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Your kids can’t be trusted— with water.

Posted by on Sep 13, 2013 in Blog Posts | 6 comments

glass-of-water

 “By the time your child says he is thirsty, he is already dehydrated.”

“…need to be reminded to drink 5 to 9 ounces (10 to 18 1/2 ounce “gulps”) every 20 minutes during activity…”

“Younger children should be given water bottles with marks on the sides showing how much they should drink each time or told how many “gulps” to drink.”

“Kids’ fluid intake needs to be supervised. Children do not instinctively drink enough fluids to replace water losses, so it is essential that you watch to see how much water they actually drink”

 

Scary stuff. Dehydration? Heat related illness? You’re a bad mom if you are not supervising gulps…

This is the kind of thing that makes me crazy— fear and not trusting in the wisdom of the human machine. The article,  which was almost exactly the info I got in a mailer from my pediatrician’s office is emblematic of how we are trained to parent from fear.

Points to ponder:

  1. Was there an epidemic of heat-related illness?
  2. Where’s the data to support the ounces or gulps needed?
  3. How can they make the statement that kids don’t instinctively drink enough? How have we survived as a species unless  the human body was actually very capable of managing thirst and hydration? Unless there are kidney or centrally mediated (i.e pituitary type) problems, the body is pretty great at managing this stuff.

    This is the kind of statement that terrifies parents into trying to control and micromanage things we don’t need to control or micromanage. AND, if we can’t trust kids with thirst, we certainly must have to control and manage their untrustworthy hunger…

  4. Think back to what playing outside or sports days were like for you growing up. Were you occasionally stopping by the water fountain, or enjoying a few Dixie Cups of water after a game?

Let’s imagine what actually implementing these guidelines might look like:

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It’s your child’s soccer practice. You can’t trust your coach to monitor and supervise every gulp, so one adult must be there for every child.  Every 20 minutes the hydration supervisor goes out on the field with a bottle that has marks on the side (or the parent can choose to count gulps but will have to sign a waiver). Then the parent refills the bottles to the correct amount. Repeat every 20 minutes. During game days, the action will stop every 20 minutes for supervised gulp breaks. Kids will be encouraged to wear “hydration alarms” that go off every 20 minutes.

If the author really believes that the child’s ability to regulate hydration and electrolyte status is that fragile, then that is what we should be doing. (And if we’re not, why aren’t legions of children passing out or overheating?)

Where is the good sense? How did any of us survive to adulthood?

Remember that there is no better consumer than a scared mom. (As an aside, notice that the second page says that sports drinks are the best choice. Wonder if sports drinks manufacturers might support and sponsor this kind of article…)

My general thoughts on hydration:

  1. Offer milk or water with most meals and snacks
  2. Offer water between meals and snacks.
  3. Fruit juices are fine. Serve with meals and snacks. Try to aim for about 4 ounces for young children, more some days, less or none others is fine.
  4. During activity, have water available, and allow time to drink it at reasonable intervals.
  5. If it’s 100 degrees, maybe the kids shouldn’t be playing eight hours of soccer, or three hours of football in full gear, but that’s a personal call.
  6. With extreme sweating/exertion and/or heat, consider electrolyte drinks or chocolate milk and water for hydration, and watch for signs of illness.

(Maybe this is a sign of changing times too. When I was little, traveling soccer and intense athletics for kids was just starting, so maybe the Dixie cup method isn’t sufficient for today’s child athletes, but is there a middle ground?)

What do you think? Is this something you see and worry about with your kids?

For fun: The 8 glasses of water myth…

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6 Comments

Join the conversation and post a comment.

  1. Andreae

    This is a big one for me. My 10-year-old suffers from chronic constipation and encopresis (likely a result of anxiety, as no doctor has ever found a physical issue). The obvious advice is lots of fibre (which we already do) and plenty of fluids (which is like pulling teeth). She’s always been an adventurous eater, but drinking is a major, major battle. I spent years trying to get her to drink water, or even juice or milk or Kool-Aid or anything, sometimes using some not-so-gentle approaches in the heat of frustration and legitimate motherly concern. Then, one day about a month ago, we were at a restaurant and the waitress came by with ice water in a wine glass with a straw and a wedge of lemon. Daughter drank it up, mugging with the wine glass and acting (a 10-year-old’s perception of) ultra sophisticated. Without even mentioning it, I served her water the same way at home, in a wine glass, with a straw, ice, lemon wedge, and she drank it down without comment. I’ve been doing it ever since, and she’s not only drinking her water at home, but doing it at school (from a water bottle she picked out herself) without any battles.

    This might seem a little tangential, but I just wanted to share the story. However, it’s not lost on me that if I had trusted her to respond appropriately to her own thirst years ago, we might never ended up in this place, and a small health blip might not have turned into a chronic condition. Or maybe it would have, who’s to know? Another thing we’re only figuring out now is that she has an extremely sensitive gag reflex, so she is able to drink much more comfortably from a straw than from a cup. I’ve always shunned straws as kind of frivolous , but if I’d known when she was small how much easier it is for her to drink that way I would have made them a staple and saved myself years of fighting, and her from years of stress around something so basic as water. Looking back, there were plenty of clues that drinking from a straw was actually easier for her (finishing juice boxes, but just barely touching the equivalent amount of juice in a cup, for example), but I was too caught up in the power struggle to notice.

