit is forced through the membrane. The rest goes down the drain.
• Reverse osmosis is slow, 3 - 6 gallons per hour.
• These systems can be expensive to install and maintain.
• Efficiency drops with lower water pressure.
• The membrane should be changed periodically to maintain effectiveness.
• Reverse osmosis also removes beneficial minerals such as calcium, fluoride   and phosphate.

NOT RECOMMENDED FOR INFANTS except in small amounts.

3. Distillers

Water distillers work by boiling water and then condensing the steam into purified water. Most units then run the water through a carbon filter. This gets rid of almost all contaminants, including microorganisms, lead, certain organic chemicals and pesticides. 

ADVANTAGES

• Distillation, especially when combined with a carbon filter, is the most effective means of home water treatment. 

DISADVANTAGES

• They are expensive to purchase and expensive to run because they use a lot of electricity.
• Distillers require regular cleaning, are noisy, and may vent off volatile chemicals. They also give off considerable heat.
• They remove beneficial minerals such as calcium, fluoride and phosphate. 

NOT RECOMMENDED FOR INFANTS except in small amounts.

According to Zoltan P. Ronan MD MSc, distilled, purified, or reverse osmosis water leaches minerals from the bones and teeth (Read his article Why purified water is bad for you for more information).

Bottled water

A booming industry over the past decade is bottled water. There are now well over 20 different TYPES, and over 3000 different BRANDS of bottled water marketed worldwide. 

Many people drink bottled water because they prefer the taste to tap water. Others drink it because they think it is safer than tap water, but there is NO evidence to support this.

According to the National Resources Defense Council's drinking water program, a study on bottled water found that over 25% or more of bottled water was really just tap water in a bottle. About 22% of the brands tested contained in at least one sample chemical contaminants at levels above state health limits.

How can you tell if bottled water is safe?

Bacteriologically NO bottled water should be presumed to be safe for INFANTS. 

Unlike municipal water suppliers, bottled water manufacturers are NOT mandated to test water daily or to provide consumers with test results. Even where bottled water is of a high quality, once it leaves the manufacturers improper or prolonged storage conditions can increase the bacterial content of the water.

• MINERAL WATER is not recommend for infants or children due to high mineral levels. 
• SPRING WATER also contains varying mineral levels and is not recommended for infants, except in an emergency*.
• SPARKLING OR CARBONATED WATER is not recommended for infants. 
• PURIFIED OR DISTILLED WATER is not recommended for infants or children. According to Zoltan P. Ronan MD MSc, distilled, purified or reverse osmosis water leaches minerals from the bones and teeth (Read his article Why purified water is bad for you).

* In an  emergency, use nursery water, spring or bottled drinking water but make sure you  boil it prior to use .

For more information on bottled water see Bottledwaterblues.com.

Water softeners/ water conditioners

Artificial softened water is NOT suitable as drinking water for infants.

Water softeners have little to do with water filtration/purification. A water softener DOES NOT remove microbiological contaminants that cause illness. They simply make the water more pleasant to wash with. 

Water softeners soften or condition hard water by replacing hard ions in the water, like magnesium and calcium with softer sodium or potassium ions. Water containing high levels of sodium or potassium should NOT be used for drinking, making coffee, juice, infant formula or for cooking.

Can water be harmful to a baby?

Offering occasional, small amounts of safe drinking water will NOT harm a healthy, thriving breastfed or formula fed baby, even if it is offered PRIOR to starting solids.

However, in unusual circumstances it is possible to upset a baby's electrolyte balance by providing large amounts of additional water. In extreme cases, water intoxication can occur if a child takes in large amounts of fluid without corresponding electrolytes, i.e. giving formula over-diluted with water or giving a child large amounts of water to drink.

Provided water is NOT offered in place of milk (breastmilk or infant formula) and a healthy child is NOT forced to drink more water than he wants then water intoxication is UNLIKELY to occur.

Is it necessary to give water to babies? 

Water is just as important to babies as as it is to everyone else. However, babies receive most of their water needs from breastmilk or infant formula and there is little need for additional water before a child starts eating solid foods.

