Experts say no sugary drinks for kids, but parents can’t do it alone

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This week, four of the largest organizations dealing with pediatric health came together to endorse new guidelines about what young children should drink. On the surface, these recommendations are not surprising: They suggest that kids under five should be drinking primarily water and dairy milk and avoiding sugary drinks and juices. 

But heeding even this intuitive advice is a major public health challenge — one that will take more than just informed consumer choices. These guidelines point to an urgent need for stronger regulations, system changes and more cooperation from industry to protect our children’s current and future health. 

Consider this: Even though the dangers of sugary drinks may be well-understood, close to half of all children between ages two and five consume sugary drinks such as sodas or fruit-flavored drinks every day. The excess sugar in these drinks is a significant driver in rising obesity rates among children. It’s now estimated that if current trends continue, more than half of today’s children will be obese by age 35.

But we can’t pin all of this on parents. Confusing labeling and misleading marketing are undermining parents’ best intentions to make the right choices for their children. 

If you want to see what parents are up against, just stroll down a typical grocery-store juice aisle. You’ll find row after row of highly sugared, fruit-flavored drinks masquerading as juices trying to sell parents on their supposed healthy virtues. These beverages assign themselves deliberately confusing names like juice drink or juice blend, and they often feature prominent photos of wholesome-looking fruit on their packaging. Their labels feature meaningless or misleading claims such as “all-natural ingredients” or “made with natural fruit juices.” 

Add in a bevy of new products — from specially engineered toddler formulas to plant-based milks that are often loaded with sugar, all claiming to be the right choice for your child’s health — and it’s no wonder parents are confused. Even nutrition experts sometime struggle to quickly find the impostors without probing the fine print. 

The new guidelines — part of Healthy Eating Research, a national program of the Robert Wood Johnson Foundation — are an attempt to clarify what’s healthy and what’s not. Experts from the Academy of Nutrition and Dietetics, the American Academy of Pediatrics, the American Academy of Pediatric Dentistry and the American Heart Association worked together to develop the recommendations, which endorse breast milk or formula for infants and primarily water and dairy milk, which has many nutrients essential for young developing bodies and brains, for children ages one to five. 

But the guidelines need corresponding action from government and industry to have an impact. As a starting point, the Food and Drug Administration needs to take a stronger role enforcing regulations and imposing new standards on food labeling and marketing. Checking the use of no- and low-calorie sweeteners in fruit-flavored drinks and not allowing pictures of whole fruit on packaging of juice drinks that are not 100 percent juice are good places to start. 

Additionally, food and beverage makers could voluntarily agree to make it easier to identify the amount of real juice and added sugars in their fruit drinks by having this information on the front of the package. Companies could help by immediately adopting new nutrition facts labels that for large food manufacturers will be required by the FDA by January 2020, which clearly identify added sugars.

They could also ensure that their products comply with recommended serving sizes. While the recommended portions of 100 percent juice is no more than four ounces for one- to three-year-olds and six ounces for four- to five-year-olds, most juice boxes are actually slightly larger, and those extra calories and sugar quickly add up.

These guidelines would confirm our common-sense understanding of what’s healthy for our kids. But the need for them also shows how difficult it can be for parents to turn their good instincts into wise, healthy purchases. We can be doing more to help parents — and, in the interest of our kids’ health, we need to be doing so. 

Mary Story is a professor of family medicine and community health, and global health at Duke University and director of the Healthy Eating Research program, which is funded by the Robert Wood Johnson Foundation. More information on the beverage guidelines, including parent-focused guides and videos in English and Spanish, can be found at


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