Health & Nutrition - A real thirst?

Dr Kristy Howells and Dr Jackie Musgrave
Tuesday, March 2, 2021

It’s not all about healthy eating – what about healthy drinking? Dr Kristy Howells and Dr Jackie Musgrave explain how to ensure young children are achieving good hydration

Adequate hydration helps children to concentrate
Adequate hydration helps children to concentrate

Practitioners in settings are very conscious of the need to promote healthy eating for children, but recent research suggests that ‘drinking and the impact of fluid intake is often the forgotten part of food and diet’ (Howells 2021).


As the benefits of hydration are often not as widely discussed as the benefits of healthy eating, here are some pointers on why adequate hydration is essential for children:

  • Children need to be adequately hydrated in order to gain good bladder control, avoid constipation and to promote concentration levels.
  • Children aged between four and five are recommended to need 1.6-1.7 litres of fluid a day to remain hydrated; 20-30 per cent of that total amount is obtained from food, leaving 1.1-1.3 litres for children to drink (World Health Organization, 2017).
  • Research by Kenney and Chiu (2001) found that children do not always recognise the early stages of thirst; and Shaw (2010) suggested children find it difficult to understand when and what to drink. This results in children not exhibiting any desire to drink and they may never ask for a drink or appear to want a drink.

It is important, therefore, that we support and educate children about this aspect of their health, understanding how their bodies feel, and learning to understand thirst reactions; and that we also think about policies and practice about the provision of fluids. The new educational The Water Songmight help educate children about when, why and how to drink healthily (see References and resources).

Williamson and Howells’ (2019) research explored four- and five-year-olds’ understanding of why it was important to stay hydrated. The children identified that running was a reason for experiencing thirst, but most struggled to explain why it is important, with some telling the researchers it was ‘so you don’t die’. This response may appear dramatic; however, it is an example of children’s thinking and highlights how they may become anxious if they are unable to have access to drinking facilities.


Anecdotally, it seems that measures to combat cross-contamination in nursery during the coronavirus pandemic are restricting children’s access to fluids.

For example, some settings have removed water bottles to reduce the risk of children drinking from each other’s bottles. Instead, children are given access to fluids at set times throughout the day. However, this leaves children unable to access water independently if they feel thirsty.

Another reason that settings give for reducing children’s access to fluids throughout the day is to reduce the number of toilet visits. With handwashing more important than ever during the pandemic, practitioners have to spend more time supervising children, which has an impact on staffing.

The knock-on effect of restricting fluids during the day in nursery is that the children then drink almost excessive amounts when they return home. For some, this has made them return to bed-wetting, when previously they had been dry through the night.

The attendant impact on their self-esteem and the potential impact of children not receiving adequate hydration can affect not only their cognitive abilities because of impaired concentration, but also their ability to develop independence and learn about the needs of their bodies.

Many changes in practice to protect us all from the spread of the virus are essential. However, it is really important to consider how some changes may have unintended consequences on children’s health and well-being and how we could continue to support and encourage children to drink healthily.

References and resources

  • Amanda’s Action Club (2021) The Water Song,
  • Howells K (2021) ‘Physical Education and Health Education’ in McDonald R and Gibson P (eds) Inspiring Primary Learners. Routledge
  • Kenney WL and Chiu P (2001) ‘Influence of age on thirst and fluid intake’, Medicine & Science in Sports & Exercise 33 (9), pp1524-32
  • Shaw V (2010) Hydration in infants and children,
  • Williamson J and Howells K (2019) ‘Young children’s understanding of fluid intake’, International Journal of Nutrition, 4 (4), pp1-8
  • Pacey, ‘Hygiene and prevention’,

Dr Kristy Howells is a reader in sport pedagogy at Canterbury Christ Church University, and Dr Jackie Musgrave is programme leader for early childhood, Faculty of Wellbeing, Education and Language Studies, at Open University

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