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Fruit Juice: What’s Healthy and What’s Not
Most parents think fruit juice is healthy for young children. It's natural, filled with vitamins, and fat-free. And since juice is sweet, young children will drink it readily. Nine out of ten infants are given juice. Toddlers drink an average of 6 oz. of juice per day, and 10% of young children drink more than 12 oz. of juice per day.

But too much of a good thing can be bad for you. Studies have shown that many children suffer from tooth decay, stomachaches, diarrhea, and growth problems as a result of drinking too much juice. Let's look at the facts to help you make juice a healthy part of your child's diet.

What's in fruit juice?

Fruit juice is primarily comprised of water and natural fruit sugars including fructose, sucrose, glucose, and sorbitol. Juice also contains many nutritious components: some juices have high levels of vitamins A and C, and others may be fortified with added vitamins and minerals. Orange juice fortified with calcium has approximately the same calcium content as milk. Juice with pulp also contains fiber. Whole fruit is even healthier than juice, though, since it contains more fiber and less sugar and calories per serving.

Beware of juices called fruit drinks, punch, cocktail, or beverage: these contain as little as 10% fruit juice with lots of added sugar. Read the labels on fruit drinks and you'll see that, after water, the second ingredient is often high fructose corn syrup or corn sweetener. These fruit drinks have little nutritional value.

What can happen when children drink too much juice?
Fruit is one of the five major food groups for a healthy diet. From 2-6 years of age, it's recommended that children eat two servings of fruit a day, one of which may be a 6 oz. cup of 100% fruit juice.

When children drink too much juice, however, the high sugar concentration can cause several health problems:
  • Tooth decay: If you put your baby to sleep with a bottle of juice or let your child drink juice throughout the day from a bottle, juice box or cup, the sugar from the juice stays on the teeth and can cause severe tooth decay. This is known as Baby Bottle Tooth Decay or Early Childhood Caries.

  • Stomachaches and Diarrhea: Young children's digestive tracts can be overloaded by too much sugar. When a child regularly drinks more than 6 oz. of juice a day, the excess sugar that cannot be absorbed passes into the child's colon where it can cause petrol, intestinal cramping, and diarrhea. Some juices are harder to digest than others. For example, apple and pear juice have a higher fructose and sorbitol sugar content, which tends to make them more difficult to digest than white grape juice. If a child has diarrhea from a stomach virus, giving him juice can make it worse. In addition, unpasteurized juice may contain bacteria such as E. coli and salmonella, which can cause serious illness for infants and young children.

  • Growth problems: Studies have found that children who drink too much juice are more likely to be seriously underweight—they tend to fill up on the water and sugar in the juice and lose their appetite for other more nutritious foods. If your child is a picky eater, check how much juice he's drinking. When you cut back on the juice, he's likely to be hungrier for other food. On the other hand, some studies have found that children who drink too much juice can also become overweight when they drink too many calories in the juice in addition to their other food.

When, what, and how much juice should I give my baby?

Child nutrition experts recommend the following:
  • Don't give juice to babies under 6 months of age. Some experts say to wait until after 1 year. Wait until after a year to give citrus juices since they can cause a rash around the mouth in infants.

  • Give young children juice in a cup rather than a bottle. Don't let your child take juice to bed or sip juice throughout the day.

  • Read the labels on juices—choose 100% fruit juice, and only pasteurized juice. Also look for juice with added calcium.

  • Limit juice to 4-6 oz./day for children 1-6 years old.

  • Encourage your child to eat more fruit rather than juice. Be a good role model by eating fresh fruit yourself.

  • If your child has tooth decay, stomachaches, persistent diarrhea, or is underweight or overweight, check how much juice she's drinking and try cutting back to see if it makes a difference.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician