Do exclusively breast-fed babies need water?

A mother asked:

Doctor, the weather is getting hotter slowly. Our baby is still exclusively breast-fed. Do you need additional water?

It is true that small babies need to increase liquid intake in hot days, but babies under 6 months old who are exclusively breast-fed do not need to drink water, just drink more breast milk.

Children, especially small infants, are prone to heatstroke due to abnormal temperature rise in hot summer or early autumn, high temperature, high humidity and strong heat radiation.

Small babies have a large relative demand for water and poor tolerance to water shortage, while high temperature, high heat and excessive sweating may cause dehydration to varying degrees.

Therefore, in high temperature weather, when the temperature reaches ≥ 32 ℃, in addition to keeping the baby in a cool and ventilated indoor and outdoor as far as possible, no matter how much activity, it is necessary to appropriately increase the intake of liquid.

However, supplementing liquid does not mean drinking water directly. For exclusively breast-fed babies (infants within 6 months old), breast milk is the best choice for supplementing liquid and can meet the needs of all liquid, energy and nutrients in this age group.

Breast milk contains a small amount of sodium (salt), which can meet the physiological needs of infants within 6 months old. However, if drinking plain boiled water too much, it may not only lead to a decrease in lactation volume and affect the intake of energy and nutrients, but also increase the risk of hyponatremia, especially premature infants.

Question again: So, is it OK to use light saline, sugar saline, soup (soup, rice soup, noodle soup, etc.) or oral rehydration salt solution for the baby?

Not recommended.

The kidney of small infants has poor sodium excretion ability, and these solutions are all complementary foods. It is not recommended to add them at this age (unless there are medical indications). Moreover, if the solution is not properly configured, such as the concentration is too high, the risk of hypernatremia will be increased and various risks will occur.

To sum up, it is hot, and babies who are exclusively breast-fed (babies within 6 months old) do not need extra water, so breast milk is fine.