Children younger than one should drink breast milk or formula, and should only drink fruit juice if advised by a doctor, according to the American Academy of Pediatrics. The organization made the recommendation in the journal Pediatrics amid concerns about rising childhood obesity and tooth decay.

This is the first time since 2001 that the doctors’ group has reviewed its recommendation on fruit juice, which is a leading source of dietary sugar.

Between the ages of one and four, young children should consume no more than 118 milliliters of fruit juice, the doctors’ group says. The academy recommends that children between the ages of four and six restrict their juice intake to no more than 177 milliliters a day, while children between seven and 18 should limit their fruit juice consumption to 236 milliliters.

The new guidelines recognize that 100 percent natural and reconstituted juice can be a healthy part of a child’s diet. However, the group said juice should count for no more than one of the two to two-and-a-half recommended servings of fruit per day.

If fruit juice is given to young children, the academy discourages parents from putting it in a bottle or “sippy” cup, which may be in a child’s mouth all day, promoting cavities. Instead, it’s recommended that the juice be consumed all at once in a cup.

The group had previously recommended that parents wait until a child is six months old before introducing fruit juice to the diet. However, in light of the growing rates of obesity and other negative health effects, the American Academy of Pediatrics revisited the recommendation.

Juice is a frequent beverage of choice among U.S. teenagers and children, who experts say would rather drink it than water.

Dr. Steven A. Abrams, chairman of the Department of Pediatrics at the Dell Medical School at the University of Texas, and co-author of the policy statement, said there was nothing “magical” about the academy’s revised recommendation. 

Dell said the group simply saw no need or beneficial role for juice in very young children.

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