Water and Babies Donít Mix

Watered-down formula can be harmful or even fatal.

By Sally Thompson

If you haven’t thought how dangerous water can be for a newborn, think again. In Tampa, Fla., a 5-month-old almost died recently from drinking watered down formula, a money-saving strategy his young mother did not realize could be harmful or even fatal. Hospital doctors who treated the baby after he had a seizure diagnosed him with water intoxication and malnourishment. These types of incidents are a jarring reminder that parents must be thoroughly educated in infant health care. Armed with knowledge, parents can avoid infant health risks such as water intoxication.

Don’t Dilute Formula

Infant water intoxication occurs when an infant consumes excessive amounts of water, especially over a short period of time. The most common cause of infant water intoxication is diluted infant formula. According to Rosemarie Rocchio, RNC, MS, and SCN Educator at Phelps Memorial Hospital in Sleepy Hollow, NY, “Diluting the formula weakens the caloric composition and adds fluid that has no nutritional value for the infant. Diluting formula or giving water ultimately affects serum values of electrolytes, and shifting of fluid between the vascular system and the tissues, as well as not meeting protein and caloric requirements for normal weight gain and growth.” Furthermore, the low sodium levels that ensue during water intoxication can rapidly trigger failures in the central nervous system.

A Delicate System

Babies and water simply don’t mix.

An infant’s systems are extraordinarily delicate because they are still developing through the first year of life. Rick Stafford, M.D., FAAP, and Director of Neonatology at Northern Westchester (NY) Hospital, explains, “It is so easy for infants to overdose on water because they need a very specific concentration of electrolytes.Even a seemingly small amount of water can be fatal because an infant’s homeostatic mechanisms are not matured.” A disruption of this fragile system can have catastrophic effects on an infant’s health. Infants suffering from water intoxication may display a number of symptoms, including lethargy, malnourishment, puffiness in the face, low body temperature, fluttering eyelids, irritability and irregular heartbeat. The baby’s internal mechanisms begin to fail immediately.

Excess water dilutes the sodium in the infants’ blood, flushing it out of the body.This reduces the electrolytes in the body, alters brain activity and may cause swelling of brain tissue, which can result in seizures, coma or even death. Fluid can accumulate in the lungs, resulting in severe breathing difficulties. “If the intoxication progresses into seizures, infants will likely suffer from the long-term effects of the damage experienced in the central nervous system,” says Stafford. While water intoxication can lead to horrifying health concerns, the syndrome can be easily avoided.

Breast Is Best

It is absolutely necessary that the public be fully informed about infant water intoxication and infant health care in general. When discussing prevention methods, Stafford emphasizes the importance of breastfeeding. “First and foremost, breastfeeding babies is undoubtedly the safest and healthiest method of nourishment. If you must use infant formula, make sure to follow the given directions carefully, especially if using powdered formula.” The precise balance of sodium, electrolytes, fat and protein in breast milk and formula mixtures meet the specific requirements and fragile needs of developing infants.

Also, breast milk and appropriately prepared formula contain enough water to keep an infant hydrated. Therefore, in normal circumstances, babies under a year old should exclusively drink breast milk and/or formula. Depending on the baby’s health and level of development, most physicians agree that it is permissable to begin introducing small amounts of water into a baby’s diet after he has started eating a variety of solid foods.
Parents must ask their baby’s pediatrician before taking this step because one can never be too careful when a child’s life and well-being are at stake.