Author: Gauri Kshirsagar
Water has many important roles in the body. It helps transport nutrients, maintains blood volume, regulated body temperature and removes waste products. It is very important for children to drink enough fluid so their body can function properly and they can feel their best.
So how important is water in a child’s diet? More often than not, water is the forgotten nutrient. When we think in terms of nutritional needs we tend to think about calories, protein, fat, vitamins and minerals. But what about water or any other fluid for that matter? Adequate fluid intake is crucial in maintaining hydration status. Water, juice, or any other fluid that does not contain caffeine or alcohol can be used to maintain hydration.
The body needs water to:
- Maintain body temperature by sweating
- Remove waste in the urine
- Move nutrients throughout the body.
What are the advantages of drinking enough water?
Good hydration helps children to:
- Maintain a healthy weight
- Improve concentration
- Reduce the risk of chronic disease.
- It also helps to reduce common problems like constipation and urinary tract infections.
How much fluid does a child need OR how to calculate daily requirement of water for a child?
|Age||Daily requirement of a child|
|Young infants (0-1 year)||150ml/kg|
|Toddler (1-3 years)||100ml/kg|
|Adult (above 3 years)||50ml/kg|
For example if your toddler weighs about 12kg then the daily intake of water will be 12X100 = 1200ml of water. A child between the ages of one and three usually needs about 1.3 litres of fluids a day. This includes about 350ml of milk as well as water, coconut water, soups, fresh juices and other fluids he/she regularly consumes.
How and when to start feeding drinking water to a baby?
A baby till the age of 6 months requires exclusive breast feeding on demand which take cares of the fluid intake of the baby. In case the baby is on formula feed the above mentioned fluid requirement can be taken into account. Once the weaning is started, the baby can also be fed with regular intake of water. I remember the first time my babies started drinking water; they were very confused, since they couldn’t grasp the taste of the water. What I did was to add little bit of juice or sugar to get them drink water for couple of days and later weaned them off the sugar and juice.
What options other than plain water can be given to a child?
- Dilute juice with equal parts of water before giving it to your child.
- Whisk two tablespoons of yoghurt (dahi) with a glass of water and a pinch of salt to make refreshing chaach.
- Squeeze a fresh lemon (nimbu) or orange (santra) into half a glass of water with a pinch of sugar or salt.
- Give coconut water.
- Water is often recommended over juice due to the high sugar content in juices. Too much juice may result in diarrhea, abdominal pain, bloating and flatulence. It also can contribute to increased dental cavities when taken by mouth. So try to include more plain water.
- Try not to give your toddler aerated drinks until he is older. Each 240ml of an aerated drink contains not only 100 empty calories, but also caffeine. Caffeine is addictive and may make him urinate often. This will make him lose more fluid than he is gaining.
- Always use filtered AND boiled water for drinking
What are the signs that a child requires more fluid?
- Strong smelling nappies
- Yellow urine
- Less wet nappies than normal due to decreased amount of urine (infants should have 6-8 wet nappies/day and an older children should have 4-5/day)
- Headaches, tiredness
- Dry lips and skin
- More thirsty than usual
- Dark circles around eyes
- Weight loss
The best way to tell if your toddler is getting enough fluids is to check his urine. If he getting enough, his urine will be light-colored or colorless.
Some tips to make your toddler drink water:
- You can try and give water in different colored bottles with their favorite cartoon characters on it. You can also change the type of bottle like a Sippy cup or a one with a straw etc. Just to keep it fun
- Most of the kids don’t like to drink water at room temperature, hence warm water is an alternative and if the toddler tolerates then cool water can also be an option.
- Water should be given at least half an hour before a meal ideally an hour before. Drinking water just before mealtime can decrease appetite. Also It is not a good idea to give your child more than the recommended amount of fluids per day. If you do, it may cut his appetite for solid foods that have other essential nutrients like iron and vitamins.
- For taste you can try mixing juice with water. Too much juice may result in diarrhea, abdominal pain, bloating and flatulence. It also can contribute to increased dental cavities when taken by mouth. So try to include more plain water. Coconut water is a better choice.
- Active toddlers need a lot of water to replace the fluids they lose, especially during warm or humid weather. It is true that a toddler can become dehydrated easily, mainly because he can ignore his thirst when caught up in play. By the time your child realizes he is thirsty, he may already be mildly dehydrated.
- For a younger child who may not be able to tell you when he is thirsty, offer water every time you get yourself a glass. Try to do this every hour.
- It is important to have a rough idea of his fluid intake during the day. Do keep a measure of the fluid intake. Fever and other illnesses may make him thirstier, while cold or rainy weather may make him less thirsty.
- Keep water within easy reach of your child. Put it in his own special water bottle, cup or sipper so that he can drink when he wants to. You might also want to offer your child a drink of water if he wakes up at night.
- Packaged juice or squash with added sugar has low nutritional value. No more than 120 to 180ml should be given to toddlers.
- Always make “water drinking” a task which should be followed like a proper meal time
Infants and children have higher fluid requirements, why is that so?
- Children have more water content to body weight ratio in their bodies compared to adults.
- Foetus has >90% total body mass consisting of water
- Term infant has about 75% of body mass as water. This ratio decreases during 1st year of life and remains stable until puberty
- Comparatively adults have lesser amounts of water composition , i.e 60% in males and 50% females
- Infants and toddlers have higher skin surface area to body weight then adults, hence they loose more water due to sweating. Even 1-2 bouts of diarrhea and vomiting can lead to sudden dehydration. This is usually not so in adults.
- An infant has Higher respiratory & metabolic rate due to water lost via lungs and dramatic growth in 1st year of life
- Newborn babies have immature renal function, i.e the renal functions are not fully developed to excrete urine according to the status of hydration of the body. So even if the baby has dehydration the kidney still produces dilute urine and not concentrated urine, which leads to more dehydration.
- One of the most important factor is Thirst sensitivity. It is a learned behavior to drink water when there is dryness in the throat. Children don’t display this thirst sensitivity hence they can go on long periods without drinking or may not drink enough after exercise.
- Also they body gets adjusted to less amount of fluids in the body by decreasing rate of sweating hence it poses a risk during exercising as body will not tolerate heat and cool off.
Also do check my previous post Managing Diarrhoea and Dehydration in children at home
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