Fluid Intake in Infants and Young Children c pr Community ...

1 Community PAEDIATRIC REVIEW5 Community P diatric ReviewcprA NATIONAL PUBLICATION FOR Community CHILD HEALTH NURSES AND OTHER PROFESSIONALSVOL 15 NO 3 SEPTEMBER 2006An initiative of theCentre for CommunityChild Health,Royal Children s Hospital, MelbourneEXECUTIVE INDEXS leep and Settling1 Development in InfantsFluid Intake in Infants5and Young ChildrenSleep and Settling Development in InfantsCENTRE FOR Community CHILD HEALTH, THE ROYAL Children S HOSPITAL, MELBOURNESUPPORTED BY AN EDUCATIONAL GRANT FROMIt is widely known that an unsettled infant canbe a major cause of stress for some surprisingly infant sleep and settling is amajor component for health professionalsworking with families. Of interest is the debateabout what techniques are appropriate forparents and Children .

2 Some organisations havequestioned some settling techniques that couldbe detrimental to an infant s mental healthand/or parent- infant considering sleep and settlingdevelopment, it is important to understand theparameters of sleep to be able to support thefamily and plan an appropriate course ofaction, if any, for the parent to follow. Themajority of parents already have an idea aboutthe importance of sleep; however it is theunderstanding of the child s ability to selfregulate that makes the process more difficultfor some is important to keep in mind that a parent sexpectations of sleep patterns may not reflectthe developmental ability of the infant toregulate themselves. To sleep through thenight from the day they are born is anunrealistic expectation in most is sleep?

3 Sleep is a physical and mental resting state inwhich a person becomes relatively inactive andunaware of their environment. It is worthremembering however, that infant sleep is asindividual as the infant serves as a restorative function for ourbodies and minds and is very necessary fornormal functioning during the can be divided into 2 distinct ) Non-rapid eye movement (REM) sleep quiet sleepIt is during this stage that we lie quietly with aregular heart rate and breathing isvery little dreaming happening in this stage andit is where the most restorative functions is in the earliest months of life that the non-REM sleep divides itself into four stages. It isthese stages that identify progress throughsleep, from drowsiness to a very deep I:This is a state of drowsiness, and is asimilar experience to what you might feel asyou are drifting off in a lecture or in front of theTV.

4 You nod off and may miss some of theTEL 1800 55 Frank OberklaidSharon FosterMichele MeehanDr Jane Redden-HoareVicki AttenboroughCarolyn BriggsJenny DonovanLibby DawsonProduction EditorRaelene McNaughtoncprCommunity P diatric ReviewSUPPORTED BY AN EDUCATIONAL GRANT FROMCENTRE FOR Community CHILDHEALTHTHE ROYAL Children S HOSPITAL, MELBOURNEFor further information contact the Centre for Community Child Health, The Royal Children s Hospital, Melbourne. Phone 03 9345 6150 or Fax 03 9347 2688 COPYRIGHT 2006. THIS PUBLICATION IS COPYRIGHT. APART FROM ANY FAIR DEALING FOR THE PURPOSE OF PRIVATE STUDY, RESEARCH, CRITICISM OR REVIEW AS PERMITTED UNDER THE COPYRIGHT ACT, NO PART MAY BE REPRODUCED BY ANYPROCESS OR PLACED IN COMPUTER MEMORY WITHOUT WRITTEN PERMISSION.

5 ENQUIRIES SHOULD BE MADE TO THE PRODUCTION 1800 55 2229 Why water is importantWater has many important roles in the body. It helpstransport nutrients, maintains blood volume, regulatesbody temperature and removes waste and Young Children : Have a higher metabolic rate which increases heat production, waste products and Fluid requirements. Have immature kidneys and do not concentrate urine as well as adults. May not be able to verbalise that they are thirsty and unlikely to have independent access to beverages. All these factors contribute to an increased risk ofdehydration in Infants and Young can be life threatening. Symptoms to beaware of include sunken eyes, decreased urine output,irritability and dry skin, mouth and eyes.

