Is Your 5-Month-Old Preferring Water Over Milk? Key Concerns

At 5 months old, sometimes the baby prefers to drink water instead of milk?

Hello, Doctor: My daughter is currently 5 months and 11 days old.
Recently, after spitting up, an elder gave her some water to rinse her mouth, and since then, she has been asking for water continuously.
Sometimes, she can go 5 to 6 hours only drinking water without any milk.
Drinking water calms her down, and the elder, wanting to keep her quiet, has been allowing her to drink water, up to 160cc at a time.
Now, she insists on having water before bedtime to feel sleepy and go to sleep peacefully.
I am concerned whether this amount of water could lead to water intoxication or other issues.
Additionally, my daughter has a lot of nasal mucus; she may need to have her nose cleaned 1 to 3 times a day, or else her nostrils get blocked.
Is this normal? Thank you.

Yu, 30~39 year old female. Ask Date: 2023/06/16

Dr. Xiao Kaiwen reply Pediatrics

Infants under 6 months old should not be given too much water because their kidneys are not fully mature.
However, small amounts of water, such as rinsing the mouth after feeding milk, are acceptable.
Since your baby is over 5 months old and only consumes 160 cc of pure water a day, it should be fine and not lead to water intoxication.
Even without a cold or nasal discharge, it is normal for the nasal passages to have some secretions daily; if there is any nasal obstruction, it can be cleared.

Reply Date: 2023/06/16

More Info

It's understandable to be concerned about your 5-month-old daughter's preference for water over milk, especially given the potential implications for her nutrition and hydration. At this age, infants typically rely on breast milk or formula as their primary source of nutrition. Water should not replace milk in an infant's diet, as it does not provide the essential nutrients that milk offers.

Key Concerns Regarding Water Intake
1. Nutritional Needs: At 5 months, your daughter should be primarily consuming breast milk or formula. These provide the necessary calories, proteins, fats, vitamins, and minerals essential for her growth and development. If she is drinking water instead of milk, she may not be getting enough of these vital nutrients, which could affect her growth and overall health.

2. Water Intoxication: While it is rare, excessive water intake can lead to a condition known as water intoxication or hyponatremia, where the sodium levels in the body become dangerously low. This can cause symptoms such as irritability, lethargy, and in severe cases, seizures. It's crucial to monitor how much water she is consuming. If she is drinking significantly more water than milk, it may be wise to consult a pediatrician.

3. Feeding Practices: It's important to establish a routine that prioritizes milk feeding. If she is refusing milk, it may be helpful to limit her access to water, especially during feeding times. Encourage her to drink milk first, and if she is still thirsty afterward, you can offer a small amount of water. This approach can help reinforce the importance of milk in her diet.

4. Nasal Congestion: Regarding the nasal congestion and the need to clear her nose frequently, this can be quite common in infants. Babies often have more mucus production, and their nasal passages can become blocked easily. If she seems to be uncomfortable or has difficulty breathing, it might be worth discussing with her pediatrician. They can provide guidance on safe methods to relieve nasal congestion, such as saline drops or a humidifier.

Recommendations
- Reinforce Milk Consumption: Aim to have her drink milk at regular intervals throughout the day. If she refuses, try different feeding positions or environments to make it more appealing. Sometimes, a change in routine can encourage infants to accept milk better.

- Limit Water Intake: While hydration is important, at this age, water should not be a primary source of hydration. Limit her water intake to small amounts and ensure that milk remains the main focus of her diet.

- Consult a Pediatrician: If you notice any signs of dehydration, such as a decrease in wet diapers, or if you have concerns about her water intake or nasal congestion, consult her pediatrician. They can provide tailored advice and check for any underlying issues.

In summary, while it’s normal for infants to explore different tastes, it’s crucial to ensure that milk remains the primary source of nutrition at this age. Monitoring her water intake and reinforcing milk consumption will help support her growth and development effectively.

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