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Dr. Bill and Martha Answer:
Is fruit juice a necessary component of an infant's diet?

Question:
I have a 6-1/2-month-old daughter who is very active and healthy. At her last visit to get her shots, the nurse said we must start giving her 4 ounces of juice a day. Up until this time I have breastfed her and gave her breastmilk in a cup during her evening meals of baby food. The nurse explained that juice offers essential nutrients that breastmilk cannot offer. For some reason I have always been partial to believing that juice is not necessary to an infant and if anything can do more harm than good. Hopefully you will be able to help me with this dilemma.

 Answer:
You are correct; juice is not necessary for an infant. In fact, juice is way down on the list of healthy foods for babies, for several reasons. First, fruit juice is not a nutrient-dense food. Most fruit juices contain nearly as many calories per ounce as milk, but nearly all of the calories in juice come from carbohydrates. Juice is not a source of balanced nutrition. Infants who drink large amounts of juice consume a lot of calories to take the place of calories of more nutrient-dense foods, such as your breastmilk and foods containing protein, minerals and healthy fats. In my practice I have noticed a condition I have dubbed “juice abuse.” Some infants are not growing optimally (not thriving) because they have too much juice. Also too much juice can interfere with growth, especially juices with high fructose and sorbitol that can lead to chronic diarrhea and diminished absorption of vital nutrients. Juice is best used to flavor water. Toward the end of the first year if your child does enjoy juice, limit her consumption to no more than 12 ounces a day and dilute with at least equal parts of water. Get used to offering your child your breastmilk or water if she is thirsty. Children have a natural sweet tooth and will prefer juice to water unless they are programmed from doing so. Get your child into the habit of drinking water as a thirst quencher, or as a second choice, diluted juice. Another problem with juice is tooth decay. Avoid letting her lie down with a bottle of juice. When a child falls asleep the natural rinsing action of the saliva diminishes, allowing the sugary juice to bathe the teeth and lead to decay.