Safe Sips

Most parents know it’s important to get children to eat healthy foods, but what about getting them to enjoy healthy drinks? It’s a question that has been the focus of attention for leading pediatricians and dietitians lately. The American Academy of Pediatrics has issued advisories for parents to avoid 100 percent fruit juice for babies under the age of 1 and to avoid sports and energy drinks for older children and adolescents.

None of that surprises NorthBay Healthcare pediatrician Bruce Hewett, M.D., and his daughter, NorthBay dietitian Laura Hitt, R.D. They’ve been advising parents similarly for years.

“I get this question a lot from parents, about what’s appropriate and what isn’t,” said Dr. Hewett, who works at the NorthBay Center for Primary Care in Vacaville. “No juice for children under a year and only modest amounts for toddlers.”

The concern is that juice offers no nutritional benefits early in life, and can actually take away from what babies really need: breast milk or formula, and the protein, fat and minerals (like calcium) that they provide.

“Fruit juice is not a substitute for fruit as children grow,” added Laura, who works with patients at the NorthBay Center for Diabetes & Endocrinology as well as at the Center for Primary Care. “Fruit juices don’t offer the nutrients. There is no protein, no fiber. A better option would be a piece of fruit and a glass of water.”

There are other reasons to avoid the 100 percent juice option for young children, said Dr. Hewett.

“You don’t want children to develop an affinity for sweet, sugary drinks,” he explained. “The fact is, the more sugar you consume the more you crave it and that correlates directly to obesity and other health issues.”

Laura added that it’s also important not to send the child to bed with a juice bottle or let them drink a lot of it between meals. It’s not healthy for their teeth and can impact their overall appetite.

If you commit to consuming only water as your drink of choice, you can make great strides toward keeping a healthy weight.
~Matthew Heeren, M.D.

Dr. Hewett said he also warns parents not to link food or drink to emotions. “Don’t reward with food or put a high emotional value on it,” he explained. “Don’t tell them ‘If you are good today, you can have two cookies.’ Instead, try telling them, ‘If you are good today, you will get 30 minutes of uninterrupted play time with daddy.’ That puts the value on what they really want, which is their parents’ time.”

As children get older and more active, sipping healthy drinks remains important, both Dr. Hewett and Laura agreed. Laura said one important piece of advice for parents is to not to keep soda in the home. “It just should not be an option. It should only be available on rare occasions.”

And as for sport drinks, Dr. Hewett tells parents to give Gatorade when a child is vomiting and can’t hold anything down, but otherwise keep the energy and sport drinks out of the dietary equation.

Sport drinks, which contain carbohydrates, minerals, electrolytes and flavoring, are intended to replace water and electrolytes lost through sweating during exercise. They can be helpful for young athletes engaged in prolonged, vigorous physical activities, but in
most cases are unnecessary on the sports field or the school lunchroom.

Energy drinks don’t belong in any child’s diet, added Laura. The drinks contain stimulants like caffeine, guarana and taurine. Caffeine in particular has been linked to a number of harmful health effects in children. “Water should be the drink of choice,” Dr. Hewett said.

Recommendations from the American Academy of Pediatrics

No juice for infants under age 1. Intake of juice should be limited to, at most, 4 ounces daily for toddlers ages 1–3. For children ages 4–6, fruit juice should be restricted to 4 to 6 ounces daily; and for children ages 7–18, juice intake should be limited to 8 ounces or 1 cup of the recommended 2 to 2 ½ cups of fruit servings per day.
Toddlers should not be given juice from bottles or easily transportable “sippy cups” that allow them to consume juice easily throughout the day. The excessive exposure of the teeth to carbohydrates can lead to tooth decay, as well. Toddlers should not be given juice at bedtime.
Children should be encouraged to eat whole fruits and be educated about the benefits of the fruit as compared with juice, which lacks dietary fiber and may contribute to excessive weight gain.
Human milk or infant formula is sufficient for infants, and low-fat/nonfat milk and water for older children.
Consumption of unpasteurized juice products should be strongly discouraged for children of all ages.
Children who take specific forms of medication should not be given grapefruit juice, which can interfere with the medication’s effectiveness. In addition, fruit juice is not appropriate in the treatment of dehydration or management of diarrhea.
Energy drinks pose potential health risks because of the stimulants they contain, and should never be consumed by children or adolescents.
Routine ingestion of carbohydrate-containing sports drinks by children and adolescents should be avoided or restricted, because they can increase the risk of overweight and obesity, as well as dental erosion.