Newborn needs only milk/formula for nutrition

breast feedingby Dr. Kendall Sprott at New Jersey Medical School

Q: I have a 3-year-old son and am expecting a daughter in February. I only nursed my son for a short while, because of work, which required quite a bit of travel. I will be working from home when my daughter is born and have forgotten some of the issues with breast feeding. I was wondering about the need to give her additional water. My son doesn't drink plain water at all, preferring juice, soda and milk. Is there a certain amount of water that children need?

A: Breast milk is the ideal food for newborns. Breast milk production is stimulated by nursing, which empties the breasts. Babies are born with a suck reflex, and will suck and swallow when anything similar to a nipple is placed in their mouth. The first few days of nursing are the most important for establishing successful breastfeeding. 

he initial feeds can surprise mothers, who might not expect the vigor with which the baby latches onto the breast. With frequent nursing, the mom and the nipples adjust as the quantity of milk increases. Initially, newborns nurse every two to three hours and consume between 2 and 3 ounces. As the volume of milk increases with feeds, the interval between feeds increases and the child takes in 3 to 4 ounces every three to four hours. Unless pumped, the amount of breast milk consumed isn't measured and the number of wet diapers is an indication of sufficient intake, along with documentation of weight gain.

I advise mothers to nurse from each breast with every feed and to switch every five minutes, limiting feedings to 20 minutes. I think it's important to stop after 20 minutes to allow the breasts to refill and the nipples to rest.

When a newborn is ingesting enough milk for adequate weight gain, he is getting enough water to produce urine that is neither extremely concentrated or diluted. Breast milk, cow's milk and most formula contain 20 calories per ounce. A newborn requires a minimum of 100 calories or 5 ounces for optimal growth.

Children like your son, who don't drink plain water, may be taking in excess calories and frequently are picky eaters because a significant amount of their calories are coming from liquids. By limiting the calorie-rich liquids, their appetites usually improve, increasing their solid intake.

Your body is not concerned with the source of water, but will absorb it from the GI tract and keep the concentrations of salts in the body within fairly narrow limits. When the salt concentration is diluted from ingested water, the kidneys will get rid of water, producing more urine, until the concentration falls back to normal. The suggested daily intake of water is a guideline that most people don't strictly follow. Our bodies easily adapt to the typical variations in water through our thirst and kidneys.

Babies are limited in their ability to communicate thirst and hunger through crying. They are dependent on others to provide them with adequate calories and water. They do not need extra water when they are receiving adequate nutrition through breast milk and formula. They may require extra water to replace abnormal losses from conditions like diarrhea, vomiting, rapid breathing, sweating and fever.


source - The Star Ledger