Water and Infants

During my infant well child exams, I advise mothers not to give water to infants. I usually get a perplexed face from the mother and sometimes a few words from the grandmother. During residency, I rotated through AI DuPont Children's Hospital emergency room. One evening, a young infant boy came to the ER with a seizure. He had no medical problems and no history of seizures. His family history was unremarkable. The family denied any high fevers or any accidental ingestions. Upon further investigation, the baby was recovering from a viral cold and the parents were giving water to prevent dehydration. Labs revealed a critically low sodium (hyponatremia). The baby was treated and released and the parents were counselled on not to give water to infants.

Providing water to infants to prevent dehydration increases the risk of seizure by diluting and then decreasing the sodium count in the blood. The low sodium then causes altered brain activity. The reasons why this occurs are 1) kidneys are not mature to flush out the excess water and 2) the infant diet does not contain enough salt to balance the excess water. Water intoxication can lead to several signs and symptoms including drowsiness, irritability, facial swelling, low body temperature, poor coordination, nausea and vomiting, irregular breathing, and then seizures.

Treatment is giving infants anti-seizure medications and salt containing fluids. Prognosis is excellent. Babies typically recover without any problems.

The best way to prevent water intoxication seizure is to not give water to babies. This includes tap water and commercially bottled water. Also, there have been reported cases of water intoxication from repeated dunking during swimming lessons. If the baby shows signs of dehydration, continue to give formula and/or breast milk. An oral rehydration solution such as Pedialyte can also be utilized.

Contact your primary care physician for more information. Thank you and have a nice day.