There is no calculation or 'formula' for how much water to give an infant past 6 months of age. There are many factors that determine the need for water, such as the ambient temperature, the nature of solids (such as how much water is in the food, ie fruit/veggies vs salted meats), how frequently the baby is nursing/breastmilk volume, the infant's weight, level of activity, fever, etc, etc.



I suggest breastfeeding the infant when thirsty, and feeding solids.

If the infant's voids are plentiful, urine is light yellow, the infant is fine without water, then voila, no water needed.

IF the infant seems restless, urine appears dark/stinky, then offer water. If it is a warm/hot environment, not unreasonable to add a few ounces of water in a cup at mealtime.



I wrote a Clinical Question of The Week on the amount of water needed by breastfeeding women. I feel that this method could also apply to infants as well.

https://themilkmob.org/questions/fluid-intake-sport-breastfeeding/



Anne



Anne Eglash MD, IBCLC, FABM
Clinical Professor, Department of Family and Community Medicine
University of Wisconsin School of Medicine and Public Health
Medical Director, UW Lactation Services
Medical Director, Mothers Milk Bank of the Western Great Lakes
Founder and President of The Milk Mob, dedicated to building Breastfeeding Friendly Medical Systems and Communities










Subject: Re: Introduction of Water



This is my question. I used to educate parents that no additional water is needed for exclusively breastfed infants under a year. I have recently seen recommendations that "infants need additional water when solids are started because of their osmolar load." (Wombach and Riordon 2016, p. 701) Some sources suggest 2 ounces of water in 24 hours is fine for infants over 6 months, while others recommend 4 ounces. Is there a standard recommendation?



In addition, what strategies would you recommend for an infant over 6 months, who only takes breast milk from the breast, mom works, and infant is falling off the growth curve?



Carolyn


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