Water Intoxication In Babies: Causes, Signs, And Treatment

Baby With Symptoms Of Water Intoxication

Image: Shutterstock

Water intoxication in babies is a condition that may cause severe physiological changes, such as low body temperatures and seizures. Feeding more water than the baby’s body can handle may upset the electrolyte balance of their system, leading to water intoxication.

Just like for adults, water is a vital nutrient for babies too. It is, thus, essential to fulfill their limited yet crucial water needs. Although water intoxication in babies is rare, it may be caused by overconsumption of water through excessively diluted formula or plain water given instead of ORS during diarrhea. This can cause an electrolyte imbalance in the body, leading to serious health problems. Parents and caregivers need to know the right amount of water to give to babies and be aware of the signs of overconsumption.

Read this post to learn more about the symptoms, possible causes, effects, and preventive measures for water intoxication in babies.

In This Article

Key Pointers

Water intoxication in babies occurs when they are fed more water than their bodies require.
The condition leads to electrolyte imbalance and other related complications.
Water intoxication can be avoided by feeding only breast milk to babies younger than six months. Babies 6-12 months old should have no more than a cup of water a day.

How Much Water Should Babies Have?

Offer 0.5 to 1 cup of water to your baby each day after 6 months of age

Image: Shutterstock

Babies under six months of age should not drink water. Their hydration requirements at this age are optimally met by breast milk and formula. Thus, feeding them water can put them at a higher risk of water intoxication. From six months to 12 months, you can offer 0.5 to 1 cup (4 to 8oz. per day) of water to your baby each day if needed (1).

The recommended water quantity and breastfeeding or formula-feeding are sufficient to meet the infant’s hydration requirements. However, in some instances, such as hot weather and sickness, sipping extra water shouldn’t be a problem. Nonetheless, be cautious not to make it a habit.

Symptoms Of Water Intoxication In Babies

Excess water in the body causes hyponatremia, where the body’s sodium levels fall abnormally low. It could affect the functions of several organs, including the brain.

Below are some of the common signs and symptoms of dilutional hyponatremia in babies (2) (3).

Unusually clear urine
Dizziness and lethargy
Irritability and fussiness in the otherwise happy baby
Low body temperature (hypothermia) of less than 97°F (36°C)

Hypothermia can suggest water intoxication in babies

Image: IStock

Nausea and vomiting
Swelling of the extremities, i.e., arms, legs, face and brain swelling
Irregular breathing
Fits due to sodium deficiency

In extreme cases, water intoxication may lead to coma and seizures in babies.

If you observe any of these symptoms in your baby, consult a pediatrician.

Be watchful

Water intoxication may lead to changes in your baby’s behavior. It may also cause blurred vision, muscle cramps, and poor coordination (2).

Causes Of Water Intoxication In Babies

Babies don’t consume water voluntarily. Thus, water intoxication occurs when babies are fed excess water by caretakers in the following ways.

Feeding water and diluted juices: Babies up to six months of age don’t require water. Their hydration needs are optimally met with exclusive breastfeeding or formula feeding. However, some parents may begin feeding water and diluted juices to their babies to keep them hydrated and offer nutrition. The little one’s kidney functions are not yet mature enough to process water, making it unsuitable for them.

Feeding excessively diluted formula: Different formula brands require different amounts of water for preparation. Experts advise parents to follow the instructions on the package and use the mixing ratio as mentioned. It is crucial as using less water than mentioned can make the formula too thick, which may lead to constipation in babies. On the other hand, using too much water can dilute the formula, disturbing the electrolyte balance and nutritional intake, thus increasing the risk of water poisoning (4) (5) (6).

Feeding from a cup: Experts advise phasing out bottle feeding for babies between 12 and 24 months (7). Thus, babies begin sipping water from cups, causing them to gulp excess water when unmonitored.

Sipping water from a cup may cause babies to drink excess water

Image: IStock

Treatment For Water Intoxication In Babies

Water intoxication in babies is a state you can’t treat at home. Therefore, if your baby shows symptoms of excessive water consumption and intoxication, considering pediatric care is advisable. Depending on the severity of the symptoms, the doctor will chart a treatment plan to restore the body’s electrolyte balance and resolve symptoms.

In most cases, restricting the baby’s water intake and letting extra water exit the body through urination will resolve the condition. However, in severe cases, the doctor may recommend diuretics and the restoration of sodium levels through an intravenous saline drip.

Quick tip

While preparing formula milk for your baby, always add the powder to the measured water and not the other way around. This will help in preventing water intoxication (6).

Tips To Prevent Water Intoxication In Babies

Doctor may recommend diuretics for babies in severe cases

Image: IStock

Here are some simple parenting tips for hydration management to ensure your baby consumes water appropriately and in the right amounts.

