Ok to mix breast milk with water?
Our 2 month old breast feeds 90% of the time, but if my wife is away we will use pumped breast milk from a bottle. The other day my wife was out and we only had 1.5 oz of defrosted breast milk. Our baby usually eats 2 oz per feeding, so I added .5 oz of warm water so that she wouldn't get hungry before mom got home (first time I've done this).
My wife says this is bad and could lead to water intoxication. Is this correct? Should I avoid adding water to breast milk at all times?
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In Germany it is common to let babys drink water (or tea) if they are not hungry but thirsty. So I don't see any problem in filling up a bottle of milk with such a small volume of water.
But the concentration of sodium in tap water here is much less then in the states. (Please see en.wikipedia.org/wiki/Water_fluoridation#Use_around_the_world)
Maybe it is an option for you to use low-sodium bottled water.
Breastmilk is about 80-90% water as it is, so there really is no need to add additional water to it. Water use is also discouraged for the reason you used it: newborns can fill up on water, so they should not be given water. (It's like filling up on cookies instead of an actual meal. Their growing bodies need good nutrition.)
Your wife is correct that water intoxication can happen in infants.
Too much water dilutes sodium in the blood and flushes it out of the
body, thus altering brain activity, which can lead to a seizure.
Infants under 1 year of age may be more prone to these types of
seizures than older children because a young infant’s diet does not
contain enough food sources to replenish the lost sodium. Also, an
infant’s immature kidneys cannot flush out excess water fast enough,
causing a dangerous buildup of water in the body.
Certainly avoid adding water to breastmilk. Typically, water is not fed to infants until they start solids/baby food - and then too, it is supplied with meals. Once they are weaned off, water intake is increased to compensate.
I'd recommend keeping some back-up formula on hand, or even a soother to get relief from the sucking motion. Also try distracting the child until the mother returns, rocking him, etc. Don't use cow's milk as that also doesn't have sufficient nutrition. Stick with breast milk or infant formula.
Adding half an ounce of water for a one off feeding is not going to harm the baby in any way.
Doing this for the majority of feeds is likely to be an issue in terms of nutrition and in the extreme perhaps water intoxication.
The mistake here is to conflate a small issue as being an extreme case. Despite being unable to process water as well as adults, babies can still handle a number of ounces of water at a time safely. www.stlouischildrens.org/articles/wellness/water-intoxication-in-infants
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