    • katja

      Oh, Andrea, I’m so glad you are finding ways to help your daughter. I touch on chronic constipation in my book as well. It’s another one of those things that I see mistreated and ignored… I so often hear from parents who are told the answer is to push fruits and veggies/fiber and liquids, and then they get stuck in the power struggle… Have you ever tried Miralax? The biggest problem is that the problem is brushed off, or treatment is stopped after a few weeks, when it takes up to 6 months for the colon to learn to function again. I think I’ll do a post on the topic. May I excerpt your comment as a starting point?
      Yes, often, the delivery vehicle makes a difference for kids. Fancy straws, a pretty cup, a carrot cut in circles, rather than sticks :)
      Chronic constipation, and withholding is not merely solved by increasing water, but takes a far more comprehensive approach, so I hope you can let go of that guilt that if you’d just figured out how to get her to drink more water, this wouldn’t have happened. I am happy for both of you that you are getting out of this fight! :)

  2. Zahra

    To be fair, I’ve heard it tell quite a few times that thirst is a late sign of dehydration. Other symptoms, such as tiredness, occur earlier. What I do try to do, is keep a (sports) bottle of water on my desk while I work. Mine can hold a bit more than 3 cups of water, which means I have to get up much less often. Otherwise, I forget to drink and do get thirsty (the “drink 2 glasses of water before I even eat when I stop for lunch” thirsty).

    • katja

      Hi Zahra. I’ve heard that too, my question is, where is the data to support the idea that thirst is a late sign, and that you’re already dehydrated? It’s one of those things we all seem to know is true, and gets repeated, but I just wonder… Glad you’ve found a way to feel good that works for you. I think that’s the critical message. Thanks for commenting!

  3. Andrea

    Hi Katja,

    the original reason for this post doesn’t really need commenting about. However, I was working on some doc for some oil company working somewhere in the desert and they made a big hoo-ha about heat stroke, drinking on a schedule, not waiting until thirsty, etc. (but they said that energy drinks were not suitable, though), but I suppose that their situation cannot be compared to everyday life NOT in the desert…
    HOWEVER (capital letters this time), I do disagree with your “general thoughts”.
    Let’s see
    Offer…
    I do dislike this word… Why should I offer and not wait to be asked for it? I would prefer “Make available” or such like. You might mean the same thing, but I think the underlying meaning is profoundly different (as you well know). Let Michelle Obama do the “offering” 😀
    Offer milk or water with most meals and snacks
    I find that a non starter. In my view, milk is a FOOD, NOT a drink and as such it should be treated. Let’s look at the composition and, for example, its protein content which is quite high and I don’t see how encouraging drinking it can be helpful in a balanced diet. This could be another cultural difference. I know that in the States they like drinking milk during meals, and I am not sure how it works in northern Europe, but still… Cannot believe it is right.
    Fruit juices: serve with meals and snacks.
    Another non starter… shall we talk about sugar intake?
    Water and only water should be offered as the norm at meal times and in-between meals. Juices only occasionally, especially those containing next to no fruit.
    Try to aim for about 4 ounces for young children, more some days, less others is fine.
    Well, this is what Michelle is saying, isn’t it… I don’t really know how much liquid is in “4 ounces” and I assume it isn’t that much, but it would not cross my mind to monitor other people’s drinks intake in any way, shape or form, unless there is a very strong medical reason for doing so. I have absolutely no idea whatsoever how much water my kids drink, but it seems to be enough 😀

    • katja

      Thanks for posting, Andrea. I try not to comment about what people eat or drink, more about how, but I often am asked the ‘what’ questions. I think there are cultural issues here, and yes, I mean in general “make available” though I could see if kids were having fun playing on a hot day that a reminder that there’s water is not a bad thing, and is very different than counting gulps every 20- minutes. (Kids can get engrossed in play and fun.) Fruit juice and sugary drinks are in general consumed, and lots of them by children, to the exclusion of water and milk and making it harder to self-regulate and meet nutritional needs. Many recommend no juices, but I take a more “liberal” view, that within balanced meals and snacks and regular mealtimes, and the DOR, should be fine. Yes, 4 ounces isn’t much, so some days it might be 8 or 12, and other days none. I tend to view it that it all evens out. Most of the health campaigns say “zero sugar sweetened beverages.” I don’t mind so much. I also wanted to give a general idea for how to handle extreme activity and heat and hydration needs. Thanks for keeping me honest. I remember laughing at the toddler drink boxes which are 4 ounces I believe. My kiddo could drink three times as much… Great comment.
      So, I offer general starting points for those who ask, with of course the understanding that families and intakes differ. If we asked what French children drank in the 1950s, it might have been watered down table wine. That would be my preferred beverage sometimes! I’ve had dietitians tell clients that diet soda was a “preferred beverage” for toddlers. Really. I also don’t know how much M drinks, I just know it’s a lot more than I do!