Month 4 Worry: When to Give Baby Water or a Sippy Cup
The most common medical concern for parents of 4-month-old babies
Introducing new foods can be a complicated and controversial issue in newborns. Timing, safety, and food & nutrition are issues that must be considered. Yet there is something exciting about moving forward with diet, especially with your first baby.
Water is reasonably safe and certainly nutritious, right? Many parents ask me, “Is there anything else to consider when introducing the first sippy cup?”
What’s the Issue?
It turns out that there are safety considerations to think about when introducing water to your baby for the first time. The immature kidneys of an infant under four months of age cannot balance salt and water effectively, and too much plain water (tap water or water without added salt) can actually dilute your baby’s blood. This can lead to low salt balance, a medical condition called hyponatremia.
In short, too much water can lead to seizures in a young infant. This is also why mixing powdered or concentrated formula carefully for young infants (according to the exact package instructions) is important.
Consider the Numbers
So when to offer your baby water? Doctors generally recommend that parents:
- Introduce water at about four months of age. Remember that the cornerstone of an infant’s diet is breast milk or formula until one year of age. That said, extra water in a sippy cup is good for practice beginning at four months of age. Water intake is really unlimited, but most babies will get off to a slow start volume-wise (less than four ounces daily). I recommend no fruit juice at this time, not even 100 percent natural juices.
- Wean Baby off all bottle supplements by one year of age. All babies need to learn to drink from a cup, and it’s the rare child who needs specialized help in achieving this milestone; it’s just a matter of practice. (For those moms still breastfeeding at a year, keep it up! There are many known and presumed benefits to breastfeeding past the first birthday for both baby and mother. An occasional sippy cup in addition to your breastfeeding would be great.)
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