Author: Mariko Morita M.D.,
Editor: Akihiko Ozaki M.D., Naoko Matsumoto,
In supermarkets and drugstores, juice for infants and toddlers feature labels such as “For children aged 5 months and more” or “For children aged 1 and more,” etc.
Parents who read these labels may wonder if they should comply with them. The reality, though, is that they don’t have to take them seriously at all!
Up until 2007, there used to be questions regarding whether you are letting your their 3- to 4-month-old children drink thin juice or soup written in a mother-child hand book.
In addition, some childcare books over the years used to recommend to provide children fruit juice after they take a bath.
However, the American Academy of Pediatrics now declares that it is not advisable to give juice to infants up to 1 year old. (1)
This is true even for juice containing 100% fruit juice. Why? The fiber in the fruit is removed in juice, so the sugar can be more rapidly absorbed than the original fruit could be. Juice sometimes causes overnutrition and tooth decay, and conversely, it can lead to malnutrition as well.
In one academic paper that was published in 1997, the nutritional status of 1,675 British children aged 1-and-a-half to 4-and-a-half were analyzed. It found that the shortage of the intake of iron, zinc and vitamin D occurred in children with a high intake of sugar, honey and fruit juice. Moreover, the intake of iron and zinc was below the minimum requirement, especially in children in whom more than 24% of their energy stemmed from sugar. (2) Iron deficiency causes anemia and also affects the development of the nervous system. In addition, zinc deficiency can negatively impact the immune system as well as the healing of wounds. It is suggested that children with a high intake of candy and juice consume less milk, meat, bread and vegetables, which causes them to lack iron and zinc.
Also, in 1994, American researchers reported eight cases of children aged 1 to 2 years old who suffered growth disorder due to the excessive drinking of fruit juice. (3) The child who consumed the most juice drank 850 ml of juice a day. The cause of these children’s growth disorder was the insufficient intake of protein, fat and other nutrients. However, the children gained weight by improving meals.
Juice isn’t absolutely bad, but in general, it is not a healthy drink.
Think of it as one of your child’s favorite items—one that he or she should not overdrink. If you decide to give your child fruit around his or her 6-month birthday, instead of giving him or her juice, crush the fruit, and provide it with the pulp containing the fibers. After your child turns a year old, if you want to give him or her juice, give him or her 4 ounces or less of juice per day only on special days, such as when you go out to eat or when you go to your friend's house, etc.
The American Academy of Pediatrics suggests that juice be given in a cup. Carrying juice in baby bottles and straw mugs with a lid may lead to the overdrinking of juice among children, which causes dental caries. Many children may be able to drink 4 ounces of juice fairly quickly when they use straw mugs. Also, hydration should be performed with water or barley tea, and it is better to provide a small amount of juice with a cup at a fixed time, such as during snacks.Also, avoid providing beverages with sugar, such as sodas, fruit drinks and sweet tea. Some studies indicated that the intake of drink with sugar in infancy could increase the ratio of obese children and decayed teeth during childhood.
As an exception, beverages with sugar are recommended when your child gets gastroenteritis. In addition, it is considered that an oral rehydration solution is favorable as a hydration supply when a child is suffering from diarrhea or vomiting. Fruit juice has less sodium, and depending on the type and amount, sugar cannot be fully absorbed. Unabsorbed sugar may be fermented in the colon and generate gas or cause diarrhea. Taking advantage of this principle, conversely, fruit juice is sometimes used for the treatment of constipation.
Recently, however, a study revealed that as far as mild dehydration goes, half-diluted apple juice may be superior to an oral rehydration solution. At the University of Calgary in Canada, research was conducted on 648 children aged 6 months to 5 years from 2010 to 2015.
They separated children with gastritis and mild dehydration into two groups.One group drank only oral rehydration liquid for hydration. Meanwhile, the other group drank half-diluted apple juice first, then an oral rehydration solution. After the discharge, they were allowed to drink whichever they liked. The proportion of the participants who required a medical consultation again was higher in the patients with only rehydration liquid compared with those with the diluted apple juice and oral rehydration liquid combination (25% vs. 16.7%). Such a trend was prominent in children over 2 years old.
The key message of this paper is not that apple juice is excellent but that as far as mild dehydration goes, it is important to drink what a child can drink. Although an oral rehydration solution is superior to other types of drinks, even some adults may not like its salty flavor.
Considering the types of sugar they contain, apple juice, pear juice and prune juice are prone to cause diarrhea, but this research found that apple juice did not cause a significant problem in this area. I believe that not only apple juice but also orange juice or grape juice work well.If your child doesn't drink much oral rehydration solution, please try half-diluted juice.
1.Heyman MB, Abrams SA, Section On Gastroenterology H, Nutrition, Committee On N. Fruit Juice in Infants, Children, and Adolescents: Current Recommendations. Pediatrics. 2017;139(6).
2.Gibson SA. Non-milk extrinsic sugars in the diets of pre-school children: association with intakes of micronutrients, energy, fat and NSP. Br J Nutr. 1997;78(3):367-78.
3.Smith MM, Lifshitz F. Excess fruit juice consumption as a contributing factor in nonorganic failure to thrive. Pediatrics. 1994;93(3):438-43.