6 Dehydration canalso contribute to constipation as the colonic contentsbecome dry and hard, making stools more difficult topass. Fluid requirementsThe daily Fluid Intake for Children 0 12 months oldshould be around 150ml/kg. After 6 months, a portion ofthis Fluid is provided by solids and it is normal for fluidintake to 1 5 years old should drink at least one litreeach day. This includes water, milk on cereal and Fluid choices are described Fluid choicesBreast milk is the best Fluid for Infants under 12 the first 6 months, it provides all the nutrition theinfant needs. infant formula should be used for thoseinfants who are not breast fed. Cow s milk should not beintroduced as a beverage until the infant is 1 year old,however, small amounts of cow s milk may be used infood ( on breakfast cereal) after 6 months of water is the best drink for Children .

7 Water should beoffered to all Children over 6 months to supplement fluidintake and can be offered in a cup from this time. Ifchildren are consuming spring or rain water, a fluoridesupplement may be necessary but this should bediscussed with the child s or milk products are essential for ensuring youngchildren (over 12 months) have an adequate Intake of keynutrients such as calcium and zinc. However, too muchmilk may contribute to nutrient deficiencies as the childwill easily fill up on milk at the detriment of other milk to 600ml/day and encourage Children to eat avaried diet. Cow s milk should be offered in a cup, avoidoffering it in a bottle, as this promotes tooth decay andexcessive Intake of our Children are drinkingAccording to the 1995 National Nutrition Survey, juicewas a popular beverage choice, with 85% of boys, agedbetween 2-3 year old, drinking juice (fruit or vegetable) onthe day of the survey compared to 79% who consumedwater.

8 The average Intake of juice in this age group was388ml per day, far above the daily juice contains the vitamins from fruit but it lacks thefibre and variety Children would be getting if they atefresh fruit. If Children are drinking juice, it should belimited to one small glass per day, preferably with a meal. The percentage of Children drinking soft drink was alsoalarming, with 26% of all 2-3 year olds and 33% of 4-7year olds, consuming soft drink on the day of the Intake in Infants and Young ChildrenProblems with too many sweet drinksSweet drinks such as cordial, soft drink, sports drinks andfruit juices are not necessary for Children and excessconsumption can contribute to common nutritionalproblems. Toddler Diarrhoea Juices and soft drinks are especially concentrated andsome Children may find it difficult to digest such largeloads of sucrose or fructose.

9 Managing toddler diarrhoea may be as simple as removing fruit juice. Dental cariesRegular consumption of sweet beverages contributes to tooth decay and poor oral health. Putting babies or Young Children to bed with a bottle also increases the risk of decay. Fussy eatingAlways ask what type and volumes of fluids Children are drinking. Children may fill up on sweet drinks or milk and be less inclined to eat a variety of food. Weight gainRecent research shows soft drinks can contribute to obesity and industry data suggests that soft drink Intake is increasing. Habits are formed at a Young ageand we should be encouraging our Children to be drinking less soft drink and other sweet beverages. Situations requiring increased Fluid requirementsHot/humid weather and activityChildren playing outdoors or in a car on a warm day canlose high volumes of Fluid and are very susceptible todehydration and heat stress.

10 Thirst is not always the bestindicator of hydration and Children should be offered fluidmore regularly in the warmer weather, particularly if theyare hot weather, babies will usually naturally demand morefluids and it is acceptable to give formula fed babies smallamounts of cool boiled water after the bottle if they seemextra thirsty. Breast fed babies may need extra breastfeeds and mother should maintain her hydration. It is notusually necessary to offer water; however, occasionallythis may be Children are unwell they may not feel like drinkingor eating despite an increased need for fluids. This is anappropriate time to offer flavoured beverages such aswatered down juice or flat and diluted soft drink toencourage Fluid Intake and provide some energy(kilojoules).