How Much Should My Child Drink in a Day?

By: Christine Cox, The Choosy Mommy

Capri has always been my drink chugger. As soon as you hand her a drink, she drinks all of it. Then she usually asks for more, in which I oblige. It is rare that she leaves a cup with any kind of liquid in it. This goes for all drinks: water, milk, juice, smoothies, etc. I used to worry that she was drinking too much, especially when we were potty training. We were in the bathroom every 10 minutes! And then I would wonder if she was getting enough to drink since she was always chugging her drinks. My mind was going in so many directions. So I talked to our pediatrician.

There are many factors that come into play when discussing how much a child should drink in a day. Age, weight and even gender are considerations for determining the proper amount of liquid that a child needs. The weather, the child’s activity level, and the overall health of the child are also reasons for drinking more or less.

According to Reliant Medical Group, toddlers who weigh the following should drink, on average, this amount of water and milk in a day to stay properly hydrated:

• Children age 1, weighing 30 pounds or less need to drink 32 to 40 ounces
• Children 31 to 41 pounds need to drink 40 to 48 ounces 
• Children 42 to 63 pounds need to drink 48 to 56 ounces 

Remember that our bodies are made up of nearly 60% water. Children (age 1 and up) need to drink plain, unflavored water daily to keep their organs functioning properly. Newborns and infants obtain their daily fluid intake from breastmilk or formula and do not require additional water. Please discuss this further with your pediatrician if you have any concerns with your child who is under 1 as drinking water can be very dangerous for newborns and infants.

Pediatricians also advise parents to serve only 100% fruit juice because of the sugar and extra calories in sweetened juices or juice cocktails. To ensure your children aren't drinking too much juice, follow these guidelines from the American Academy of Pediatrics:

• Birth to 6 months: No fruit juice, unless it's used to relieve constipation.
• 6 to 12 months: Limit juice intake to 4 to 6 ounces and serve it in a cup (not a bottle) to avoid tooth decay. (According to AAP.org, babies should drink breastmilk or formula for the first year of life. Try to avoid introducing juice until child is a toddler. If juice is introduced, wait until 6-9 months and limit consumption to 4-6 ounces a day).
• 1 to 6 years: Up to 6 ounces per day, again in a cup, not a bottle.
• 7 years and older: Up to 12 ounces a day.

While the total amount of water that children should be drinking in a day seems high, we need to remember that fruit and vegetables contain water too. Think of what your children eat in a day to help determine the correct amount they need to drink. And if they are highly active one day compared other days, they may need more to drink than usual.

If you are concerned your child is drinking too much, or too little, try to chart the amount your child eats and drinks in a week and discuss the topic with your pediatrician.

When it came to my daughter, I chalked her drinking habits up to being highly active. Her urine output and color were always normal for her and her skin was not dry at all; three highly noticeable sign of dehydration. Anytime she asks for a drink, I provide her with one, no matter if it is morning, noon or night. I know a lot of parents try to stop offering fluids at a certain time when nighttime potty training. Please take into consideration how active your child was all day before declining your child a drink at night.

If you need to help your children get excited about drinking, check out our song from the My Wiggle Makes Me Giggle CD, My Choosy Cup.

Do you provide easy access to water all day? Do your children drink a lot of water? How much, on average, would you say they drink in a day?

About the Author: Christine Cox is the blog master for Choosy Kids and owner of The Choosy Mommy. She has always had a passion for writing and is honored to contribute her work to this blog. Most of her writing inspiration comes from her daughter, Capri, who is fun-loving and full of energy, and son Cam, who is learning new things everyday. Click here to learn more about Christine.

NICU Strong: How to Help Your NICU Baby

By: Christine Cox, The Choosy Mommy

My baby, Cam, is almost 7 months old now (actually he’ll be 7 months on Christmas Day!) He has come a long way since he was born 7 weeks early due to me having HELLP Syndrome. You can read more about his birth on HELLP Syndrome: Knowing About It Could Save Lives.

Cam spent 13 days in the Neonatal Intensive Care Unit (NICU). These were the hardest 13 days my husband and I ever experienced. But they were the first 13 days of Cam’s life and we had to be strong for him.

Luckily we had a team of wonderful doctors and nurses caring for Cam when we couldn’t be there. We made sure we saw him every day but couldn’t be there 24/7 because my husband still had to run his business and I still had to care for my then 2 year old daughter, Capri, at home.

I learned a lot about premature babies in those 13 days. Those two weeks opened my eyes to a whole new world of experiences and firsts – especially as a parent of two children now. And this sensitive time in my life broke me because it was so hard to see the other tiny babies in the NICU just fighting for a chance to live…any parent’s fear. I realized that we take a lot of things for granted, like assuming that infants know how to eat, breathe, swallow and suck and to do some of those things simultaneously! I prayed for Cam to learn as fast as he could to do all of those things just so he could come home sooner but I knew he would learn at his own pace.

We all feel helpless in these kinds of situations because the baby’s fate is usually out of our control. But in case you or someone you know ever becomes a NICU parent, here are some tips for managing this experience.

