Milk Intake and Solid Food Challenges in Infants

Regarding the issues of milk supply and complementary foods?

Hello, Doctor: My son is 10 months old and weighs 9 kg.
He has been suffering from a cold for 6 weeks.
He consumes formula milk three times a day, with each feeding being about 150-180 ml, and he has solid food (porridge) three times a day, with each serving being about 120-150 g.
He does not like to drink water, so his total daily fluid intake may be less than 600 ml.
He urinates about 6-7 times a day, but the volume is not significant (except for nighttime), and his urine does not appear noticeably yellow.
I would like to ask if his total daily fluid intake is insufficient? A month ago, he was having solid food twice a day and formula four times a day, with each feeding being at least 180-210 ml, and he could sleep through the night.
Now, he wakes up at irregular times during the night asking for milk (which does not seem to be related to poor sleep due to the cold).
Could this be a result of insufficient fluid intake?

rkshih, 30~39 year old female. Ask Date: 2020/12/11

Dr. Xiao Kaiwen reply Pediatrics

To determine if an infant is adequately hydrated, we primarily assess urine output.
If the infant produces more than six pale, non-concentrated urine outputs in a day, this indicates sufficient hydration, and your child is likely not experiencing dehydration.
In fact, unless there are conditions such as vomiting, diarrhea, persistent high fever, or mouth sores from enterovirus that prevent feeding, if the infant remains active and is gaining weight normally, they should not be at risk of dehydration.

Reply Date: 2020/12/11

More Info

When it comes to infant nutrition, especially for a 10-month-old child, it is crucial to ensure that they are receiving adequate hydration and nutrition from both milk and solid foods. Based on your description, your son is currently consuming about 450-540 ml of formula milk daily, along with approximately 360-450 g of solid food. While this may seem like a reasonable amount of food intake, the concern about hydration is valid, especially since you mentioned that he does not drink much water.

At this age, infants typically require around 700-900 ml of fluids per day, which includes milk, water, and any other liquids they may consume. The fact that your son is only getting about 600 ml of total fluid intake (including milk) could indeed be insufficient, particularly if he is not drinking water. Dehydration can lead to various issues, including irritability, constipation, and even sleep disturbances, which might explain why he is waking up at night asking for milk.

In addition to ensuring adequate fluid intake, it is essential to consider the balance of nutrients in your child's diet. Formula milk is designed to provide the necessary nutrients for infants, including proteins, fats, vitamins, and minerals. However, as your child begins to consume more solid foods, it is important to ensure that these foods are rich in nutrients. Foods such as pureed fruits, vegetables, and grains can provide essential vitamins and minerals. Additionally, incorporating protein sources like pureed meats or legumes can help meet his nutritional needs.

Regarding the frequency of waking up at night, it is not uncommon for infants to experience changes in their sleep patterns, especially during periods of illness or when they are adjusting to new dietary habits. If your son has been ill for six weeks, it is possible that his discomfort from the illness is contributing to his sleep disruptions. However, if he is waking up frequently and asking for milk, it could also be a learned behavior where he associates waking up with feeding.

To address the hydration issue, consider offering small amounts of water throughout the day, especially during meals. You can also try offering water in a fun cup or with a straw to make it more appealing. Additionally, you might want to introduce foods with higher water content, such as pureed fruits (like watermelon or oranges) or soups, which can help increase his overall fluid intake.

In summary, it is essential to monitor your child's total fluid intake and ensure that he is getting enough hydration from both milk and water. If you continue to have concerns about his hydration, nutrition, or sleep patterns, it would be advisable to consult with a pediatrician. They can provide personalized guidance based on your child's specific needs and health status.

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