The debate over breast feeding and bottle feeding has been at the forefront of infant-feeding concerns over recent years, but now the American Academy of Pediatrics, as well as local health professionals, are warning about possible complications from another traditional childhood beverage - fruit juice.
The academy recently issued a statement that fruit juice can cause gastro-intestinal problems and diarrhea. Doctors and dentists warn that too much juice can cause bad dietary habits and tooth decay.Dr. William Klish, a member of the academy's Committee on Nutrition and head of nutritional services at Texas Children's Hospital in Houston, says the gastro-intestinal problems are mostly associated with apple and pear juice, both containing sorbitol, a naturally occurring sweetener.
"Sorbitol can't be digested and passes to the large intestine where it reacts with the naturally occurring bacteria there to create acids and gas and cause loosening of the stool," Klish said.
"Traditionally we've used juices when a child has diarrhea, to replace the liquids they've lost," Klish said. "Now we're seeing evidence that the juices can make the problem worse. We always know that some children get stomach aches when they eat green apples, and now we're realizing that the sorbitol there is the same sorbitol that's in juices."
Klish also said juice is low in calories and has few vitamins.
"It's a traditional beverage and is easy to give children who don't like the taste of water," Klish said, "but parents should know that drinking four or five 8-ounce servings a day can cause problems."
Fort Worth, Texas, pediatrician Dr. Audrey Rogers routinely advises parents of her patients to avoid fruit juice.
That juices are "natural" confuse parents, she said, and they don't realize they're giving their children something that can be bad for them.
"Juice is nothing but empty calories, full of sugar," Rogers said. "They have very few nutrients, and the nutrients they do have are nothing that a child can't get from a chewable multivitamin with iron. A child can get everything he needs from milk, water and his solid foods."
Pediatric dentist Dr. Bruce H. Weiner sees another problem that results from too much sweetness - baby bottle decay.
"Children are hospitalized every week with baby bottle decay, and it's the result of babies being put to bed with bottles," Weiner said.
Saliva, the mouth's main bacteria-fighting agent, shuts down when children are sleeping, allowing the sugar present in juice or milk to eat away at their forming teeth.
"Any of the `oses,' lactose or fructose, will do the damage but I'd say most cases can be put down to apple juice," Weiner said. "Parents think it's cute when kids ask for apple juice and give it to them with little thought."
Weiner suggests that any juice should be given to children with a meal, and parents should not allow children to carry bottles of juice around to use as a liquid pacifier. - Beverly Bundy, Fort Worth Star-Telegram