I recently wrote about my 4-year old who only drinks milk from her straw sippy cup wondering when to give them up. A number of you mentioned you had no idea either. So I asked around, did some investigative work and discovered 5 important things parents need to know about starting, using and stopping sippy cups.

1. Start them early: Babies usually start solids by the time they’re 6 months. This is also the time it is okay to introduce water and (diluted) juice. It’s a good idea to get a few starter sippy cups, with handles, lids and a hard spout, to get your child used to the idea that liquids (including milk) can come in something other than a bottle or breast.

While babies will have fun throwing these cups for a while, by 9 months many will start drinking from it. The American Academy of Pediatrics (AAP) recommends children stop the bottle and drink from sippy cups by one year of age.

2. Use sippy cups wisely: Once your child is using a sippy cup you need to use them wisely. According Healthy Children, a website powered by the AAP, avoid using sippy cups as a pacifier or allowing kids to sip on them throughout the day unless its filled with water. Sprout sippy cups filled with milk, juice or juice drinks, allow sugar (even natural sources) to stay in the mouth longer and increase the risk of tooth decay.

This may be why cavities have increased by 15 percent from 1994 to 2002 in children 2-5 years old according to the Centers for Disease Control and Prevention (CDC).

3. Drop the sprout cups ASAP: Traditional sippy cups are only supposed to be used as a short transition to real cups. Overuse of sippy cups can cause more than dental caries, they can also contribute to speech difficulties.

Because children suck on sippy cups the way they do bottles, if used too long, it can change the position of the tongue and teeth, potentially causing lisps and articulation problems. According to this Web MD article, the traditional sippy should only be used for about a month. Using cups with a straw are much better for speech development and dental health.

Bottom line: switch to a straw cup as soon as you can.

4. Encourage kids to drink from regular cups: The AAP recommends teaching children to start drinking from regular cups between 12 and 15 months. Once children master this, you might want to use regular cups at meals and straw cups for water on the go.

Another drawback to young children sucking for too long is something called Oral Myofunctional Disorder (OMD). According to the International Association of Orofacial Myology’s website, the symptoms include one of the following:

1. abnormal thumb, finger, lip, and tongue sucking habits
2. an inappropriate mouth-open lips-open resting posture problem
3. a forward interdental rest posture of the tongue problem
4. a forward rest position of the tongue against the maxillary incisors problem
5. a lateral, posterior interdental tongue rest posture problem
6. inappropriate thrusting of the tongue in speaking and/or swallowing.

These abnormal habit patterns, functional activities, and postures can open the dental bite beyond the normal rest position. This can result in a disruption of dental development in children and over-eruption of selected teeth in adults.

A prime example of an OMD, familiar to all pediatricians and dentists, is a retained sucking habit or use of a sippy cup. While it is tempting to ignore such habits since some children do outgrow them, many children do not spontaneously discontinue noxious habits and will need help in eliminating the habits.

5. Part with sippy cups between 2 and 3 years: According to the AAP Pediatric Nutrition Manual, children are developmentally ready to give up sippy cups by 2 to 3 years of age. Will it hurt to use them to prevent spills once and awhile? Probably not. If your child uses an open cup and some sippy cups with straws it is probably okay.

But just like we advance textures with our babies and let toddlers use utensils, we have to do the same with drinking. It’s an important and overlooked part of development.

Anyone having trouble getting your child to give up the sippy cup habit?

Resources/References

AAP Pediatric Nutrition Handbook — 2008

Preventing Tooth Decay in Children

So long Sippy Cups Hello Straws

IAOM — Dentists and Physicians

If you watch TV you’ve probably seen the commercials for Nestle’s Juicy Juice. Juicy Juice has a line of 100% juice and two other functional juice beverages: Immunity and Brain Development. How do their product claims stack up? Let’s take a close look…

Juicy Juice Fruit Juice: This is your standard 100% Fruit Juice product with added vitamin C in a variety of flavors. Check out 5 Things Every Parent Needs to Know about Fruit Juice for more tips on choosing juice. In general, you want juice products that are 100% fruit juice. So with this product, what you see is what you get.

Juicy Juice Brain Development: This product contains DHA, an essential omega-3 fatty acid. Take notice of the claims used for this product. The Juicy Juice website says “enhanced with DHA, an essential building block for brain development.” This is an example of what the FDA calls a “structure function” claim. As long as the product is a good source of a nutrient/ingredient, which the FDA generally defines as providing a minimum of 10% of the recommended daily value (DV), marketers can talk about its structure and function in the body. Don’t mistake this for meaning that the product has been proven to enhance brain development (a company would need to do a clinical study to make such a claim).

DHA is indeed an essential building block for brain development that is especially important for young children. But the two questions that stand out to me the most are:

1. How much DHA do children need; and
2. How much DHA is in the product?

One 4-ounce serving of Juicy Juice Brain Development contains 16mg of DHA. The AAP recommends no more than 4-6 ounces of fruit juice per day for children up to 6 years old and 8-12 ounces for older children. There currently are no recommendations for DHA in the United States. International health groups, however, do have recommendations for adults. According to the DHA/EPA Omega-3 Institute,if you take international recommendations and adjust them to the calorie intakes of young children, 2-3 year olds need roughly 145 mg per day DHA and 4-6 year olds need 200 mg.

