Juice for babies and toddlers: when, how much and better drinks

Babies under 12 months don't need fruit juice. The AAP says juice offers no nutritional benefit before age 1 and shouldn't be part of a baby's diet. Australian and UK guidance agrees that juice isn't needed in the first year, and breast milk or formula stays the main drink, with sips of water from around 6 months.

After 12 months, juice is still optional. If you offer it, keep it small, serve it with a meal in a cup, and choose whole fruit most of the time. This guide sets out each country's limits, why whole fruit is better, what juice does to teeth, what the sources say about juice for constipation, and the drinks to offer instead.

Can babies have juice before 12 months?

All three countries say no juice is needed in the first year:

The CDC's list of foods and drinks to avoid or limit says children under 12 months shouldn't have any fruit or vegetable juice, and that juice isn't necessary after 12 months either. The AAP's position on fruit juice adds that juice can encourage a preference for sweet flavours over plain water. The NHS guide to drinks and cups says babies under 12 months don't need fruit juice or smoothies.

In Australia, Pregnancy, Birth and Baby, drawing on the Australian Infant Feeding Guidelines, says it's not recommended to offer drinks other than water and breast milk or formula before 12 months, and lists juice, soft drinks and cordial as unsuitable. The one exception in the sources is juice for constipation, covered below.

How much juice can a toddler have?

Juice isn't necessary after 12 months, but if you choose to give it, the limits differ by country:

The AAP's 2017 recommendations say juice should be limited to, at most, 4 oz a day for toddlers aged 1 to 3, and 4 to 6 oz for children aged 4 to 6. The NHS guide to feeding young children suggests diluting juice 1 part juice to 10 parts water and serving it with meals, and says that from age 5, undiluted juice is fine, up to 1 glass (about 150 mL) a day with a meal.

Australian guidance is the strictest. The Royal Children's Hospital Melbourne's sweet drinks tip sheet (2013) says children don't need any juice and, if it's chosen, to limit it to 1 small cup of juice with no added sugar once or twice a week. Pregnancy, Birth and Baby's healthy eating guide for children lists fruit juice among drinks to limit or avoid.

"Fruit drinks" and "juice drinks" are not the same as 100% juice. The CDC says they contain added sugars and should be avoided, and that children under 2 shouldn't have added sugars at all.

Why is whole fruit better than juice?

The AAP says juice offers no nutritional benefit over whole fruit, and that whole fruit also provides fibre and other nutrients. The Royal Children's Hospital Melbourne explains that a child needs only half an orange for their daily vitamin C, but a glass of juice takes three or four oranges, concentrating the sugar. It adds that fresh fruit supplies fibre that helps prevent constipation and keeps children full for longer.

Easy swaps:

• Instead of apple juice, offer stewed or grated apple.
• Instead of orange juice, offer peeled orange segments with the membrane and seeds removed, cut small.
• Instead of a smoothie, offer mashed banana or soft fruit with yoghurt and a cup of water.

See banana for babies, strawberries for babies and yoghurt for babies for safe ways to serve these by age.

How does juice affect babies' teeth?

Juice is sweet and acidic, and frequent sipping keeps sugar on the teeth. Australia's healthdirect's guide to children's teeth says children, and even babies, can get tooth decay, especially from bottles containing juice, cordial or other sweet drinks. It suggests encouraging water when your child is thirsty rather than juice, and never letting a child fall asleep with a bottle of milk, formula, juice or any sweet liquid.

The AAP says toddlers shouldn't have juice from bottles or easy-to-carry sippy cups that let them sip it throughout the day, or at bedtime. The NHS says giving juice at mealtimes rather than between meals helps reduce the risk of tooth decay, and suggests an open or free-flow cup. The NHS list of foods to avoid advises avoiding food and drink with added or natural sugars, including fruit juice and smoothies, for children aged 4 and under. For moving from bottle to cup, see cups and dropping bottles.

Can juice help a constipated baby?

This is the one area where some sources suggest juice before 12 months, and they don't all agree.

• Australia. Pregnancy, Birth and Baby's constipation guide says to speak with your health visitor or doctor if your baby is under 6 months. From 6 months, it suggests prune or pear juice, or extra water, plus more fruit and vegetables. For older babies, it suggests juice diluted half prune juice and half water, starting with 10 mL and increasing until poos are soft.
• US. The AAP's constipation symptom checker suggests small amounts of pear or apple juice for constipation in babies older than 1 month, with prune juice after 3 months, and gives amounts by age. This is an exception to the AAP's general no-juice advice.

Because the advice differs, check with your GP or health visitor before giving juice to a baby under 6 months. The Royal Children's Hospital also notes that sweet drinks can cause loose poos in young children. Constipation in babies covers what's normal, what else helps and when to get urgent care.

What should my baby or toddler drink instead?

• Under 6 months: breast milk or infant formula only. Pregnancy, Birth and Baby says this applies even in hot weather.
• From around 6 months: breast milk or formula as the main drink, plus small sips of water from a cup. The AAP's recommended drinks guide suggests about 120–240 mL (4–8 oz) of water a day from 6 to 12 months.
• From 12 months: Pregnancy, Birth and Baby says the best drinks are water and milk, and suggests about 4 cups of fluids a day for children aged 1 to 3. The AAP suggests about 2 cups (16 oz) of milk and 1 to 4 cups (8–32 oz) of water a day at 12 to 24 months.

Water for babies covers how much water to offer and when to boil it, and moving to cow's milk covers which milk and how much after 12 months.

If you do give juice, how can you make it safer?

1. Wait until after 12 months. Before then, offer whole fruit and water instead.
2. Choose 100% juice with no added sugar. The CDC suggests checking the label.
3. Dilute it. The NHS suggests 1 part juice to 10 parts water for young children.
4. Serve it with a meal, in an open cup. Not in a bottle, not to sip through the day and not at bedtime.
5. Use pasteurised juice only. The AAP says children of all ages should avoid unpasteurised juice.
6. Don't use juice for illness. The AAP says juice isn't appropriate for treating dehydration or diarrhoea. Oral rehydration solution is the better choice; gastro in babies explains the Australian advice on well-diluted juice for a child who refuses it.

What's worth noting about drinks?

If you're trying to cut back on juice or work out a constipation pattern, a few days' note of what your toddler drinks, how much, and when, alongside their poos, helps you and your GP or health visitor see what's going on.

When should I get help?

Call 999 now if your child:

• has green or yellow vomit, or is vomiting with a swollen, hard tummy (see constipation in babies)
• has had no wet nappy or wee for 12 hours, as the NHS urgent-help guide lists
• is floppy, much sleepier than usual or hard to wake

Get medical help today if your child:

• has diarrhoea or vomiting with fewer wet nappies than usual (see signs of dehydration)
• has blood in their poo

Talk to your GP or health visitor if:

• your baby is under 6 months and you think they're constipated, or constipation hasn't improved after a few days of changes at home
• your toddler drinks a lot of juice or milk and isn't eating much food
• you notice marks or spots on your child's teeth; Australia's healthdirect suggests seeing a dentist from a young age