Is Your Child Getting Enough Water?
Water Is a Super Nutrient
At first glance, water—which contains no vitamins, minerals, fiber, protein, or carbohydrates—may not seem to contribute much to your child’s overall health. Yet more than half a person’s body weight is water, making water so crucial to kids’ bodies, they can’t survive for more than a few days without it.
Among its many duties, “water aids digestion, helps prevent constipation, normalizes blood pressure, and helps stabilize heartbeat,” says Dr. Joel Steinberg, MD, professor of pediatrics at UT Southwestern Medical Center of Dallas. Water also carries nutrients and oxygen to cells, cushions joints, protects organs and tissues, helps regulate body temperature, and maintains electrolyte (sodium) balance.
For optimal health, kids generally need about a liter of water for every 1,000 calories they consume. But don’t worry about doing the math. With the exception of infants and older kids who get so busy playing they forget to drink, “let your child’s thirst drive be your guide,” says Dr. Steinberg. Make plenty of water available and let your kids drink as much as they want. A benchmark that kids are drinking enough: “They’re urinating every couple of hours,” says Dr. Michael Farrell, MD, chief of staff at Children’s Hospital Medical Center of Cincinnati.
Water Reduces the Risk of Heat-Related Conditions
Because water helps control the body’s temperature, “it’s the first line of defense against heat-related illnesses such as heat exhaustion and heatstroke,” says Dr. Andy Spooner, MD, director of General Pediatrics at Le Bonheur Children’s Medical Center in Memphis. “Both of these illnesses are the result of dehydration.” Although children can become dehydrated any time of year, it’s more likely to happen in the hot summer months because kids lose more water through the skin as perspiration.
Heat exhaustion results when the body loses too much water (10 to 15 percent of body weight) through sweat within several hours. Fortunately, in school-age and younger kids, heat exhaustion is rare. “But it can happen with children who play outside and forget to drink because they get caught up in what they’re doing,” says Dr. Spooner. Signs of heat exhaustion include fatigue, anxiety, and drenching sweats.
To guard against dehydration and heat exhaustion, make sure kids have easy access to water so they can drink at will. Carry bottles of water when you’re traveling and at the beach, the park, and at summer festivals. Encourage water breaks if you sense your child is distracted and has forgotten about drinking, especially if he’s physically active. In fact, “30 to 40 minutes before children play sports, have them drink a cup to a cup and a half of water,” advises Dr. Steinberg. Then make sure they drink another cup to a cup and a half every half hour during the activity. Dr. Steinberg advises against routinely giving kids sports drinks such as Gatorade, which contain salt and sugar. “Kids don’t lose a lot of salt in their sweat. Water is all they need,” he says.
With heatstroke, a potentially fatal condition, body temperature rises to dangerously high levels because the body gets so hot, it can’t cool itself. Although dehydration contributes to heatstroke, it’s mainly related to a hot environment, says Dr. Steinberg. “We see heatstroke in Texas in kids who’ve carelessly been left in cars with the windows rolled up on a hot day. The ambient temperature of the car can get up to 140 degrees, and toddlers and small children can die in as little as an hour.” (Heatstroke is an emergency; call 911 if you think your child may be suffering from it.)
Water Aids Weight Control
You’ve probably heard the latest statistics: 15 percent of children in the US are overweight or obese (that’s almost nine million kids), which is triple the proportion from 1980. To help your child beat the obesity rap, encourage her to drink water or juice spritzers (seltzer with a splash of fruit juice) between meals instead of juice boxes or regular soft drinks.
Researchers have found that kids who are regular soda drinkers consume more total calories than those who don’t—and not just the 120 calories or so sodas generally contain per 12-ounce can. “Studies show that when we consume calories in liquid form, we don’t compensate for those calories by eating less at subsequent meals,” says Dr. Rachel K. Johnson, PhD, RD, professor of nutrition at the University of Vermont in Burlington.
Besides promoting water drinking, drink water yourself between meals. “Parental modeling is a strong influence on children’s eating patterns,” says Dr. Johnson. “If children see their mom drinking water, they’re more likely to drink it than some other type of beverage.”
Meanwhile, stick to milk at meals (and do so yourself, to set a good example). For growing bones, “kids need the calcium,” says Dr. Johnson (and so do you). Plus, studies show that a calcium-rich diet may also help keep weight in check.
Water Keeps Teeth Healthy
For structurally stronger, more decay-resistant teeth, kids need fluoride. “It’s critical to have fluoride in the water through the age of 14,” says Dr. Cynthia Sherwood, DDS, a spokesperson for the Academy of General Dentistry in Independence, Kansas. “Fluoride strengthens permanent teeth that are forming under the gum,” says Sherwood. (By the time teeth have erupted, fluoride’s primary job of strengthening teeth from the inside out is over.)
Generally, if your tap water comes from a public water supply, it’s adequately fluoridated. But if you have well water, drink primarily bottled water that’s not fluoridated, or have a water filter on your kitchen faucet (which can remove heavy metals and fluoride from public water), talk with your pediatrician or your child’s dentist about having your child take a daily fluoride supplement or fluoride combination multivitamin, advises Sherwood. Fluoride supplements are available in liquid form for infants and toddlers and chewable tablets for older kids, says Sherwood.
Water Keeps Teeth Healthy
During the first year of life, babies generally don’t need water. “They don’t need any additional fluids beyond formula or breast milk,” says Dr. Farrell. In fact, giving infants water can be dangerous because they easily suffer from water intoxication, a condition in which their developing kidneys can’t excrete water fast enough. As a result, water builds up in the body and dilutes the electrolyte balance of the blood, causing seizures, coma, even death.
“To cause water intoxication, it takes no more than three, eight-ounce bottles of water given over 12 hours,” says Dr. James P. Keating, MD, McKim Marriott professor of pediatrics at Washington University School of Medicine in St. Louis. Water intoxication can also happen if your baby swallows too much water during an infant swimming class.
To avoid water intoxication, simply give your baby a little extra breast milk or formula instead of water if you sense he’s thirsty on especially hot days, says Dr. Keating. (Diluted formula is another cause of water intoxication. Check the label for proper mixing instructions.) And be sure to instruct caregivers to do the same. Avoid giving your baby water if he’s vomiting or has diarrhea. Under those circumstances, an oral electrolyte maintenance solution such as Pedialyte may be necessary. Consult your pediatrician.
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