New recommendation: No fruit juice for children under a year

Claire McCarthy, MD
Claire McCarthy, MD, Faculty Editor, Harvard Health Publishing

Follow me on Twitter @drClaire

Juice. Many people think of it as a healthy drink, something that should be part of a child’s diet. But it turns out that it’s not necessarily healthy at all — and doesn’t need to be part of a child’s diet. In fact, the American Academy of Pediatrics just came out with the recommendation that children under a year should drink no juice at all. This is a change from the previous recommendation, which was that children shouldn’t have juice before six months of age.

This recommendation may seem surprising, but here’s why experts aren’t wild about juice:

  • It doesn’t have much nutritional value. Yes, there are some vitamins in it, and the ascorbic acid in some juices can help the body absorb iron. But children are always better off eating the fruit (or vegetable) itself instead of the juice. It’s healthier and has fiber the body needs.
  • It can lead to cavities, especially when children carry around bottles or sippy cups and drink little bits all the time. When children do this, there is cavity-causing sugar in the mouth all the time.
  • It can lead to overweight. Our bodies are designed to eat our calories, not drink them; we don’t get filled up by juice, no matter how many calories of it we drink.
  • It can lead to diarrhea, especially in toddlers.
  • It can actually interfere with the absorption of some medications.

It’s true that juice is healthier than, say, soda. But when it comes to overweight and cavities, juice isn’t all that different. The point is simply that children don’t need it. Water and unsweetened milk (or fortified alternative milks for those with allergies or lactose intolerance) are the only beverages a child really needs. And as I said above, the better way to get whatever nutrition a juice might offer is to eat fruits and vegetables instead.

After a year, it’s okay to give a child juice, with some caveats:

  • Keep it to one serving a day. For children younger than 7, a serving is 4 ounces; for 7 to 18, it’s 8 ounces.
  • Make sure it’s 100% juice. There are a lot of fruit “drinks” out there that have lots of sugar and little or no juice. Read labels carefully.
  • Make sure that any juice you give your child is pasteurized, for safety.
  • Don’t give juice in a sippy cup or bottle! This is very important for preventing cavities. If you’re going to give that one serving of juice, have it be something your child sits and drinks from an open cup and finishes in one sitting, not something he or she carries around (or that you stick in the diaper bag for outings). If you want to bring something along, have it be a reusable water bottle.

These are guidelines — and with any guideline, there may be exceptions (if your child is on an iron supplement, for example, your doctor may want you to give it with orange juice). If you have questions about this recommendation, or anything else about what your child should eat or drink, talk to your pediatrician.