title: Do babies need water in Sri Lanka?
abstract: OBJECTIVE
  To study the prevalence of exclusive breast feeding and the reasons for water supplementation, and investigate whether water is necessary in the humid climate of Colombo.
  
  
  METHODS
  Well baby clinic in De Soysa Maternity Hospital for Women, Colombo.
  
  
  METHODS
  200 breast fed infants born in a baby friendly hospital between the ages of 1 and 4 months.
  
  
  METHODS
  The study sample was randomly selected. Sick infants and those of working mothers were excluded. The mothers' knowledge of feeding practices was recorded in an interviewer administered questionnaire. The infants' weights, lengths and rectal temperatures were measured and the osmolality of urine estimated. The room temperature and relative humidity were recorded on each day of study. The data were analysed using the Chi-Square statistical test.
  
  
  RESULTS
  69% of mothers introduced supplementary fluids within the first 4 months, because of advice from grandmothers or relatives, thirst, hiccups or constipation. 45% had introduced water with "rathakalkaya", a fluid traditionally given to infants in Sri Lanka. 90% of mothers had attended antenatal clinics in the De Soysa Hospital for Women. 70% of mothers who gave supplementary fluids were aware of the importance of exclusive breast feeding. The range of urine osomolalities of exclusively breast fed infants was 60 to 204 mosmol/kg. There were no significant differences in core temperatures and number of times urine was voided daily, or urine osmolalities, between exclusively breast fed and fluids-supplemented group of infants.
  
  
  CONCLUSIONS
  Despite delivery in a baby friendly hospital a majority of mothers supplemented breast milk with water or other fluids during the first 4 months. The advice of grandmothers had a significant influence on early feeding practices. Exclusively breast fed infants were found to maintain water homeostasis under the hot, humid climatic conditions of this study.
authors.affiliation: Faculty of Medicine, University of Colombo.
authors.forename: M P
authors.initials: MP
authors.lastname: Senanayake
authors.forename: H
authors.initials: H
authors.lastname: Weerawarna
authors.forename: K W
authors.initials: KW
authors.lastname: Karunaratne
authors.forename: T U
authors.initials: TU
authors.lastname: de Silva
mesh_terms: D001942:Breast Feeding; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D013188:Sri Lanka; D014867:Water
chemical_list: D014867:Water