Some parts of the U.S. are just now starting to thaw from a pretty rough winter, but in Arizona we are rapidly approaching 100 degree F heat. Young children don't seem to mind operating at full-speed in hot temperatures but can dehydrate faster than adults, so it's especially important to make sure that they are drinking enough fluids, especially in hot weather. We want to share some favorite mom hacks that keep kids - and adults - hydrated all summer (and all year) long.
How much is enough?
Most pediatricians recommend that babies receive at minimum 20-24 ounces of breast milk or formula per day. Many babies will drink much, much more than this. For babies under 6 months of age, breast milk or formula will fulfill all of their hydration needs, and additional water is not recommended (and can even be dangerous). Breastfed babies should have at least 5-6 wet diapers and at least 6-12 feeds per day, depending on baby's age. Hydrated babies have moist (shudder) mucous membranes of the mouth and eyes, pale yellow urine, plenty of tears when crying, and no sunken soft spot.
Babies 6 months and older can have a few ounces of water per day, gradually increasing water intake toward their first birthday. It is important to not displace breast milk or formula with water until baby is closer to 1, as baby's milk will remain their main source of nutrition and hydration.
Fluid need estimates for toddlers vary depending on the source. The National Academies of Science, Engineering and Medicine recommends about 44 oz of fluid (5.5 cups) per day for 1 - 3 year olds, while other various sources recommend about 4-6 cups of fluid per day. If you'd like to calculate your child's estimated fluid needs by weight, check out this calculator.
Instead of focusing on a number, watch your toddler. His urine should be pale yellow (unless taking B vitamins, perhaps as part of a multivitamin supplement), and he should not have a dry mouth. Watch for crankiness, headache, lethargy, dizziness and dry skin - all signs that your child is dehydrated. Call your pediatrician immediately if you're worried about your child's safety when it comes to their hydration status.
Other hydration estimates from the Academy of Nutrition and Dietetics are below:
Your child will need extra fluid while playing outside in the heat, performing strenuous activity or while sick.
What counts as fluid?
Water, milk, juice, and fluid from soup, veggies, fruit, and other high-fluid foods like popsicles all count toward your child's water intake. We don't recommend juice regularly unless indicated by your doctor for constipation (and new AAP guidelines recommend no juice before a child's first birthday), so stick to water as much as possible.
If your toddler drinks milk, it is recommended to limit their intake to no more than 16-24 ounces (2-3 cups) per day - that leaves a need for at least 1-2 cups for water for a child that drinks milk.
At Feeding Littles we recommend water as the sole beverage besides milk and encourage free access to water throughout the day for all children 12 months and older. Serving at least 3 types of veggies and at least 2 fruits daily also helps to increase your child's water consumption.
What can I do to keep my child hydrated?
Happy start of summer, and happy drinking (water, that is)!
Many parents who follow Feeding Littles utilize the concept of Baby-led Weaning (BLW), which means that babies feed themselves whole foods from the start. (Don't worry - it doesn't mean that baby weans early from the breast or bottle - the term weaning is the European use of the word, meaning introduction of solid foods.)
With BLW, parents don't spoon food into a baby's mouth. While this approach can be great for many families, it doesn't fit everyone, and many parents choose the "Traditional Weaning/Feeding" (TW) route where babies are spoon fed purees and gradually eat other textures, building up to self-feeding all foods. The goal of either approach is for a baby to learn how to eat all safe textures; BLW babies get there faster, but TW works well for many families too.
With spoon feeding/TW, parents are sometimes coached on what to feed baby and how much to offer, but nobody tells them how to actually do it. Turns out, most of us don't do it correctly from a developmental and motor perspective. Since Feeding Littles supports all ways of feeding babies (as long as they're fed!), we want to give you some pointers on how best to spoon feed a baby. Even if you plan to do BLW, keep reading - these tips apply to feeding kids in general, and some of these concepts may be completely new to you!
Remember: we share this information to educate and help you have your best feeding experience possible. We never intend to offend or shame anyone into thinking they have "done it all wrong" - we simply want to provide information that most people don't learn anywhere else. In the end - your child, your choice. Do what's best for your family.
#1: Starting too early - remember, "solids" refers to anything but breast milk or formula.
Parents hear that most governing bodies, including the American Academy of Pediatrics and the World Health Organization, recommend waiting until around 6 months to start solid foods. Some interpret this to mean that purees should be started earlier and whole, more "solid" foods can start at 6 months. This recommendation is meant to apply to all "complementary foods," which means anything but breast milk or formula, not just food that is in whole form. We think that a baby's gut and immune system is more ready for food around 6 months and when baby is showing readiness signs like good head control, sitting with minimal assistance, bringing hand to mouth, and interest in food. For some babies, this is earlier than 6 months, and for others it's later. We don't recommend starting much later than 7 months for allergen exposure reasons.
