Parents have a primary role in the education of their children; this responsibility includes health instruction. Through the encouraging and strengthening of healthful lifestyle habits, parents will give their children an invaluable gift: each child will be able to take good care of himself throughout his lifetime by adopting behaviors and taking actions to prevent disease and promote wellness. Among the necessary learning is the awareness of fluid intake for the proper functioning of the body.

Water is an essential component in the human body, and the most abundant substance in our tissues. Water is considered an indispensable nutrient for life and is important in nutrition, development, and prevention of noncontagious diseases during childhood (Arredondo, Méndez, Soo & Pimentel, 2017).

Throughout this article, we will look at the importance of hydration in children, the recommended fluid intake according to each stage of development, and the negative effects generated by an inappropriate intake of water, as well as general recommendations for both parents and teachers to stimulate children to drink enough fluids each day.

Water as an essential nutrient
All the reactions of our body are carried out in an aqueous medium that promotes the proper functioning of the cells. Water also serves as a transporter of nutrients and substances within the blood vessels, facilitates the chemical reactions of the body, and helps to expel waste products and eliminate toxins. Water serves as a building material for growth, facilitates digestion, helps minimize temperature changes, and has an important role in the making of lubricating fluids such as saliva as well as mucus in the respiratory tract, the digestive system, and the genitourinary tract. Water protects against negative impacts in the whole body; and during pregnancy, water becomes a barrier that keeps the fetus from external physical threats (Santiago, et al., 2018).

Daily water intake needs
Although a complex, functional, and wonderful system, the body is not capable of producing or storing enough water by itself to meet its needs. Therefore, it is necessary to pay attention to what is drunk during the day to ensure that enough is ingested to satisfy the physiological needs. As mentioned previously, much of the body's constitution is water, but this percentage changes with age. It is said that in children water represents 65 to 80% of body weight (Santiago, et al., 2018).

Natural fluid intake during growth and development increases with age. The water and nutrient needs of both newborns and nurslings are directly related to breastfeeding. International health organizations recommend that, during the first 6 months, babies be fed breast milk exclusively because it meets all their nutritional needs. No liquid supplement is required (Rodríguez, Aredondo, García, González & Soo, 2013).

When breastfeeding is discontinued and solid food is introduced, water should also be added to the diet. Water consumption recommendations are developed according to body surface area and weight. In teenagers, the amount of liquids needed is related to sexual maturation and the increase in size and weight typical in this stage (Rodríguez, et al., 2013). Table 1 presents the daily water needs for different ages; these may be higher in places with high temperatures and when there is vigorous physical activity.

It is important to emphasize that the main source of hydration must be natural water, instead of sweetened beverages. These represent a health risk because they contain high amounts of sugars, which facilitate the development of short- and long-term diseases (Santiago, et al., 2018).

Table 1. Daily water needs according to age

AGE WATER INTAKE (mL or L)
Newborns and nurslings (0-6 months) Breast milk
Nurslings (6-12 months) 30 - 60 mL (1-2 oz)
1-3 years 1 - 1,4 L
4-8 years 1,5 - 1,8 L
BOYS
9-13 years 1,9 - 2,5 L
14-18 years 2,6 - 3,3 L
GIRLS
9-13 years 1,9 - 2,1 L
14-18 years 2,2 - 2,5 L

Source (in Spanish): Santiago-Lagunes, L. M., Ríos-Gallardo, P. T., Perea-Martínez, A., Lara-Campos, A. G., González-Valadez, A. L., García-Osorio, V., ... & Zárate-Aspiros, R. (2018). Importancia de una hidratación adecuada en niños y adolescentes. Revista Salud Quintana Roo. 11(39). 27-30. 

Effects of inadequate hydration
Childhood and adolescence are fundamental stages in the physical and cognitive development of human beings. Therefore, any deficiency in nutrition can represent a serious danger to health and produce some problems during growth, with negative consequence that can even be fatal. The characteristic signs of each stage of dehydration are presented below. If necessary, immediately promote water consumption and ask for advice from a health professional.

Mild to moderate dehydration Severe dehydration
  • Dry mouth
  • Tiredness or sleepiness
  •  Increased thirs
  • Decreased production of urine
  • Few or no tears when crying
  • Muscle weakness
  • Headache
  • Dizziness or lightheadedness
Extreme thirst
Sleepiness or irritability
Very dry mouth, skin, and mucous membranes
Lack of sweating
Little urine (may be amber or dark yellow) or none
Sunken eyes
Wrinkled and dry skin that lacks elasticity
Sunken fontanelle
Low blood pressure
Tachycardia
Fever
Delirium or unconsciousness

Recommendations to stimulate water consumption

  • Always have water available at home, school, and church.
  • Carry a bottle of water at all times.
  • Choose plain water instead of sugar-sweetened beverages.
  • Add lemon to drinking water, avoiding sugar. This will improve the flavor and lead to more water drinking.
  • Stay alert to the signs of dehydration.

Conclusion
Water is an essential element for the proper functioning of our bodies; therefore, both parents and teachers must be involved and interested in encouraging its consumption among the children they care for. Neglecting water intake can cause serious health problems that may even lead to death. Stay alert to the signs of dehydration, and follow the foregoing recommendations to achieve an excellent state of hydration.

References (for texts in Spanish)

  • Arredondo-García, J. L., Méndez-Herrera, A., Medina-Cortina, H., & Pimentel-Hernández, C. (2017). Agua: la importancia de una ingesta adecuada en pediatría. Acta pediátrica de México, 38(2), 116-124.
  • Bartrina, J. A. (2015). Pautas para una hidratación saludable. Archivos Latinoamericanos de Nutrición, 65.
  • Daniels, M. C., & Popkin, B. M. (2010). Impact of water intake on energy intake and weight status: a systematic review. Nutrition reviews68(9), 505-521.
  • Rodríguez-Weber, M. Á., Arredondo-García, J. L., García-de la Puente, S., González-Zamora, J. F., & López-Candiani, C. (2013). Consumo de agua en pediatría. Acta pediátrica de México34(2), 96-101.
  • Santiago-Lagunes, L. M., Ríos-Gallardo, P. T., Perea-Martínez, A., Lara-Campos, A. G., González-Valadez, A. L., García-Osorio, V., ... & Zárate-Aspiros, R. (2018). Importancia de una hidratación adecuada en niños y adolescentes. Revista Salud Quintana Roo. 11(39). 27-30.

by Belén López Maynez
Master in Nursing | Mexico

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