Hydration in children
1Research Institute of Child Nutrition, Heinstück 11, D-44225 Dortmund, Germany. fr.manz@t-online.de
Insights
Optimal water intake for adults and children requires more research. Current recommendations focus on 24-hour intake, but individual hydration needs, especially in infants and toddlers, need further study for better public health guidance.
Area of Science:
- Public Health
- Pediatrics
- Nutrition Science
Background:
- Water supply is a fundamental public health issue with evolving scientific approaches to defining adequate water intake.
- Hydration is critical in pediatrics, with optimal intake potentially achieved through breastfeeding in infants.
- Existing research highlights unique water metabolism in infants and the need for more data across age and gender groups.
Purpose of the Study:
- To review current understanding of water intake recommendations and identify knowledge gaps.
- To explore hydration status, water metabolism peculiarities, and health effects across different life stages, particularly in children.
- To address the need for revised and consolidated fluid consumption recommendations, considering factors like obesity and sweetened drink consumption.
Main Methods:
- Literature review of scientific periods defining adult water intake.
- Analysis of pediatric hydration, including infant water metabolism and diarrhea.
- Examination of hydration status in relation to febrile convulsions, drinking behavior, and sex differences in children.
Main Results:
- Pediatricians recognize optimal hydration in breastfed infants.
- Water intoxication is rare in children; hyponatremia may link to febrile convulsions in toddlers.
- Spontaneous drinking behavior may be established in toddlers; sex differences in hydration exist.
- Further research is needed on health effects of various hydration states and intakes.
- Circadian rhythms of urine osmolality and tolerance to alcohol/caffeine in children require investigation.
- Consensus on sweetened drink use is crucial given childhood obesity trends.
Conclusions:
- More data are essential to define optimal water intake ranges for diverse age and gender groups.
- Current dietary reference intakes for water focus on 24-hour periods, necessitating a review of nutritional counseling practices.
- Consolidated and revised recommendations for fluid consumption are needed to address public health concerns and parental guidance.
Abstract:
Water supply is a basic public problem. In modern science, three periods with different approaches to define recommended water intake in adults can be distinguished. Pediatricians agree that hydration in children may be optimal only in breastfed infants. More data are required on the health effects of different hydration states and varying water intakes in particular age and gender groups to define optimal ranges of water intake. The fetus grows in an exceptionally well-hydrated environment. Water metabolism shows several peculiarities in preterm and term infants. Infant diarrhea remains a major topic of basic and clinical research. Water intoxication in infants, toddlers, and children is rare and can only be found in exceptional circumstances. Hydration status characterized by hyponatremia may play a role in the pathogenesis of febrile convulsions in toddlers. There is increasing indirect evidence that spontaneous drinking behavior of a population may be fixed and anchored in the age range of toddlers. Sex differences in hydration status are common, but not obligatory. What causes theses differences? What is behind the various circadian rhythms of urine osmolality in children? At what age and in what quantities can alcohol and caffeine consumption be tolerated? How can individual susceptibility be defined? Reflecting on the modern epidemic of obesity in children and adolescents, a public consensus concerning use and misuse of sweetened drinks seems mandatory. Dietary reference intakes of water refer to 24-hour intake. In nutritional counselling, food and meal-based dietary advice is primarily given. Young parents are confronted with a flood of advice of varying quality. Recommendations on fluid consumption should be collated and revised.
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