Exclusive breastfeeding is something that our country and the World Health Organization have been advocating for many years, but even the director of a town health center, who is a medical professional, did not know or understand it, let alone ordinary people.
Therefore, it's very necessary to popularize this knowledge point.
Do exclusively breastfed babies need extra water?
All major guidelines advocate against feeding
In his book "The Sears Parenting Method," Dr. William Sears, one of the most renowned pediatricians in the United States, advocates that exclusively breastfed babies do not need to be given water for the first six months.
Cui Yutao, a renowned pediatrician in my country, also suggests that babies under 6 months old do not need extra water unless there are special circumstances.
The WHO believes that breastfeeding can reduce child mortality and its health benefits can extend into adulthood. It recommends that infants be exclusively breastfed for the first 6 months of life to achieve optimal growth, development and health, meaning that no food or drink other than breast milk should be given, and even water should not be given.
It is worth mentioning that exclusive breastfeeding is also a national policy promoted in major hospitals in my country.
Why do exclusively breastfed babies not need extra water?
Breast milk is the best food for babies in the world, bar none.
Breastfeeding is the most economical, safest, most nutritious, and most beneficial feeding method for newborns' growth and development in the world.
Breast milk is 80% water. For exclusively breastfed babies (infants under 6 months old), breast milk is the best choice for supplementing their water intake and can meet all the fluid, energy and nutrient needs of this age group.
Tik Hassen, a senior official at the World Health Organization’s China office, once reminded Chinese parents with an old Chinese proverb: “No matter how precious the water is, it is not as good as a mother’s breast milk.”
Therefore, there is no need to give extra water before the age when complementary foods need to be introduced.
Even with a small amount of colostrum, it can still meet the baby's hydration needs.
Giving water doesn't do any good either.
A newborn baby's stomach is very small. Giving the baby water indiscriminately will affect the amount of breast milk intake and energy obtained, and may even increase the burden on the baby's kidneys, affecting the baby's better growth and development.
Feeding water may also reduce the amount of breast milk being suckled by the mother—with less stimulation from suckling, the mother's milk production will be delayed and less milk will be produced.
The American Academy of Pediatrics states that all supplements (including water, sugar water, formula, or other liquids) should not be given to infants under 6 months of age who are breastfed, unless there is a medical indication and the advice of a doctor.
Under what circumstances can you give water to a baby under 6 months old?
Raising a baby is a highly practical matter, and sometimes it requires specific analysis of specific problems.
Just as diabetic patients should avoid high sugar intake, they also need to supplement with high sugar when they experience hypoglycemia.
In theory, babies under 6 months should be exclusively breastfed without needing to be given any other complementary foods or water, but that is under normal physiological conditions.
If the baby has diarrhea, fever, or other medically indicated conditions, additional water can be given under the guidance of a doctor, depending on the degree of dehydration.
How to manage breast milk-related jaundice?
According to research findings, as the rate of breastfeeding increases, the incidence of breast milk jaundice also increases year by year.
The incidence of breast milk jaundice has now reached 20%-30%, becoming one of the main causes of hyperbilirubinemia in hospitalized newborns.
Although the prognosis for this disease is good and treatment is only necessary in severe cases, it should still be taken seriously in order to promote breastfeeding.
Breastfed infants develop jaundice 4-7 days after birth, peaking at 2-4 weeks (serum bilirubin can exceed 256.6-342.0 μmol/L), and are generally in good condition with no signs of hemolysis or anemia.
Jaundice usually lasts for 3-4 weeks and gradually subsides in the second month, but in a few cases it may take up to 10 weeks to completely disappear.
During the jaundice period, if breastfeeding is stopped for 3-4 days, the jaundice can be significantly reduced, and the bilirubin level will decrease by ≥50%.
If breastfeeding continues, jaundice may not reappear, and even if it does, it will not reach the original level.
Recommended practices for breast milk jaundice
The "Guidelines for Promoting Breastfeeding (2018 Edition)" provides the following recommendations regarding breast milk-related jaundice:
On-demand breastfeeding (frequency ≥ 8 times/24 hours) helps prevent breast milk-related jaundice;
Infants with breast milk-related jaundice should not be breastfed.
For infants with a confirmed diagnosis of breast milk-related jaundice, phototherapy and other treatments are not recommended when bilirubin levels are below the threshold for phototherapy.
For infants with a confirmed diagnosis of breast milk-related jaundice, when bilirubin levels reach the indication for phototherapy, mothers are allowed to breastfeed and care for the newborn during the intervals between phototherapy sessions.
For infants with a confirmed diagnosis of breast milk-related jaundice, if their general condition is good and there are no other complications, routine vaccinations can be administered.
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