In Reply.—I did believe, when the article was written, that my work could be used as a reason for supporting to encourage breast-feeding but I doubt that depriving poor infants of adequate formula by weakening the WIC program will increase breast-feeding.
This summer, I admitted a 3-month-old breast-fed infant with seizures and a serum sodium level of 114 mmol/L. The grandmother had advised the mother to stop nursing for a day and to give water instead. The infant had taken an amount of water similar to the infants in our report. Caretakers should know that interrupting feeds and offering a hungry infant water can cause water intoxication.
Parents and health workers should avoid all situations in which hungry infants are given water instead of breast milk or infant formula. Increasing the availability of breast milk or formula, especially to infants living in poverty, would be an important preventive step.