At what age can a newborn start drinking water?

When Can a Newborn Start Drinking Water?

Newborns should not be given water until they are at least 12 months of age unless clinically indicated, as recommended by the American Academy of Pediatrics. 1

Why Water is Not Recommended for Infants Under 12 Months

• Human milk or infant formula should be the only nutrient source for infants until approximately 6 months of age, providing all necessary hydration and nutrition 1
• There is no nutritional indication to give water to infants younger than 6 months, as it provides no benefits and may cause harm 1
• Water supplementation can lead to reduced intake of breast milk or formula, potentially resulting in inadequate nutrition and compromised growth 2, 3
• Early introduction of water may interfere with successful breastfeeding and lead to early weaning 4, 5

Potential Risks of Early Water Introduction

• Water intoxication can occur in newborns due to their immature kidneys, which cannot handle excess free water 2
• Excessive water consumption may disrupt electrolyte balance and potentially lead to hyponatremia (low sodium levels) in infants 1
• Giving water instead of breast milk or formula can result in malnutrition, as water contains no calories or nutrients 1
• Early introduction of water is associated with shorter duration of exclusive breastfeeding 3, 4

Fluid Requirements for Infants

• For newborns and infants under 6 months, breast milk or infant formula alone provides sufficient hydration, even in hot weather 1
• Breast milk production naturally increases to meet infant needs, from less than 100 ml per day on the first day to 500-600 ml per day after 4-5 days, reaching 600-800 ml per day after 1 month 1
• After 6 months, when solid foods are introduced, breast milk or formula continues to be the primary source of hydration 1

Special Circumstances

• For infants with diarrhea or dehydration, oral rehydration solutions (ORS) should be used rather than plain water 1, 6
• If an infant is receiving formula and develops diarrhea, the formula should be diluted with an equal volume of clean water until the diarrhea stops 1
• For severe dehydration, medical attention should be sought immediately as intravenous rehydration may be necessary 6

Recommendations for Appropriate Fluid Introduction

• At 6 months, when solid foods are introduced, small amounts of water may be offered in a cup, but breast milk or formula should remain the primary fluid source 1
• After 12 months, plain water can be introduced as a healthy beverage option alongside continued breastfeeding or whole milk 1
• Fruit juice should also not be introduced before 12 months of age, as it offers no nutritional benefits over whole fruit and may contribute to dental caries and poor nutrition 1

Common Pitfalls to Avoid

• Cultural practices that encourage early water supplementation should be addressed through education about the risks 3, 4
• The misconception that infants need additional water during hot weather should be corrected - breast milk or formula provides adequate hydration 2
• Avoid using water to "calm" a fussy infant, as this may mask hunger cues and lead to inadequate nutrition 1, 3
• Never dilute infant formula beyond the manufacturer's instructions, as this reduces nutritional content 1