Q&A: toddler's fluid intake

Rebecca writes:

"I'm having a bit of an issue with my 15 month old's weaning and fluid intake.  She received all of her fluid intake from breastfeeding for the first 12 months.  I started to introduce milk shortly thereafter. Prior to the introduction of milk, she would normally nurse 4 times a day (as well as eat 3 meals a day and snacks).  I first replaced one feeding in the afternoon with milk and it seemed to be going well.  She would drink quite a few ounces of milk from a sippy cup.  I then stopped the second feeding and she refused to drink milk as a replacement, but also didn't want to nurse.  I have recently stopped another feeding and she will again not take milk as a replacement.  At this point she is barely drinking a few ounces of milk from a cup throughout the day and only nurses in the morning when she wakes up. She eats a lot of fruits (which I know have a high water content) but I am very concerned that she is not drinking enough.  She still has wet diapers throughout the day, although not the volume she used to have. Also, I have tried various cups and the one we are using is the one she likes the best so I don't think that's the issue.  I have also tried to get her to drink water or juice, but that doesn't work either.  Can it be that she is getting most of her fluid intake from the one nursing session and fruit??

I am planning to ask the doctor at her 15 month check up next week, but would really like your advice as well."

It doesn't sound to me like she's getting enough liquids. People can go for years with inadequate fluid intake (Exhibit A being my father), so it's not the kind of thing that will stop her in her tracks, although it will make her feel bad. Fatigue, crankiness, weight gain (in adults--I don't know about kids), constipation, dehydration, and odd sleep* are all symptoms of inadequate fluid intake.

She may start drinking more when it gets hotter (I'm assuming you're in the northern hemisphere, so if you're not, ignore what I just said). You could also try to get her to drink more by offering popsicles (you can make them by mixing water and juice and freezing them in popsicle molds or little paper cups with wooden popsicle sticks for handles) or trying different kinds of "milks" like rice milk or oat milk. I could never stand cow's milk--it just tasted/tastes strange to me--but I think both rice milk and oat milk are delicious. Maybe she just doesn't like the taste of the cow's milk, but would go for other milk-like liquids.

She's at the beginning of the testing age, so she may be trying to exert control by refusing something she knows you want her to drink. If that's the case, then the surest way to get her to drink it is to pretend you don't care. Or to pretend she's not allowed to have it. You could take big, drawn-out sips of the rice milk and talk about how someday when she's a big girl she'll be able to drink rice milk, too. It might even work.

I think this is probably just one blip in the process of weaning, and that it'll resolve itself as she figures out the balance of how much she nurses and how many other fluids she drinks. But I'd keep trying (without letting her know you're trying, of course) to see if she'll drink other liquids, just on principle.

Let me know what your doctor says about this, too. I'd be curious to see if s/he agrees and has any suggestions.

* Being tired all the time and unable to wake yourself up easily, but also not getting solid restful sleep.

Comments

[Nancy]

Y'know, it's a myth that we're all running around dehydrated. Especially a toddler- if she's thirsty, she'll drink, although there's probably truth in the idea that she's refusing because she knows her mom wants her to drink!

But kidneys are an amazing organ, they keep us fluid-balanced unless we're drought-like thirsty, and even then they do a pretty good job. If you drink huge amounts you just pee huge amounts, you don't use the surplus for anything (those who have kidney stones are an exception, as in that case you're trying to flush it out with a huge river of pee, but toddler's aren't prone to those!)

On the other hand, if she's constipated, then that would be more of a sign that she needs to take a little more fluid in, as the body will shortchange the bowels if fluid intake is too low, to keep everything else in balance.

[AskMoxie]

Oh, I'm not saying we're all running around dehydrated. Just that plenty of people area little dehydrated on a daily basis. (I also subscirbe to my mother's theory, which is that you can fix many problems by drinking a glass of water and taking a little nap.) And some, like my dad, have all the problems of inadequate fluid intake but never do anything about it except suffer along.

Another thing I can think of is to check the consistency of her pee. If it's yellow or has a strong smell then that would be another sign that she's not taking in enough fluid.

[Meira]

Y'know, my ped just told me yesterday that breastfed babies take longer to accept cow's milk, which made perfect sense to me, as my two are not thrilled with it. But they will drink it mixed 1/2 & 1/2 with soy milk, so that's an idea.

[MotherLawyer]

So long as she has wet diapers she's drinking enough.

My sister, the ped, swears this is true.

I agree with the thought that she will drink if she is thirsty and not to panic about it. I'd be interested to know if she will start drinking more as it gets warmer like Moxie said.

If you are worried about calcium and protein intake, you could feed her yogurt.

[Moxie]

Meira, my friend's daughter didn't want to drink soy milk because of the name, so her mom told her it was elephant milk and she drank it like it was going out of style. It's a little too close to the rat's milk episode of The Simpsons to me, but still funny.

[Kate]

What about plain water? No nutritive value, but the best for hydration, isn't it?

We still haven't introduced milk--Miss M was off all dairy from 11-18 months--but water is the beverage of choice. To get her used to it I just used to offer it all.day.long. Sometimes she'd take a sip, sometimes refuse. Now she tells me when she's thirsty--and that can mean she needs two sips or six ounces of it. FWIW, my nephew (2 1/2 yo), who was never off dairy and loves other dairy products of all kinds, has never been a big fan of milk but drinks water all the livelong day.

[Amy]

you might also try serving it at different temperatures and see if that makes any difference. My friends daughter will not drink anything cold. She has to warm her apple juice, water and milk up to room temperature or she will refuse it. She just hates the sensation of cold food or drinks.

I also agree about trying other kinds of milk like things besides cows milk. If she is used to the sweeter taste of breast milk something like vanilla soy milk or rice milk might taste better to her. But like others have said if she isn't showing any symptoms of dehydration and seems happy and lively and is having wet diapers I wouldn't worry too much.

[tabetha]

I agree that she is getting enough is she has wet diapers. If you think she needs more, though, here are a few ideas.

1. Breastmilk is warm. It may be that she needs her beverages warmed a little. Once she starts drinking it warm, you can begin gradually cooling it until she is drinking it cool.

2. My kids really like juice, but they are only supposed to have 4-6 ounces a day, according to my pediatrician. From the very beginning, I mixed their juice half and half with water (sometimes I even put more water than juice). They never knew the difference, and it was getting a little extra water in them too.

3. I bought some of those flip top cups with straws and only put water in them. They love the neatness of the straws and drank the water, even when they normally wouldn't touch water. I still use them sometimes, but rarely have they had anything in them besides water.