From an Occupational Therapist's perspective, additional cognitive signs are important to watch for when assessing readiness for any food. Before starting spoon feeding (or any complementary food feeding), make sure to ask yourself these questions:
Starting food too soon may not only cause digestive upset (including constipation!), but for some babies it can be a negative experience when they're truly not ready. Watch your baby and look for these cues that he's ready for food!
#2 Force feeding, holding down baby's hands, and tricking baby to eat.
As parents we have a lot of things to accomplish on any given day. Sometimes feeding seems to be just another item on our endless to-do list. Try to remember that your child's feeding journey is important in establishing great feeding dynamics into adulthood. We want our kids to know how to eat when they're hungry, stop eating when they're full, and fill their tummies with foods that help them feel their best. That process starts the moment your child is born, as you learn your baby's hunger and fullness cues. It intensifies as you begin your solid food journey. Below are a few tips to help you honor your baby's cues and help him listen to what his body - not the clock or an external rule - has to say:
When spoon feeding, most of us put the spoon toward the top of a baby's mouth and then scrape the food off the top lip or hard palate so it's comes off the spoon. Watch this video for an example of what this looks like, and notice how baby is also being fed quickly and without much time to open his mouth or respond to the spoon. See how he leans away and looks a little overwhelmed:
Furthermore, as baby gets messy and her face becomes covered in food, we usually like to scrape it off with the spoon. Here is an example of face scraping:
Depositing food at the top of a baby's mouth makes her an inactive member of the feeding process and doesn't teach her where food should go when she eventually brings it to her mouth herself. When we scrape her face after she has taken a bite, it can be uncomfortable and may lead to feeding aversions, as many babies don't like the sensation. Below are some additional tips about the mechanics of spoon feeding that you may find helpful:
#4 Staying on purees for too long.
Pureed food feels safe for parents who worry about babies choking on whole foods. Unfortunately, if a baby isn't introduced to other textures relatively quickly, he may have difficulties graduating off purees. One study suggests that if babies aren't fed lumpy foods by 9 months, their risk of feeding difficulty later in life increases. Babies aren't meant to be on pureed food for life - the goal for all babies is to eventually eat real food. Here is the typical progression of food texture in TW:
Of course, this continuum of textures is more important in feeding therapy and with kids who really struggle with various textures. Once you feel confident in your baby's eating ability, play around with lumpier foods like mashed fruit or veggies, soft finger foods like cooked green beans, or ground meat. Spoon feeding pureed food should be a short stage in your baby's eating experience. Your baby won't be able to pick up small pieces of food until he has his pincer grasp, but he can get longer, strip-shaped foods starting at 6 months.
Side note: keep in mind that baby food pouches are still pureed food, and they don't offer a sensory experience for the eater. We recommend using them sparingly.
#5 Spoon or hand feeding your toddler.
Barring developmental or medical challenges, most toddlers should self feed without being hand or spoon fed by a parent by 14-16 months. Some parents of older toddlers hand feed them regularly in order to "get them to eat," and we completely understand the fear behind trusting that your child will, in fact, eat when he's hungry. Hand feeding older toddlers doesn't allow them to decide how much to eat and can start to interfere with their hunger and fullness cues. It also prevents the toddler from honing in on age-appropriate feeding skills and takes away from much of the sensory and motor development experiences that feeding provides. If you need strategies to help with your picky toddler, check out our online course.
When spoon feeding an infant who starts to grab for the spoon, instead of getting frustrated, try to celebrate this huge developmental milestone! Your baby is showing you that he wants to start feeding himself - remember, that's the goal! Check out this video of a parent appropriately responding to her baby's desire to self-feed:
In this next video, watch how mom hands baby a loaded NumNum GOOtensil, which is designed to encourage babies to self feed. The center of the GOOtensil is hollow and allows purees or other smooth textures to be captured without worrying about which side of the utensil is "up," and the handle is short - perfect for baby's hands.
Need more help feeding your baby? Be sure to join our Feeding Littles Group on Facebook and follow along on our Facebook and Instagram pages! Stay tuned for an online version of our live Baby-led Weaning class, coming soon!
Megan and Judy, co-owners of Feeding Littles, bring you helpful info on food, nutrition, picky eating, and feeding young children. Megan McNamee MPH, RDN is a Registered Dietitian Nutritionist based in Scottsdale, Arizona. Judy Delaware, OTR/L is an Occupational Therapist specializing in feeding therapy with children 3 and under in Boulder, Colorado. Megan and Judy are both moms of two and love helping families develop a healthy appetite for all foods!