A new policy statement from the American Academy of Pediatrics Committee on Nutrition recommends that parents avoid giving their infants fruit juices for the first year of life. Juices have a high sugar content while lacking the fiber that whole fruit has, leading to poor dental health and increasing children’s risks of inappropriate weight gain (overweight/obesity) and malnutrition. Catherine Saint Louis notes it’s been 16 years since the AAP updated its guidelines:
In the past, the American Academy of Pediatrics had advised parents to avoid 100 percent fruit juice for babies younger than 6 months. On Monday, the group toughened its stance against juice, recommending that the drink be banned entirely from a baby’s diet during the first year. The concern is that juice offers no nutritional benefits early in life, and can take the place of what babies really need: breast milk or formula and their protein, fat, and minerals like calcium, the group said…
Four ounces of apple juice has no fiber, 60 calories and 13 grams of sugar. By comparison, a half cup of apple slices has 1.5 grams of fiber, 30 calories and 5.5 grams of sugar. The fiber in a piece of fruit also increases fullness.
In terms of sugar and calories, store-bought juice is similar to soda. For instance, four ounces of lemon-lime soda has 12.6 grams of sugar and 46 calories, both slightly less than apple juice.
The policy statement reinforces the nutritional rationale for eating a diet rich in fruits and vegetables:
Fruit, along with vegetables, is recommended to provide necessary vitamins and minerals, reduce the risk of cardiovascular disease, potentially protect against cancer, and curb excessive caloric intake… Although whole fruit is to be encouraged, up to half of the servings can be provided in the form of 100% fruit juice (not fruit drinks). A 6-ounce glass of fruit juice equals 1 fruit serving. Fruit juice offers no nutritional advantage over whole fruit. A disadvantage of fruit juice is that it lacks the fiber of whole fruit. Kilocalorie for kilocalorie, fruit juice can be consumed more quickly than whole fruit. Reliance on fruit juice instead of whole fruit to provide the recommended daily intake of fruit does not promote eating behaviors associated with the consumption of whole fruit.
Before presenting their recommendations, the AAP wants parents to remember these important principles of infant feeding:
The American Academy of Pediatrics (AAP) recommends that human milk be the only nutrient fed to infants until approximately 6 months of age. For mothers who cannot breastfeed or who choose not to breastfeed, a prepared infant formula can be used as a complete source of nutrition. No additional nutrients are needed.
The AAP is serious about limiting fruit juice consumption in children (and avoiding juice drinks and other sugar-sweetened beverages altogether):
0-12 months (infants) — NO fruit juice.
1-3 years (toddlers) — No more than 4 ounces/day of 100% juice.
4-6 years — No more than 4-6 ounces/day of 100% juice.
7-18 years — No more than 8 ounces (1 cup)/day of 100% juice.
Here are a few of the other recommendations:
Toddlers should not be given juice from bottles or easily transportable covered cups that allow them to consume juice easily throughout the day. Toddlers should not be given juice at bedtime.
Children should be encouraged to eat whole fruit to meet their recommended daily fruit intake and should be educated regarding the benefit of fiber intake and the longer time to consume the same kilocalories when consuming whole fruit compared with fruit juice.
Families should be educated that, to satisfy fluid requirements, human milk and/or infant formula is sufficient for infants and low-fat/nonfat milk and water are sufficient for older children.
In the evaluation of children with malnutrition (overnutrition and undernutrition), the pediatrician should determine the amount of juice being consumed.
In the evaluation of children with chronic diarrhea, excessive flatulence, abdominal pain, and bloating, the pediatrician should determine the amount of juice being consumed.
In the evaluation of the risk of dental caries, pediatricians should routinely discuss the relationship between fruit juice and dental decay and determine the amount and means of juice consumption.
Pediatricians should routinely discuss the use of fruit juice and fruit drinks and should educate older children, adolescents, and their parents about differences between the two.
Pediatricians should advocate for a reduction in fruit juice in the diets of young children and the elimination of fruit juice in children with abnormal (poor or excessive) weight gain.
Read more conclusions and recommendations on fruit juice consumption in children from the AAP here.