Heidi - apologies if this duplicates other messages (catching up on Lactnet
...)  WHO "Update" No 9, August 1991 entitled "Breast-feeding and the use of
Water and Teas"  states " ... The intake of such supplementary fluids is
associated in young infants with an increased risk of disease and a
shortening of the duration of breast-feeding.  Moreover, several studies
have shown that these fluids are not actually needed by healthy infants
during the first semester of life if they are exclusively breast-fed...
...... The importance of breast-feeding in the prevention of diarrhoea has
been demonstrated in several studies.  The protection is greatest among
infants who are exclusively breast-fed.  Recent research has demonstrated
that giving young infants supplementary fluids such as water and/or teas in
addition to breast milk is associated with a significant increase in the
risk of diarrhoeal disease.  In a study conducted in a poor urban community
in Lima, Peru, the incidence and prevalence rates of diarrhoea in infants
younger than 6 months were significantly higher among those who received
water and teas in addition to breast milk than among those who were
exclusively breast-fed.  The diarrhoea prevalence rates *doubled* with the
additon of these supplementary fluids.  A case-control study of infant
mortality in Brazil showed that infants who received water, tea, or juice in
addition to breast milk were at increased risk of diarrhoeal death.  Each
additional feed with these fluids substantially increased the risk of
death..... With the low concentrations of sodium, chloride, potassium, and
nitrogen in breast milk, only a relatively small amount of the fluid intake
is needed for excretion of resulting waste products.  Calculations indicate
that healthy infants who consume enough breast milk to satisfy their energy
needs receive, with a considerable safety margin, enough fluid to satisfy
their fluid requirements, even in hot and dry environments ....
Supplementation in the form of water and teas in early infancy is a common
practice and one that is associated with significantly increased risks of
diarrhoea morbidity and mortality.  On both theoretical and empirical
grounds it is concluded that these supplementary fluids are not needed to
maintain water balance in healthy infants younger than 6 months who are
exclusively breast-fed.  Their use should therefore be actively discouraged,
and *exclusive* breast-feeding should be promoted as the ideal feeding
practice during the first 4 to 6 months of life."

References quoted are:

Armelini, PA & Gonzalez, CF. Breast-feeding and fluid intake in a hot
climate. Clinical Pediatrics, 18: 425-426, 1979

Goldberg, NM & Adams E. Supplementary water for breast-fed babies in a hot
and dry climate - not really a necessity.  Archives of Diseases in
Childhood, 58: 73-74, 1983

Almroth, S & Bidinger, PD.  No need for water supplementation for
exclusively breast-fed infants under hot and arid conditions.  Transactions
of the Royal Society of Tropical Medicine and Hygiene, 84: 602-604, 1990.

Sachdev, HPS et al. Water supplementation in exclusively breastfed infants
during summer in the tropics.  Lancet, 337: 929-933, 1991.

Almroth, SG.  Water requirements of breastfed infants in a hot climate.
American Journal of Clinical nutrition, 31: 1154-1157, 1978.

Brown, KH et al.  Milk consumption and hydration status of exclusively
breast-fed infants in a warm climate.  Journal of Pediatrics, 108: 677-680,
1986.

Hope this is what your professor needs.

Pamela, Zimbabwe