Staying Hydrated

Hey, it's hot out there!

It's gone from high temperatures in the low 70's to highs in the low 90's overnight, pretty much skipping the 80's altogether.  It may be different where you are, but this is life in the midwest.  We have three and one half seasons a year.  (We only get half a spring). 

Now that it has suddenly become hot, let's talk about staying hydrated and keeping our kids hydrated.  Adults need eight to ten 8-oz glasses of water a day.  They need more if they are very active (strenuous exercise for more than 30 minutes).  I know this has been contested in the lay literature, but I still stand by this.  Your intestinal tract will work better, your skin will stay more hydrated and you hair will shine.  More importantly, you will feel better. 

In addition to water, you may want other fluids.  I recommend 100% juice, not juice drink or juice mix, even for adults.  I would avoid beverages with added sugar-it simply isn't needed.  This includes sucrose, fructose, and high fructose corn syrup.  Green tea and coffee are said to have health advantages.  However, for every caffeinated beverage you drink, you need another 8 oz of water!  For a 3-cup a day coffee drinker, like myself, who works out hard an hour a day (5-6 days a week) that's a lot of water. 

This same advice about additional fluids applies to your children.  They need adequate amounts of water, which I will discuss in a moment.  They should get juice that is always 100% juice.  Four ounces a day is plenty.  More than that blunts their appetite for solid foods.  Avoid giving them beverages with added sugar, fructose or high fructose corn syrup. 

The hard part of this blog is talking about how much water to give your children.  There are very few published guidelines.  The ones I could find all deal with children who are already dehydrated.  This is what we are trying to avoid.  Furthermore, the amount has to change as they grow.  Therefore, you should know that much of the following information is my opinion, based on my experience and expertise.

Let's start with infants.  Breastfed infants do not need additional water.  However, mother needs to make sure she stays well hydrated.  Bottlefed infants should start getting water at 1-2 months of age.  Start with 2-4 oz a day and work up to 4-6 oz a day.  Constipated infants may benefit from 8 oz a day.  There is seldom any need to go above that amount in children less than 6 months old.  In hot weather, it is better to shelter these children from the heat, than to increase their water intake.  This is because their kidneys may not handle the increase in water the same as an adult, and their electrolytes may become unbalanced.  This can result in hospitalization.

As they get older, things start to change.  At 6-12 months of age, 8-16 oz of water a day seems to work for most children.  If your infant is constipated, try increasing their water intake more toward 16 oz a day and see if that doesn't help.  At 12-24 months of age, 16-24 oz a day works well for most children.  By age 4, I start talking directly to the children about their water intake.  I teach them that they need 1 (8 oz) glass of water for every year they are old.  That means 4 glasses for a 4 year old, 5 glasses for a 5 year old, etc, all the way up to 8-10 years of age.  This makes it very simple and easy to remember.  It also works extremely well to maintain good health. 

In those wonderful preteen and teen years we discuss the transition to adult recommendations.  This includes a discussion of caffeine and increasing water intake to compensate for that.  I will allow teens to drink 8 oz of juice a day, simply because many of them are drinking 3-4 8 oz glasses of juice drink already.  Cutting back to a single glass of 100% juice is a much healthier choice. 

Despite all this, it may be difficult to keep up with the hot weather.  How do you know if you child needs more fluids?  The early signs of mild dehydration are subtle.  They are fatigue and irritability.  Older children may exhibit confusion.  If you see these things, get your child to a cool environment and get them to drink some fluids.  Water is preferable.  Most of us get plenty of electrolytes in our diet.  However, if they have been extremely active, such as participating in competitive sports for more than 30 minutes without a break, consider an electrolyte drink.  If your child does not improve in 15-30 minutes, contact your healthcare provider.


Dr Nan N
House Call Pediatrician, Overland Park, KS

State of the art care for your child in your home.

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