Total water intake and its contributors in infants and young children

Abstract

Hydration is a particular concern for infants and young children due to their greater risk of dehydration. However, studies on their water intakes are scarce. The current survey aimed to analyze total water intake (TWI) in non-breastfed children aged 0.5-35 months compared to the adequate intake (AI) for the same age group set by the EFSA and to examine the different contributors to TWI as well as beverage consumption patterns. Nationally representative data from the Nutri-Bébé cross-sectional survey were used to assess food, beverage, and plain water consumption by age group over three non-consecutive days. With age, median TWI in 1,035 children increased from 732 to 1010 mL/d, without differences between sex, but with a great inter-individual variation, and the percentage of children who did not meet the AI increased from 10% to 88%. Median weight-related TWI decreased from 136.6 to 69.0 mL/kg/d. Among infants, 90% had a ratio of water/energy below the AI, similarly for about 75% of toddlers. Milk and milk products were the main contributors to TWI, while the part of plain water increased gradually to be 25% in the older toddlers, half of which was tap water. The beverage consumption pattern varied in types and timing, with little consumption of juices and sweetened beverages. Vegetables and fruits accounted for 20% of TWI after the age of 6 months. These initial results, showing strong discrepancies between actual and recommended water intakes in young children, should help identify ways to increase children’s water consumption.

Assessment of Water Intake among Chinese Toddlers: The Report of a Survey

“…In our study, plain water contributed 30.3% to TWI for 13~24-month-olds, compared to 13% (12~17 months) and 19% (18~23 months) in France. For 25~36-month-olds, plain water contributed 34.6% in our study, versus 23% (24~29 months) and 25% (30~35 months) in France [22]. Additionally, our study determined that the median daily plain water intake among toddlers aged 13 to 36 months was 300 mL, whereas the average plain water intake in Mexico was 227 mL [15].…”

“…Our research indicated that the median daily TWI of toddlers aged 13~24 months in China was 1015 mL, with 651 mL derived from beverages and 336 mL from foods, while that of toddlers aged 25~36 months was 1180 mL, with 696 mL coming from beverages and 449 mL from foods. This intake was slightly higher than the median daily TWI reported in France for different age groups: 999 mL (12~17 months), 985 mL (18~23 months), 991 mL (24~29 months), and 991 mL (30~35 months) [22], and lower than the mean daily TWI of toddlers aged 1-3 years reported in Mexico, which was 1283 mL, with 743 mL from beverages and 540 mL from foods [15]. These differences may be attributed to racial diversity, geographical location, cultural customs, economic level, dietary habits, feeding patterns, accessibility to beverages and food, and survey methodologies.…”

“…Currently, reports on toddlers' water intake have been limited to only three countries. Of these studies, the ones conducted in France and Mexico were particularly noteworthy as they considered both water intake from food and beverages, whereas the study in the United States solely focused on beverage consumption [15,22,23]. Our research indicated that the median daily TWI of toddlers aged 13~24 months in China was 1015 mL, with 651 mL derived from beverages and 336 mL from foods, while that of toddlers aged 25~36 months was 1180 mL, with 696 mL coming from beverages and 449 mL from foods.…”

“…However, in the survey conducted in France, nearly half of the toddlers aged 12~23 months had a TWI that reached the AI value (49% for those aged 12~17 months and 50% for those aged 18~23 months), whereas the proportion of toddlers aged 24~29 months and 30~35 months whose TWI did not reach the AI value was 88% and 84%, respectively. This may be due to the different AI recommendations set by EFSA (1100 mL/d for aged 12~23 months and 1300 mL/d for aged 24~35 months) [8,22]. The discrepancy in TWI recommendations among regions worldwide underscores the limitations of relying solely on TWI to assess hydration status.…”

Use and Acceptance of Drinking Fountains: A Pilot Study in Two Secondary Schools in Dortmund, Germany

“…Drinking sufficient water is critical for children's diet and healthy life, but unfortunately, it is not a common practice for many children. Newborns and infants are particularly vulnerable to life-threatening dehydration [1]. Inadequate hydration negatively impacts the brain's function and structure [2] and can even lead to chronic conditions, such as urolithiasis or bronchopulmonary disorders [3].…”