Expert Guidance on What Young Kids Should Drink and Avoid

Sep 19, 2019, 10:00 AM, Posted by

The nation’s leading health and nutrition organizations have issued evidence-based recommendations for parents, caregivers, health professionals and policymakers.

Young girl drinking from a cup.

“Should I be giving my toddler milk?”

“What’s the difference between fruit juice and a fruit-flavored drink?”

“I thought fat was good for my kids. Why should I switch my 2-year-old to low-fat milk?”

Every day, parents, caregivers, child-care providers and others struggle with questions like these about what kids should drink—and what they shouldn’t. They’re trying to do their best for kids’ health, but it’s not as easy as it may sound.

Ensuring that kids grow up healthy includes paying attention not only to what they eat, but also what they drink, especially during the early years when they are establishing their eating patterns. To do that, parents and caregivers need clear, consistent advice from health professionals about what drinks are healthiest for their kids. And policymakers need guidance so that they can create the strongest policies possible to help all children grow up healthy.

But, faced with an array of product choices and inconsistent messages about what’s healthy and what’s not, it can be challenging to know which beverages kids should drink, especially since recommendations seem to change every few months as kids get older.

Not only that, but until now there have been no healthy beverage guidelines for kids under age 2. The U.S. government’s Dietary Guidelines for Americans include recommendations for children ages 2 and older.

Coming Together for Kids’ Health

That’s why the Robert Wood Johnson Foundation funded Healthy Eating Research, a leading nutrition research organization, to bring together experts from four prominent health organizations—the American Academy of Pediatrics, the Academy of Nutrition and Dietetics, the American Heart Association, and the American Academy of Pediatric Dentistry—in an unprecedented collaboration to develop recommendations to help parents and caregivers choose what drinks are best for young kids.

It’s hard to imagine a group with better credibility on this subject—providing parents and caregivers with nutritional guidance they can trust. Just as important, we expect that this collaboration will improve the consistency of healthy beverage advice they receive from health professionals, like pediatricians and dentists, as well.

Healthy Beverage Consumption in Early Childhood: Recommendations from Key National Health and Nutrition Organizations is designed for children from birth through age 5 and should help inform:

  • Health professionals who help shape children’s diets, including pediatricians, family doctors, dietitians and nutritionists, nurses, dentists, and child-care providers
  • Food and nutrition programs that serve children, such as the federal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), as well as the upcoming revision of the Dietary Guidelines for Americans
  • Parents and caregivers who make choices for children every day
  • Child-care centers and homes, schools, and afterschool programs that provide meals and snacks to children
  • Food banks that assist families with children
  • Restaurants and food companies, which can adjust their labeling, marketing, and serving sizes so that the beverages they offer children are healthier

The goal is to ensure that kids are served healthy beverages, whether at home, child care, school, or at a restaurant, and that parents and caregivers feel confident that they’re making the healthiest choices for their young kids.

The recommendations grew out of a 2017 workshop convened by the National Academy of Sciences to identify policy strategies for reducing consumption of sugar-sweetened beverages among young children.

During the workshop, we heard evidence that patterns of sugary drink consumption begin early in life—and disproportionately among black, Latinx, and American Indian children and those from families who have lower incomes. These families often have less access to consistent nutrition guidance as well as to affordable healthy food choices in the places where they live. Not coincidentally, children from these families are also at higher risk for developing obesity and tooth decay and, later in life, diabetes, than white children and those from families with higher incomes.

But the problem is across the board: Too many kids consume too many sugary drinks like fruit-flavored drinks, sodas, and other beverages with added sugars. The Feeding Infant and Toddler study found that, on any given day, nearly one in three (29 percent) children ages 12 to 23 months and nearly half (46 percent) of children 36 to 47 months have a sugary drink. Further, sugary drinks are the number one source of added sugar from all foods and beverages for children 12 to 47.9 months of age.

What the Recommendations Say

For most kids, the following guidelines can help set children on the path for healthy growth and development:

  • 0-6 months: Babies need only breast milk or infant formula.
  • 6-12 months: In addition to breast milk or infant formula, offer a small amount of drinking water once solid foods are introduced to help babies get familiar with the taste—just a few sips at meal times is all it takes.
  • 12-24 months: It’s time to add whole milk, which has many essential nutrients, along with some plain drinking water for better hydration. A small amount of juice is ok now, but make sure it’s 100% fruit juice to avoid added sugar. Better yet, serve small pieces of real fruit, which is even healthier.
  • 2-5 years: Milk and water are the go-to beverages. Look for milk with less fat than whole milk, like “skim” or “low-fat.” If you choose to serve 100% juice, stick to a small amount, and remember adding water can make a little go a long way!

We need to put our children on a path to drinking healthier beverages early, and these evidence-based recommendations are a perfect place to start. We are confident that these guidelines will supply parents, health care providers, child-care providers, and other caregivers with consistent information, messages, and tools for providing the right beverages for children at the right age and setting them up for optimal health. And they provide policymakers and industry leaders with the information they need to set policies and make products that better support children’s health.

Learn more about the recommendations and share with your networks.


about the authors

Mary Story, PhD, RD, is professor of Global Health and Community and Family Medicine, and associate director of Education and Training, Duke Global Health Institute at Duke University. She started this position in January 2014. Read her bio.

Tina Kauh, PhD, senior program officer, RWJF, develops new research and evaluation programs, supports the development of team strategy, evaluates the work of grantees, and disseminates key learnings. Read her bio.