Feeding
Water, cups and drinks in the first two years
What to give, when, and in what — with a clear list of things that should not be given at all.
Drinks are a surprisingly consequential part of early nutrition, affecting teeth, appetite, iron status and long-term preferences.
Before six months
Breast milk or infant formula only.
Exclusively breastfed babies do not need additional water, even in hot weather — more frequent feeds meet the need, and water displaces milk in a small stomach.
Formula-fed babies may be offered small amounts of cooled boiled water in very hot weather, and it should not replace feeds.
Water for babies under six months should be boiled and cooled.
From six months
Introducing water with meals.
Tap water can be given without boiling from six months in countries with safe drinking water.
Offer it in an open cup or a free-flow lidded cup rather than a valved sippy cup, since valved cups require sucking and prolong the sucking action that open cups replace.
Small amounts alongside food, rather than large volumes that displace milk.
Milk feeds remain the main nutrition until around a year.
Cow's milk
Timing that is frequently misunderstood.
Cow's milk can be used in cooking and on cereal from six months.
It should not be the main drink before twelve months, because it is low in iron and can cause micro-bleeding in the infant gut, contributing to iron deficiency.
From twelve months, whole cow's milk can be a main drink, with whole rather than semi-skimmed recommended until around two years because of energy needs.
Around three hundred to four hundred millilitres a day is a common guideline for toddlers, since excessive milk displaces food and is itself a cause of iron deficiency anaemia.
What not to give
A specific list.
Fruit juice and smoothies before twelve months, and diluted and with meals only afterwards, in small amounts, because of sugar and dental erosion.
Sugary drinks and squash of any kind, including no-added-sugar versions, which train preference and erode teeth.
Fizzy drinks.
Tea and coffee, which contain caffeine and tannins that impair iron absorption.
Rice drinks, which are not recommended for children under five because of arsenic content.
Unpasteurised milk.
Goat and sheep milk as a main drink before twelve months.
Plant-based drinks as a main milk before two years, other than fortified soya on dietetic advice, since most are low in protein, energy and micronutrients.
And honey in drinks before twelve months, because of infant botulism risk.
Cups and teeth
Where the dental advice is specific.
Move from bottles to a free-flow cup from around six months and aim to stop bottles entirely by around a year.
Prolonged bottle use, particularly with anything other than water and particularly at bedtime, is a leading cause of early childhood tooth decay.
Never put a baby to bed with a bottle.
Avoid letting a child carry a cup of milk or juice around continuously, since constant sipping means constant acid exposure.
Water and milk are the only drinks that should be given between meals.
Hydration
Practical signs.
Adequate hydration shows as regular pale urine and normal alertness.
Requirements rise in hot weather, with fever, and with illness.
During gastroenteritis, oral rehydration solution is the appropriate drink, and juice and fizzy drinks make diarrhoea worse.
And breastfed babies should be offered the breast more frequently in heat rather than being given water.
Vitamin supplements
Included here because it relates to what is being drunk.
Guidance in many countries recommends vitamin D supplementation for all babies from birth or from six months depending on feeding method, since formula is fortified and breast milk is not.
Combined vitamin supplements containing vitamins A, C and D are recommended for young children in some countries.
The specifics vary considerably by country and are worth checking locally rather than assuming.
Fussiness about drinks
Common and manageable.
A child who refuses water frequently accepts it if it is the only option offered between meals, over a period of consistency.
Offering water routinely with meals from six months establishes it as normal before preferences form.
Different cups, straws and letting the child choose sometimes help.
And children who have had juice or squash generally take longer to accept water, which is the practical argument for not starting.
General information only, not medical advice. Guidance varies by country — consult your health visitor or a qualified clinician about drinks and supplements for your child.
