Q&A with Dr. Jay

Question: Can I give my one month old water to drink?

Dr. Jay: It is not recommended to give infants water to drink. Unfortunately, this is still being done. It usually occurs because some other mom or an older individual such as a grandmother tells the mother of an infant that this is what was done in the past and the child needs it. A breast fed infant or a formula fed infant gets all the water they need through the mother’s breast milk or formula. One of the main reasons that we do not recommend giving free water (water that is not in formula, breast milk or food) is the danger of water intoxication. This occurs when an individual drinks so much water that it dilutes their own electrolytes and creates very a very dangerous environment in which organs can malfunction (such as cardiac arrhythmia, kidney failure or brain damage). Another reason is that water replaces volume in the infant’s diet so that the infant does not take in the proper amount of milk therefore not taking the appropriate calories which then leads to failure to thrive. I know most of the people who give infants water will always say to me “but it’s just a few sips, what can it hurt?” It is much too difficult to keep track of how much is given each time, so I do not agree with that. The consequences of giving too much is too grave. I do not recommend free water to be given until the child is at least one year old and that is to be given in a sippy cup. The amount of that water should be discussed with your pediatrician based on what else your child is eating and drinking.

Question: My 2 year old son was not able to walk on his right leg, so we took him the ER. X-rays were done and everything looked fine and we were told there were no fractures. He is still not able to walk on that leg. What should we do?

Dr. Jay: Try to get your son to isolate where it hurts. If he says it hurts near the ankle, there is a very good chance that there is a fracture that was not detected initially. I usually recommend a visit to an orthopedic doctor where they can re-examine and perform more imaging studies. It is very common to detect a fracture a few days later. This is often called a toddler’s fracture because it happens so frequently in this age group. The orthopedic doctor will then cast the ankle for a few weeks and then your child will be back on the road to recovery. The key is proper follow-up with your pediatrician after the initial ER visit. If your child is not fully bearing weight on an injured leg within 48 hours, they need to be re-examined, either by your pediatrician or an orthopedic doctor.

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