So if your child drinks 4-6 ounces of juice that’s 16-24 mg/day, that’s not a significant amount. But if it’s used in addition to other products that contain DHA, it can help. For example, if a 3-year old drinks 2 cups of milk with DHA (64mg), 6 ounces of Juicy Juice Brain Development (24 mg) and an omega-3 enriched egg (75mg) then that’s 163 mg DHA per day. Now we’re talking.

So if you are making an effort to have your child consume a variety of DHA-rich food sources this product may be worth buying. For more on the benefits of DHA see 3 Things Most Parents Don’t Know About Omega-3 Fatty Acids.

Juicy Juice Immunity:This product makes structure function claims based on its fortification with vitamin C and Zinc. Both of these micronutrients play important roles in immune function. So the claims are “to help support immunity” and “contains C and zinc for immunity.” The product contains 100% DV of vitamin C, like a lot of juices do, but it only contains 10% DV for Zinc. Like I said earlier, this is enough to make a claim but may not be the levels parents would expect.

The third ingredient is prebiotic fiber (gum acacia). Prebiotic fibers help to promote the growth of “good” bacteria in the gastrointestinal tract. One 8-ounce serving contains 3 grams of fiber. A healthy GI tract also plays a role in immunity. My guess is that because the role of prebiotics on the immune system is not clearly defined, they are using the claim “prebiotic fiber for healthy digestion” for this ingredient.

Because there’s not a specific amount of prebiotics recommended for kids and adults, it’s difficult to tell if this added ingredient makes a difference health wise. Prebiotic fibers can also be found in other foods including bananas, whole wheat, garlic, onions, tomatoes and asparagus.

Overall, I wouldn’t pay up for this product but I might choose to buy it if the price is right.

Got a product you’d like me to review? Send it through. Have you tried Juicy Juice? Let us know what you think!

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Everyone seems to have an opinion about whether or not children should drink juice. Some parents wouldn’t dream of bringing it in to their home while others couldn’t last a day without giving it to their kids. But what’s the real scoop behind juice and its role in your little one’s diet?

Here are 5 things every parent needs to know about buying and serving the fruity drink that most kids love.

1. Look for 100% fruit juice:
When choosing fruit juice look for “100% fruit juice” on the package. This tells you that the juice is squeezed from the fruit or made from juice concentrate with some other ingredients like additional vitamin C. Fruit juice, like whole fruit, contains a variety of vitamins and minerals important for a balanced diet.

A recent study published in the Archives of Pediatric & Adolescent Medicine, looked at the diets of children 2-11 years old. The kids who consumed 100% fruit juice had lower intakes of fat and saturated fats and higher intakes of vitamin C, vitamin B6, folate, iron, and whole fruit than those not drinking juice. There was no association between fruit juice intake and being overweight.

2. Check “how much” you are serving up:
While 100% juice can play an important role in a balanced diet, letting your child sip on it all day isn’t a good idea. That’s because, unlike fruit, juice doesn’t contain fiber and it can be consumed in large amounts very easily, taking the place of other nutritious foods in the diet.

The American Academy of Pediatrics (AAP) recommends limiting juice to 4-6 ounces for children 1 to 6 years old and 8-12 ounces for kids 7-18 years old. Many of the sippy cups for toddlers and older children hold up to 16 ounces so measure the amount recommended once and then eye ball it. If your child wants more try watering it down.

3. Be on the look-out for juice drinks:
Drinks that contain less than 100% juice are often called “juice drink,” “juice cocktail” or “juice blend.” These drinks contain less than 100% juice, have added sweeteners and are often fortified with vitamin C. Some contain so much sugar and little juice that they are, nutritionally speaking, similar to a can of soda. Take Sunny Delight for example. It may have added vitamin C (and now has calcium and D) but it’s first two ingredients are water and high fructose corn syrup and it contains 2% or less juice.

4. Watch “when” and “how” you serve juice:
Sipping on juice throughout the day can increase the risk of dental cavities. The AAP recommends parents give juice in a cup, never in a bottle, for babies 6 months or older. And the best way to combat the risk of cavities is to serve juice with a meal or snack while letting your little one sip on water between meals.

5. Get adventurous with juice:
Who says you have to serve only apple, orange or cranberry juice? In fact, there are many antioxidant-rich juices on the market these days. Try pomegranate, blueberry or grape juice, which are especially high in antioxidants. Darker juices tend to be higher in these disease-fighting nutrients.

Try darker juices while making smoothies or simply use it as the juice of choice for the week.

When done right, 100% juice can play an important role in your child’s diet. And it’s especially refreshing all summer long.

Subscribe to Raise Healthy Eaters to stay up on the latest in childhood nutrition.

For more on what to feed your kids see our Nutrition for Children section.
References

Nicklas TA, O’Neil CE, Kleinman R. Association between 100% juice consumption and nutrient intake and weight of children aged 2-11 years. Arch Pediatr Adolesc Med;162(6) 557-565.

The Use and Misuse of Juice in Pediatrics. Pediatrics. May 2001.