Eat Healthy - At Choosy Kids, we talk about eating healthy all of the time, but at this point in Cam’s life, he was just learning HOW to eat. Since he was born at 33 weeks, he was supposed to just be learning how to do those things in the womb, but instead, he was forced to learn them on the outside. It was amazing to watch him learn how to do this with the help of medical equipment, his doctors and nurses, but I needed to help too. Eating was a big deal for him. For some reason, he wasn’t able to digest the formula they were giving to him in the beginning (I didn’t even start to pump yet because I was still recovering). But once he got breastmilk, his body adjusted and was able to digest it a lot better. I had to watch what I ate to ensure I was providing the best for him through my milk and still to this day have to watch my dairy intake, as it doesn’t agree with him. The most important thing a mom can do is to FEED the new infant, whether by breastmilk or formula, to establish an early loving relationship. But if you are breastfeeding, make sure you eat a healthy diet and up your calorie intake as suggested by your doctor to ensure you are sharing enough calories with your baby. Also remember to drink a ton of water – you’ll need it!

Just Breathe - Cam also had to learn to keep breathing while he was eating. There were a couple of times that he had bradycardias, or heart rate dips, while he was eating but we were lucky in that he pulled himself out of them. Some babies need to be touched to be reminded to breathe again. “Bradys,” as they call them in the NICU, are quite common. Unfortunately, every time a baby has one, he/she had to stay in our NICU another 5-7 days for monitoring (situation could vary depending on location). This was the hardest thing for me because every morning when I would call to check on him, I prayed he didn’t have a brady because I knew it would just add on extra days to his stay. As a parent, you need to remember to just breathe too. Babies can sense a lot of emotions so if parents are tense and stressed while visiting their NICU infant, they will sense those feelings. Take time throughout your day to just decompress, let out your feelings and just breathe deep.

Be Strong - As a parent, there is only so much I can do with a child in intensive care, but I knew I had to be strong for Cam, Capri, and my husband because they were just as much as part of this experience as I was.  To me, being strong meant looking forward to tomorrow as it was one more day closer to Cam coming home. Being strong meant not blaming myself for his early birth because it was out of my control. And finally, being strong meant just being there for him. Holding him, bathing him, even putting clothes on him…these seem like minor things, but he was so little so I had to be confident in my abilities and tell myself that I had the strength to do these things for him.

If you are currently a NICU parent, there are many resources available for you at the hospital. Talk to the nurses and social workers about your situation to ensure you are NICU strong. Choosy Kids also has a CD for babies called Our Special Time. The focus is on daily routines and active learning for early brain development and body awareness, which is perfect for all babies!

Additionally, if you are pregnant, learn more about HELLP Syndrome so you know the warning signs.

I’d love to hear your NICU strong story if you were in this situation. And even if you had an uncomplicated birth experience, how did you overcome any early issues with your new infants – whether it was eating, sleeping, etc. We are all parents so we are in this together!

About the Author: Christine Cox is the blog master and The Choosy Mommy for Choosy Kids. She has always had a passion for writing and is honored to contribute her work to this blog. Most of her writing inspiration comes from her daughter, Capri, who is fun-loving and full of energy, and newborn son Cam. Click here to learn more about Christine.

To Supplement or Not to Supplement

By: Heather Dyson

Many parents come to me worried that their child is not getting all of the nutrients they need for proper growth and good health, especially if their child is a “picky” eater. There are a number of different vitamins and supplements available for kids in fun shapes and tasty flavors. But parents often wonder, “Is it worth it? Does my child really need it?”

Requirements for supplementation vary depending on the child’s age. Both breastfed and formula fed infants meet most of their nutritional needs. Once your child transitions to solid foods, it is important to offer a well-balanced diet, including plenty of fruits, vegetables and whole grains, which will go a long way to helping them meet their nutritional needs. Even “picky eaters” often get enough vitamins and minerals, but a children’s multivitamin might not be a bad idea if you are worried your child does not eat enough variety. Just be sure to choose one that is made specifically for children, such as L'il Critters or Flintstones brands.

It is recommended that exclusively breastfed infants be supplemented with 1 mg/kg iron at about 4-6 months when it is believed that baby’s iron stores become depleted. Breastmilk does not contain iron in amounts that are recommended for infants. However, many feel that since breastmilk is a complete food for infants, supplementation is not necessary, especially if baby is starting solid foods. There are many foods that will provide iron for babies, including meats, eggs, dry beans (such as pinto, garbanzo, kidney, etc.) and fortified whole grain cereals. Formula is fortified with iron so supplementing is not necessary for formula fed babies.

Another vitamin that is often recommended for infants and children is Vitamin D. We get most of our Vitamin D from the sun, however in the fall through spring months we cannot get enough sun to make the Vitamin D we need. Also, the sunscreen we use to protect our skin from harmful rays also blocks the rays we need to make the vitamin. Infants can be supplemented with 400 IU of vitamin D per day and children over the age of 2 with up to 800 IU per day. Be sure to buy a children’s version as Vitamin D supplements are sold in many different dosages. Enfamil’s Vitamin D drops are a good and safe choice.

Always speak to your pediatrician or a Registered Dietitian before supplementing your child or if you are concerned about your child meeting his or her nutritional needs.

About the Author: Heather Dyson is a Licensed and Registered Dietitian who currently focuses on counseling patients with a variety of health situations, and in ages ranging from infancy to elderly. Click here to learn more about Heather.