Fort Worth, Texas,
10:22 AM

A Pediatrician’s Thoughts on New AAP Juice Guidelines

Doc Smitty with 5 things parents should know

I don’t recommend juice to families.

And, despite some relaxation in the juice-drinking policy released from the AAP, it’s unlikely that I’ll start today.

First, let’s start with what we all agree on – children under the age of 12months should not be given juice. At all. Ever. For kids up until the age of 6 months, only give your baby breast milk or infant formula. After 6 months, the AAP says parents can introduce whole fruits that have been mashed or pureed, but not fruit juice.

I’m good so far.

The new guidelines state that 100 percent fresh or reconstituted fruit juice can be used as part of a healthy diet but should be limited in amount based on child’s age:

Age (years) Amount (ounces per day)
1-3 4
4-6 6
7-18 8

There are a couple of really good warnings in the guidelines that I appreciate. Like, don’t put juice in a sippy cup so that kids can walk around all day with it. Don’t give juice at bedtime. Included is a great reminder that milk and water are really the only fluids that a child needs. Don’t give unpasteurized juices because they can carry all kinds of nasty diseases. All good stuff.

While I appreciate the flexibility and the commitment to the science that these amounts are not likely to cause obesity, there are a few practical considerations I think a family should think about before they go down the “fruit juice is OK” path.

1.Let’s think about what it will look like to give a 13 month old some juice in a non-sippy cup. While I recognize that might work for like 1 percent of the kids that age…it’s not gonna be pretty for the rest of us. Grape juice + toddler = crime scene.

2.Also consider how you are going to convince a 2 year old that 4 ounces of juice is enough for the day. “Aren’t you glad you got those 2 sips of juice, buddy?”

3.Everything your 5 year old calls “juice” is probably not really juice and it’s almost certainly not 100 percent fresh or reconstituted fruit juice. A lot of it is basically soda or sports drinks and other sugary juice-like-ish drinks. I really don’t want to be debating AAP policies with my 8 year old-because if you know him you know he’ll look them up.

4.I’m not a professional juicer and I don’t have time for that and I don’t want to spend $15 to hydrate my family. Water is free and comes out of my tap on demand.

5.How far into the fresh juice world until you’re a full on cleanser and detoxer? Nah. Not interested.

Ok, but seriously, this might be a good option for your family. If your late elementary age kid won’t eat fruits but will drink 8 ounces of juice, it apparently can count as 1 serving of fruit. And, if you think you can limit your child to the amount listed as appropriate above and can keep it to real juice, go for it.


Get to know Justin Smith, M.D.

Justin Smith, M.D., is a pediatrician and the Medical Advisor for Digital Health for Cook Children's in Fort Worth, Texas. He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles.Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” is set to open in Trophy Club in 2017.

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