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A panel of nutrition experts says even 100 percent fruit juice should be limited for children. Getty Images
  • A panel of nutrition experts is telling parents that milk and water are the two best things children under 5 can drink.
  • They say fruit juice, sweetened drinks, and even plant-based milks aren’t nutritious for young children.
  • The experts note that sweetened beverages can quickly add calories to a child’s daily diet.

Wondering what’s healthy for young children to drink?

It’s simple: milk or water.

Fruit juice, sweetened beverages, and plant-based milks aren’t on the list.

According to new recommendations from a coalition of medical and nutrition organizations, children 5 and under should only drink breast milk, infant formula, water, and plain cow’s milk from their bottles or sippy cups.

These groups include the Academy of Nutrition and Dietetics, the American Academy of Pediatric Dentists, the American Academy of Pediatrics, and the American Heart Association.

“Early childhood is an important time to start shaping nutrition habits and promoting healthy beverage consumption,” said Megan Lott, MPH, RDN, director of Healthy Eating Research (HER), which released the results.

“By providing caregivers, healthcare and early care and education providers, policymakers, and beverage industry representatives a clear set of objective, science-based recommendations for healthy drink consumption, we can use this opportunity to work together and improve the health and well-being of infants and young children throughout the United States,” Lott said.

The panel said a little 100 percent fruit juice is OK for children after their first birthday, but no more than 4 ounces daily for children ages 1 to 3 and no more than 6 ounces for those ages 4 to 5.

However, it’s better to eat the whole fruit rather than juice, since it provides fiber and is more filling than juice, Dr. Kim Yu, a family physician in California, told Healthline.

Children under age 1 should drink no fruit juice — a recommendation that might surprise parents who purchase fruit juices marketed for infant consumption.

“There is the perception that if something comes from fruit or is a blend that it’s healthier,” Yu said. “But fruit juice contains up to 120 calories per serving, and that’s 10 percent of a child’s whole daily recommended caloric intake.”

Sugar-sweetened drinks — including chocolate milk and other flavored milks — should be avoided altogether, according to the panel.

The recommendations also cast a skeptical eye on trendy drinks, such as plant-based, nondairy milks derived from almonds, rice, oats, or other grains.

These other “milks” aren’t good nutritional substitutes for cow’s milk in children’s diets, the organizations said.

In fact, they “provide no unique nutritional value,” according to a press release from HER.

“Plant-based milks are not a 1-to-1 substitute for cow milk, and most parents don’t recognize that,” Lott told Healthline.

Also rejected as nutritionally inferior are so-called “toddler formulas,” marketed to young parents under brand names such as Enfagrow, Parent’s Choice, Similac Go and Grow, and Nestle Nido.

In an ideal nutritional world, children up to age 2 would drink breast milk.

However, in the United States, parents rarely breastfeed their children beyond 6 months of age.

“For young children, especially those transitioning off of breast milk or formula, cow milk is a convenient package for these essential nutrients that’s widely available and affordable,” Lott said.

Children up to 24 months old should drink whole milk, she adds. Older children can switch to low-fat or skim milk.

Lott says the new beverage recommendations — which provide specific guidance for ages 0 to 6 months, 6 to 12 months, 12 to 24 months, 2 to 3 years, and 4 to 5 years — was needed to address age gaps in previous nutritional guidance. They also address a wider range of drinks.

Yu notes that 17 percent of children in the United States have obesity, and that consumption of sweetened drinks plays a significant role in unhealthy weight gain among children.

Yu says research showing that young children who have one serving of sugary soda daily have a 55 percent higher risk for obesity than those who don’t drink soda daily.

She concedes that allowing an occasional sweetened drink is fine. “But you don’t want to make it a trend or a daily habit,” Yu said.

“My 4-year-old is generally very happy to just drink cow’s milk and water,” Erika Hueneke, a mother from Orlando, Florida, told Healthline. “About once a week we’ll let her have a chocolate milk, a Capri Sun, or a mini Sprite as a treat. Her day care has a policy to not serve sugary drinks.”

“When we talked to parents, this seems pretty intuitive,” Lott said. “But when you go into the grocery store, there are so many choices, and it’s hard to tell if something is 100 percent juice or sugar sweetened.”

School can also be a place of temptation for young children when juice, flavored milk, or even soda is available.

Panel members said that acclimating young children to drinking unsweetened beverages can have lasting health benefits.

“We know that children learn what flavors they prefer at a very early age — as young as 9 months — and these preferences can last through childhood and adulthood,” said Dr. Natalie Muth, who represented the American Academy of Pediatrics on the panel.

“Choosing healthful beverages for children is just as important as choosing healthful foods,” added Terri J. Raymond, RDN, president of the Academy of Nutrition and Dietetics.

Nancy Brown, CEO of the American Heart Association, says overconsumption of sugary drinks contributes to heart disease–related deaths of nearly 40,000 people in the United States each year.

“The seismic shift in our culture needed to change this status quo must start with our kids,” she said.

HER conducted a review of scientific literature, existing guidelines from national and international bodies, and reports on early childhood beverage consumption before convening the expert panel and scientific advisory panel that issued the recommendations.

The recommendations are intended for healthy children in the United States.

They don’t address medical situations in which specific nutrition guidance is needed to manage a health condition (such as lactose intolerance) or specific dietary choices, such as abstaining from animal products (for religious reasons, for example).

Children who can’t drink cow’s milk for health or cultural reasons would be best served by drinking soy milk. It comes closer than other nondairy milks to matching the nutritional benefits of cow’s milk.