Baby dies after drinking watered-down breast milk: Why breastfed babies don't need water

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Baby Nevaeh's unfortunate and unnecessary death raises question around the topic of breast milk and water. Should you give an exclusively breastfed infant water? What are the consequences if you do? Find out in this article...

In March 2015, a 10-week-old American baby girl – Nevaeh Marie Landell – died of water intoxication according to news reports. Her parents have been charged with killing her by diluting her breast milk with water.

Herbert George Landell and Lauren Heather Fristed gave their baby breast milk and water mixed together, robbing the breast milk off its nutrients, claim prosecutors.

Nevaeh’s parents allegedly also refused to get her medical treatment when she got sick, citing their religious beliefs. By the time they finally took their little girl to hospital, it was too late.

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Lauren Heather Fristed (left) and Herbert George Landell (right) were charged with killing their baby by diluting her breast milk with water.
Image: YouTube screen shot

According to the warrants, watering down the breast milk resulted in a drop in Nevaeh’s electrolyte and sodium levels and made her brain swell.

Landell has been charged with felony murder and aggravated battery by depriving. Fristed was charged with aggravated battery by depriving, first degree cruelty to children, and second degree cruelty to children. US news reports state that both are in jail without bond.

It is always tragic to hear of such stories, especially when it’s quite obvious that Nevaeh would still have been alive had her parents been more educated about looking after and feeding a young infant.

What are the rules when it comes to giving water to a breastfed baby under six months? Does a baby this young need breast milk and water? Or does breast milk provide adequate hydration?

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Your child gets all the hydration he needs through your breast milk during the first six months.

Do breastfed babies need water?

Lactation experts from organisations such as the World Health Organisation (WHO) and La Leche League International (LLLI) agree that exclusively breastfed babies do not require additional water.

This is because breast milk is made up of 88% water — especially the “fore milk” that comes with each feed — and therefore fulfils all your baby’s hydration needs.

Even colostrum, which is what your newborn baby will drink in the first few hours after birth, is all that is needed to keep your little one hydrated.

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Even a newborn baby’s thirst will be adequantly quenched through the colostrum he gets from you.

Why you shouldn’t give water to a breastfed baby below the age of six months

Expert advice from the World Health Organisation, the Academy of Breastfeeding Medicine, the American Academy of Pediatrics and KellyMom.com highlight the following facts about the risks of giving water to an exclusively breastfed baby under the age of six months:

  • Giving water can interfere with the normal frequency of breastfeeding and can cause nipple confusion when the water is offered in a bottle.
  • Giving a supplement such as water or glucose water to a newborn can put him at a high risk for increased bilirubin (which may cause jaundice) and a longer hospital stay.
  • It can cause water intoxication, the signs of which include grogginess, confusion, drowsiness, twitching and seizures. Medical professionals say that drinking too much water especially in children under the age of one, may dilute a baby’s normal sodium levels and can lead to seizures, coma, brain damage and even death.
  • Water contains empty calories, which means that supplementing your young infant with it will fill him up without adding calories. This can result in insufficient weight gain or even weight loss.

 

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It’s not necessary to give your baby additional water even on very hot days as long as you nurse on demand.

Hot weather and water supplementing for breastfed babies

Even when it is very hot outside, exclusively breastfed babies still do not need additional water. However, you may have to increase the frequency of nursing to ensure your little one stays well hydrated.

This knowledge is backed by thorough research (Almroth and Bidinger, 1990; Ashraf et al., 1993; Sachdev et al, 1991) as pointed out on Kellymom.com.

These studies looking into the need for water for exclusively breastfed babies were done in both humid and dry locations at temperatures ranging from 22 to 41°C (71.6 to 105.8°F) and 9 to 96% relative humidity.

All the research pointed to one result: Breast milk provides all the hydration a baby needs, even in very hot weather.

According to KellyMom.com, even formula-fed babies do not routinely need extra water. However, some experts do advise offering water to a formula-fed baby when it is very hot outside (you could still offer extra feeds), or when the baby has fever or is ill*.

The website askdrsears.com says the following about formula-fed babies and water supplementation:

Formula contains higher concentrations of salts and minerals than breastmilk does, so that extra water is often necessary for the kidneys to excrete the extra salt. Also, because of less efficient metabolism, formula-fed infants lose more water.

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It’s okay to give your baby expressed milk or water when he starts solids.

Giving water to babies: When is it okay?

When your six-month-old baby is learning how to use a cup, experts say it is fine to give him a few sips of water a few times a day, but no more than two ounces per 24 hours.

Also, when your little one starts solids, the professional advice is that you may offer him a few sips of expressed milk or water with his solids in order to prevent constipation.

When it comes to older babies and toddlers, you can continue to breastfeed and offer water in moderation.

If you continue breastfeeding beyond a year, keep in mind that it still provides much of your child’s hydration is he is allowed to nurse unrestricted.

*It’s always best to seek prompt medical advice if your baby is sick.

References:

Almroth S, Bidinger PD. No need for water supplementation for exclusively breast-fed infants under hot and arid conditions. Trans R Soc Trop Med Hyg. 1990;84:602-604.

Ashraf RN, Jalil F, Aperia A, Lindblad BS. Additional water is not needed for healthy breast-fed babies in a hot climate. Acta Paediatr. 1993 Dec; 82(12): 1007-11.

Sachdev HP, Krishna J, Puri RK, Satyanarayana L, Kumar S. Water supplementation in exclusively breastfed infants during summer in the tropics. Lancet. 1991 Apr 20; 337(8747): 929-33.

We hope you found this article useful. Please spare a thought for baby Neveah too — she’s in a better place now. 

Have you ever received advice about breastmilk and water when it comes to your baby? We’d love to hear how you dealt with it so please do leave a comment below and tell us about it. 

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