If it were up to toddlers Jenna and Natalie, they would choose to drink juice over milk or water every time. But their mother, Paula Bothwell, won’t let them.

“Well, they’d suck juice all the time if I gave them juice anytime they wanted. It’s better for them to drink other stuff, it’s too much sugar,” Bothwell says.

According to the American Academy of Pediatrics, she’s absolutely right. Fruit juice has long been recommended as a source of vitamin C. But now, the Academy says, there should be limits.

Pediatric resident Dr. Anne Sinks: “Fruit juice should only be given with meals. It should not be given in place of a meal or before a meal or between meals. It should only be given with a meal or after a meal so it’s not replacing a child’s more nutritious solid foods.”

Kids may love juice, but if they fill up on it they’ll have no room left for the other vitamins, minerals, protein and fiber they need to grow. And dentists say it leads to tooth decay. So how much juice should kids drink?

Dr. Sinks says, “A child under 6 months of age should not be consuming fruit juice at all.” From the age of six months to six years, kids can have up to six ounces per day. Older than hat, the Academy says, eight to twelve ounces is enough.

“I don’t mind if they have it with a meal,” Paula Bothwell says. “Just to go along with what they are eating. But just for something to drink, there are plenty of other things: water!”

Tips for Parents
Historically, doctors have recommended fruit juice for children as a good source of vitamin C and an extra source of water for healthy infants. But the American Academy of Pediatrics is advising parents to give no fruit juice to infants under 6 months of age and to limit juice consumption for children of all ages.

Why? According to the AAP:
- Fruit juice offers no nutritional benefits for infants younger than six months.
- Fruit juice offers no nutritional benefits over whole fruit for infants and children older than six months.
- Excessive juice consumption may be associated with malnutrition (overnutrition and undernutrition).
- Excessive juice consumption may be associated with diarrhea, flatulence, abdominal distention, and tooth decay.
- Unpasteurized juice may contain pathogens that can cause serious illnesses.

However, the AAP also acknowledges these benefits of juice:
- 100% fruit juice or reconstituted juice can be part of a healthy diet when consumed as part of a well-balanced diet.
- A variety of fruit juices, provided in appropriate amounts for a child’s age, are not likely to cause any significant clinical symptoms.
- Calcium fortified juices provide a bioavailable source of calcium (but lack other nutrients present in breast milk, formula, or cow’s milk).

Juicy Facts
- One glass of juice (8 oz) averages 120 calories.
- The average person drinks more than 9 gallons of juice each year.
- Children are the single largest group of juice consumers.
- By age one, almost 90% of infants consume juice.
- Water is the predominant component of fruit juice, followed by carbohydrates (sugars) like sucrose, fructose, glucose and sorbitol.
- Juice contains a small amount of protein and minerals, no fat or cholesterol, and unless the pulp is included, no fiber. 
- On a typical day, young kids, ages 2 to 5, drink 15.5 ounces (or 176 calories) of sweetened drinks at 10% of their total daily calories — that's more than two times the maximum recommended amount of no more than 4 to 6 ounces daily.
- On a typical day, nearly 85% of teens consume sugary drinks — an average of 30 ounces from sun-up to sundown. That's about 356 calories a day or 16% of their total daily calories.

Some doctors believe juice may contribute to obesity in children. The Centers for Disease Control and Prevention says more than 18% of children between the ages of 6 and 11 were “overweight” in 2004.

The AAP has issued the following guidelines for juice consumption:
- No juice before six months.
- Four to six ounces of juice a day for children1 to 6.
- 8 to 12 ounces of juice a day for children 7 to 18.
- Encourage children to eat whole fruit.
- Children should not drink unpasteurized juice.

References
American Academy of Pediatrics
The Centers for Disease Control and Prevention

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