Don’t give water to babies under six months of age. Babies older than six months can have four to eight ounces (0.5 to 1 cup/day) of water each day.

Your pediatrician can provide guidance on how the urination frequency and the number of wet diaper changes can be indicators of hydration levels, as well as advise on whether serving water is necessary. While it may be tempting to offer water to infants in hot weather, it’s important to note that frequent breastfeeding can often provide sufficient hydration.

Do not over dilute the formula. Follow the mixing ratio directed on the formula’s packaging.

Image: IStock

Practice baby safety and never leave the baby unattended when they are sipping water from the cup and while they are bathing. Leaving a baby unmonitored could cause accidental ingestion of excess water.

Be watchful

Dunking your infants in the swimming pool may cause them to gulp water, leading to poolside seizures due to water intoxication (2).

Water intoxication in babies occurs when there is an excess amount of water in a baby’s body. Since breastfeeding provides adequate hydration, babies younger than six months do not require additional water. A daily intake of 0.5 to 1 cup of water is needed for six to twelve months of babies, and this may vary slightly depending on climatic conditions. When there is a fluid overload, it causes low sodium levels in the body and affects organ functioning, including the brain. Water intoxication can lead to seizures and coma at extreme levels. Parents or caregivers should follow pediatricians’ recommendations on baby hydration to feed water to babies.

Frequently Asked Questions

1. Are there any tests to diagnose water intoxication in babies?

Several etiologies can cause water toxicity, which is challenging to diagnose for their vague symptoms, such as altered mental status, disorientation, confusion, nausea, and vomiting. In addition, it may be misdiagnosed due to the variability of symptoms (8).

2. How does the body regulate water balance in babies?

The surface area of a newborn is relatively large, making insensible water losses more significant with small size and decreased gestational age. Preterm and term infants can regulate their intravascular volume within a range of fluid intakes. Hormonal effects, such as increased aldosterone levels, aid in sodium retention in newborns (9).

3. What are the risks of water intoxication in babies?

Water intoxication and overhydration in babies result in the dilution of their natural sodium levels, which may lead to grave consequences such as seizures, brain damage, and even demise (2).

Infographic: Avoiding Excess Water In Baby Formula

The pediatrician may prescribe a baby formula for babies of any age, depending on their nutritional needs. However, excess dilution of formula with water could cause water intoxication in babies. It is essential to know the proper preparation of formula milk to avoid it from becoming overly diluted. Go through the infographic below for more information.

preventing water intoxication by avoiding overdilution of infant formula (infographic)

Illustration: Water Intoxication In Babies: Causes Signs And Treatment

water intoxication in babies_illustration

Image: Stable Diffusion/MomJunction Design Team

Watch this informative video to familiarize yourself with the signs, symptoms, and preventive measures to safeguard your baby from water intoxication.

References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.

1. Recommended Drinks for Young Children Ages 0-5; AAP
2. Water Intoxication in Infants; St. Louis Children’s Hospital
3. Hyponatremic Seizures Among Infants Fed with Commercial Bottled Drinking Water — Wisconsin, 1993; CDC
4. How do I mix and serve infant formula for my baby?; AAP
5. Chapter 4: Nutrition and Food Service; National Resource Center for Health and Safety in Child Care and Early Education
6. How to Safely Prepare Formula with Water; AAP
7. Discontinuing The Bottle; AAP
8. Water Toxicity; NCBI Bookshelf
9. Fluid management: NICU Handbook; University of Iowa Stead Family Children’s Hospital

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Reviewer Author Editor Fact Checker

Dr. Anuradha BansalMD

Dr. Anuradha Bansal is a highly accomplished pediatrician and neonatologist with 13 years of professional experience. Presently, she is working as Assistant Professor in the Department of Pediatrics at PIMS Jalandhar. She has done her MBBS and MD Pediatrics at GMCH, Chandigarh.

Read full bio of Dr. Anuradha Bansal

Swati PatwalM.Sc. (Food & Nutrition), MBA

Swati Patwal is a clinical nutritionist, a Certified Diabetes Educator (CDE) and a toddler mom with more than a decade of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children.

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Rohit GarooBSc, MBA

Rohit Garoo is a writer-turned-editor with over 9 years of experience in content writing, editing, and content marketing. He did his bachelors in Science at St. Xavier's College, Hyderabad, and masters in Business Administration at Osmania University.

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Ghazia ShahMSc, MA, BEd

Ghazia is a scientist-turned-writer with three years of research experience in Cancer Biology. She did her masters degree in Biotechnology at the University of Kashmir and bachelors in Education at the same university. Ghazia then delved deeper into the science of language with a masters in English.

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