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IN THE DRINK

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Adequate fluid intake is vital for babies and small children, but what are the best drinks to give them? Dietician Melanie Levy advises.
Our newborn babies are offered either breastmilk or formula as their staple diet. Both have their pros and cons, and there are many factors which influence a mother's decision to breast- or bottle-feed.

Breastfeeding is the ideal choice, with benefits for both mom and baby. The unparalleled advantage of breastmilk is the immunity that is received not only during the first week of life via the colostrum, but continually for as long as you breastfeed. Other advantages of breastfeeding include quicker weight loss for the mother, convenience, easy absorption and decreased cost, to name but a few.

But breastfeeding may not be possible for all moms. If bottle-feeding is your choice, it is important to discuss with your doctor or dietician the best type of formula to use. Remember that each baby's needs are unique, and your baby may not be able to tolerate certain formulas because of allergy or intolerance.

Whether you're feeding your baby breastmilk or formula, there is no need to supplement with any other fluids or drinks. On very hot days, formula-fed babies may be given cooled boiled water between feeds, but this should never replace a feed. Supplementary liquids are not necessary in breastfed babies; just demand-feed your baby and he will be getting all that he needs.

A solid start
Solids are usually introduced at 4?6 months. During this time, give your baby breastmilk or formula before the solids, as milk is still his primary source of nutrition. From about a month later, once solid feeding is established, consider giving him extra drinks or fluid.

There is no set rule as to when 'tea times' should be introduced; each child is different. Some babies are content to demand breastfeed until seven or eight months, but others may need an extra drink. If your baby is eating well at meal times, is gaining sufficient weight and is thirsty in the afternoons, it may be time for that extra drink to be added.

Interestingly, the main reason for giving your baby drinks at this stage is not to improve the nutrition of the diet or to provide your baby with extra fluid. The primary goal is for your baby to learn the co-ordination of holding a mug and bringing it to his mouth. At first, your baby will actually be taking in very little of the drink offered.

Choices, choices
One needs to decide exactly what to introduce. The choices include tea (regular, rooibos or herbal), fruit juice, concentrates, powdered drinks, carbonated cold drinks, specially formulated baby drinks and cow's milk. The decision that you make will depend on a number of factors.

Always consider the nutritional content of the drink that you wish to introduce. It is a good idea to choose drinks that have substantial nutritional value. This means that the drink will be able to offer your child not only fluid, but also several vitamins and minerals.

Fresh fruit and vegetable juices will supply the vitamins and minerals that are naturally found in that food. These juices contain carbohydrates in the form of fructose, which is a good source of energy. Pure fruit or vegetable juices may be too concentrated for your baby initially, so dilute the juice to start with.

The main advantage of baby drinks is that they are fortified with vitamins. The companies producing them usually make an effort to ensure that they are 100% pure and contain no preservatives, colourants, or added sugars. Always read labels to ensure that this is the case.

Squashes, carbonated drinks and powdered drinks provide carbohydrates in the form of sugar (sucrose). Most squashes or juice concentrates only contain 6% real fruit. Be careful of giving your baby too much sugar ? many childcare experts believe that sugar causes hyperactivity.

Medical literature offers no firm evidence or controlled studies that support this theory, but some mothers are convinced that sugar changes their children's behaviour. If you child shows no overt signs of hyperactivity, there is no reason to avoid sugary drinks, as you may be replacing it with something that is far more harmful.

The effects of artificial sweeteners, preservatives, colourants and flavourings on our health are poorly understood. It has been established that certain preservatives are extremely bad for asthma sufferers.

Get a reaction?
If your child is allergic to a certain preservative, colourant or flavouring, you need to read all food labels carefully. If you are unsure of the exact contents of a product, contact the manufacturers directly or consult a dietician.

During the first six months of life, your baby's intestine is porous, allowing allergens to pass into the system and establish the early process of allergy. Cow's milk is a major allergen in children, so don't include it in any form in the diet before one year.

Research has shown that not giving cow's milk in the first year to children who are prone to allergies may actually decrease the chance of developing an allergy. After that, if your child is not allergic or if there are no food allergies in the family, cow's milk may be considered.

However, milky drinks have good nutritional value. Milk provides fat and is a rich source of calcium, which is rarely found in other drinks. Milky drinks should not replace breastmilk or formula. Encourage an older child to drink one or two cups of milk each day. If you are concerned that your child is not gaining enough weight, give him milky drinks rather than juice or tea.

One of the most important things to consider when choosing drinks for your child is his dental health. Studies have shown that carbohydrates in general (and not specifically sugar) are associated with dental cavities. Also important is the acidity of the drink.

Fruit juices are relatively acidic, so these may cause more damage to the teeth than drinks that contain added sugar. Certain carbonated cold drinks contain phosphoric acid which increases the acidity of the drink and erodes the teeth. Rooibos tea contains fluoride and therefore gives added protection to teeth.

'Nursing bottle caries', or tooth decay caused by the baby bottle, is found in babies who are often given bottles of milk or sugared liquids, so that the teeth are continuously bathed in the solution. To avoid this, you should encourage regular 'tea times', where the drink is only offered for an hour at a time. This will ensure that the time liquids are in contact with the teeth is limited.

On a buzz
Drinks which contain caffeine may interfere with sleep and behaviour patterns because it is a metabolic stimulant. It's therefore best to avoid these altogether. Remember that regular tea and certain carbonated drinks also contain caffeine so rather give your baby herbal tea or rooibos teas.

Alcohol should never be included as part of any child's intake. It has damaging effects on the body and it could affect your child's development. Some parents put alcohol onto dummies or a bottle as a means of soothing their babies, and this sets up an early association that alcohol is to be used as a comforter. This may contribute to establishing a dependency for alcohol later in life.

Look out for
  • Preservatives;
  • Sodium benzoate/benzoic acid;
  • Sulphur dioxide;
  • Sodium/potassium sulphide;
  • Sodium/potassium bisulphide;
  • Sodium/potassium metabisulphide;
  • Butylated hydroxyanisole (BHA);
  • Butylated hydroxytoluene (BHT);
  • Sodium/potassium nitrite;
  • Sodium/potassium nitrate;
  • Colourants;
  • Tartrazine;
  • Flavourings;
  • Monosodium glutamate.

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