HYDRATING

CHILDREN

Watering our little ones

Healthy HydrationThe cells in our body need water or fluids in order to live and survive. The brain, lungs, liver and kidneys

contain large amounts of water – about 65 to 85% depending on the organ.2 Appropriate amounts of fluids

are needed for human bodies to function adequately on a day to day basis, and this is no different for young

children either.

As well as the AMOUNT of water that we drink being important, the choice of fluids also matters too. This

is particularly important for young children because alongside food habits hydration habits are established

early on too. We can see this when we look at research and health statistics.

For example, research has shown that about 1 in 5 young children consumes excess energy (calories) from

drinks.3 UK data also shows that 1 in 10 children are obese by the time they start primary school and one-

third have dental caries at the age of 5 years.4,5 Bearing these figures in mind, it makes good sense to

encourage young children to drink water (which is energy and sugar free) first and foremost.

Our bodies are mainly water – 60% in adults and 75% in young children.1 Unlike adults young children cannot recognise when they are thirsty – they have an immature thirst mechanism. This means that they need us to remind them to drink small amounts and often – especially on hot days or when active. Without this, children may go long periods without drinking. This fact sheets covers ‘how much’ fluids young children need and how to best provide these.

Written by Dr Emma Derbyshire PhD, RNutr and Charlotte Stirling-Reed RNutr.Further Information: www.littlefoodie.org

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Expert Advice on Early Years Nutrition F

Foodie FluidsFoods can also provide a source of fluids alongside drinks. European guidelines are that about 70% of daily fluids come from drinks and 30% from foods.7 For children this can be particularly useful as this means that fluids can be topped up from foods – via your child’s snacks, lunchbox, or at mealtimes. Table 2 provides examples of foods with a higher water content that can help to boost young children’s fluid intakes.

Breast or formula milk will be a child’s first source of fluids. Once a baby is 6 months old this is a good time to introduce them to a free-flow cup and offer them sips of water with meals.6 Open cups are preferable for babies teeth and will help them to learn how to sip rather than suck.6 As with foods, wa-ter may need to be offered on a few occasions before young children get acquired to its taste.

For young children aged 6 to 12 months European guidelines advise that daily fluid intakes should be 800-1000ml/day.7 At this stage most of this fluid will come from their milk intakes, but it’s a good idea to introduce water at mealtimes too. As children become older and their milk feeds are reduced they can be offered fluids at regular intervals throughout the day. A range of different drinks can contribute to children’s fluid intakes but water is preferable as this is energy and sugar free. A summary of young childrens’ fluid requirements is shown in Table 1.

Age Total Fluid Intake Recommendations (foods+drinks) (ml/day)

As cups*

6-12 months 800-1000 Sips of water with meals.6

1-2 years 1100-1200 3-4

2-3 years 1300 4-5

4-8 years 1600 5-6

Table 1: Children’s fluid requirements.

FOOD FLUID CONTENT

Cucumber 97% water

Melon 92% water

Curly kale, boiled 91% water

Asparagus 91% water

Green/purple broccoli 90% water

Carrots, raw 89% water

Oranges 87% water

Apples, flesh and skin 86% water

Pears 85% water

Blackberries 85% water

Yoghurt, plain 82% water

Cod, steamed 76% water

Honeydew melon 53% water

Avocado 52% water

Source: Adapted from EFSA (2010)7

*A cup is typically around 200ml

Table 2: Foods that also provide fluids

Source: McCance and Widdowson’s Composition of Foods Integrated Dataset (CoFID)

Written by Dr Emma Derbyshire PhD, RNutr and Charlotte Stirling-Reed RNutr.Further Information: www.littlefoodie.org

Amount and Types of F uidsl

References1. Jéquier E & Constant F (2010) Water as an essential nutrient: the physiological basis of hydration. Eur J Clin Nutr 64(2):115-23. 2. Mitchell et al. (1945) The Journal of Biological Chemistry 625-637.3. Rader RK et al. (2014) Opportunities to reduce children’s excessive consumption of calories from beverages. Clin Pediatr (Phila) 53(11):1047-54.4. https://www.theguardian.com/society/2017/oct/19/obesity-primary-school-reception-children-nhs-digital-figures5. The Health and Social Care Information Centre (2015) Children’s Dental Health Survey 2013 Executive Summary. England, Wales and Northern Ireland [Internet]. Available from: http://www.hscic.gov.uk/catalogue/PUB17137/CDHS2013-ExecutiveSummary.pdf6. NHS Choices (2015) Drinks and cups for babies and toddlers. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/drinks-and-cups-chil dren/#beakers-and-cups-for-babies7. EFSA (2010) Scientific Opinion on Dietary Reference Values for water. EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA). EFSA Journal 8 (3):1459.8. American Academy of Pediatrics (2017) American Academy of Pediatrics Recommends No Fruit Juice For Children Under 1 Year. Available at: https:// www.aap.org/en-us/about-the-aap/aap-press-room/pages/American-Academy-of-Pediatrics-Recommends-No-Fruit-Juice-For-Children-Under-1-Year. aspx9. NHS Choices (2015) Water, Drinks and Your Health. Available at: https://www.nhs.uk/Livewell/Goodfood/Pages/water-drinks.aspx10. https://www.theguardian.com/society/2016/sep/01/young-children-copy-parents-sugary-drinks-study-suggests-fizzy

Please noteThis fact sheet has been based on scientific evidence available at the time that it was written. The information contained in this commentary is not a substitute for medical advice or treatment. We recommend consultation with your doctor or health care professional if you have any concerns around your child’s health.

Written by Dr Emma Derbyshire PhD, RNutr and Charlotte Stirling-Reed RNutr. Further Information: www.littlefoodie.org Copyright © Little Foodie.org

Conclusions

As with foods, the drinks we give to children early on can set the standard for things to come. As a rule of thumb introduce water from the start and keep this going as their main drink of choice if you can. Remember that children need us to remind them to drink – so offer small sips and often, especially on hot and active days which will help to keep their water levels topped up. Children also observe what’s going into our cups so remember to enjoy enough water yourself – busy parents can forget!

Top Tips for Hydrating Children

1. Provide children with a drink of water early on in the day before heading out. Avoid sending them off to nursery, pre-school or school without having had a few sips of water first.2. Avoid introducing other drinks such as squashes or juices too early on. Once introduced THEN offering them water becomes more challenging.3. Water should be children’s first drink of choice with others being saved as ‘occasional options’.4. Explain to children that water is GREAT for them. It can help them to think fast, be super at sport and perk them up when they feel tired.

Little Foodie Facts

• The American Academy of Paediatrics advises that children under 1 year do not drink fruit juice.8

• As children become older they may ask to try other beverages such as fruit/vegetable juices and smoothies. This is fine but try to keep intakes of these drinks to no more than 150ml per day.9

• What parents drink can determine what children drink10 – so take a look at what’s going into your own cup.