Before starting solids

In COOL or MODERATE CLIMATES it is not necessary to give additional water to young babies. Breastmilk contains approx 90% water and infant formula contains approx 85% water (provided it is prepared correctly). 

In WARM or DRY CLIMATES a small amount of cooled boiled water once or twice per day may be given to FORMULA FED babies from 1 month old, provided water does not replace formula feeds. BREASTFED babies do  not need additional water but may need more frequent breastfeeds.

After starting solids

Almost everything we eat, besides fats and oils, will contain at least some water, even though it may not be obvious. Fruits and vegetables contain around 75% - 95% water; fish, red and white meat 50% - 70% water. Even "dry foods" such as grains and cereals contain some water.

With a lower water content, solid food increases the renal solute load (thus work load on a baby's kidneys). Once a child starts eating solid food additional water is necessary to maintain the correct balance of water in his body. Small amount of additional water should be offered once or more every day from this time.

Other frequently asked questions

1. Is it true breastfed babies don't need extra water?

Prior to starting solids (at around 6 months of age) a thriving exclusively breastfed baby does NOT need additional water for hydration. In warm or dry climates the water content of breastmilk increases. After commencing solids additional water is recommended.

2. What are the reasons to give extra water to a formula fed baby?

• Satisfy thirst.
• Relieve symptoms of constipation.
• Satisfy a sucking urge not related to hunger. (See Hungry baby for reason why babies 'appear' hungry.)
• Delay feeds - (Overfeeding young babies can cause gastro-intestinal symptoms related to lactose overload).
• Establish healthy dietary habits i.e. acceptance of water.

3. How much water should I give my baby?

This would depend on your child's state of health, age, weight, level of activity, climate and whether or not he's started eating solid foods.

As a guide, for healthy babies and children offer the following amounts... 

• Under 1 month: DO NOT give water, unless instructed to do so by your healthcare provider.
• 2 - 6 months: Additional water is not necessary, except for the reasons mentioned in point 2 above. Limit* water to only 1 oz (30ml) at a time. DO NOT give more than 4 oz per day.
• 6 - 12 months: Offer 2 oz (60ml) at least twice per day, more often in hot weather.
• Over 12 months: Allow your child to have as much water as he chooses. Make sure it is readily available to him.

* Babies younger than 3 months have a strong suck reflex  and therefore cannot control the flow from a bottle, this means they may drink excessive amounts or water unless parents limit the amount offered. (See infant reflexes.)

4. When is the best time to offer a baby water?

DO NOT give water if it's close to feeding time (i.e. if a milk feed is due within an hour), as your child's tummy may still be full from the water when the next feed his offered and he may not drink as much milk (breastmilk or formula) as he would otherwise. If it's close to feeding time it may be better to offer his feed a little earlier.

5. How can I tell if my child is getting enough water?

If your child is healthy and thriving (i.e. gaining enough weight for his age) and he also has 5 or more wet diapers each day.

6. Do I need to boil the water before giving it to my baby?

Regardless of source pr type of water you use, it is not sterile. This means it contains varying amounts of micro-organisms such as bacteria, protazoa and parasites. Young babies, with an immature immune system , are more susceptible to gastro-intestinal infections from these organisms.

Boiling the water kills most of these micro-organisms, but not all, making it safer for young babies to drink. Boiled water can be stored the refrigerator for up to 24 hours. (Refrigeration restricts the growth of micro-organisms.)

Many health care providers recommend boiled water for infants up to the age of 12 months. Others suggest that after the age of 6 months, safe drinking water from the tap can be given provided it is offered fresh and not stored. Because water quality can vary from place to place, check with your local health care provider for recommendations for your local area.

Boil the water for 1 minute only. Longer than this will evaporate some of the water increasing the levels of minerals and nitrates. 

7. Isn't there a lot of water in fruit juice and milk?

There are also contains high levels of sugars in fruit juice. Water is the best drink for babies apart from milk.

Written by Rowena Bennett - copyright 2022. All rights reserved