Juice Boxes, And Fruitless Fruit Juice

Let’s Try A Different Straw

Thanks to Gretchen’s recommendation of the litterless juice box, Noah was trying out a new cup tonight. This one is slightly easier to squeeze to get juice out than our previous cup. It took him a minute to figure out what was going in his mouth, but as soon as that juice shot out he was trying hard to figure out how to suck from the straw. He was starting to get fluid up by himself towards the end. I was pretty impressed with this juicebox and would recommend it for first attempts with the straw.

 A Pediatrician’s Two Cents On Juice

downs syndrome baby boy child drinking juice box

He wants that juice!

Just because juice is named after fruit does not mean that it is healthy. In hact it is LOADED with sugar. During my clinic while I was a resident, I frequently saw kids for obesity. Juice is usually a child’s worst enemy when dealing with weight. Parents will come in with their overweight child and I find out they are drinking 24 ounces (3 cups) or more of juice per day. That is over 300 calories. A child should drink 4 oz of juice per day, yep you heard me correctly, 1/2 cup.

I always give the kids options for goals they should set to help with weight control. The first goal they usually choose is to elimnate ALL calories from things they drink. This means NO JUICE. Flavored no calorie water (or low calorie) is a great substitute for juice. Five calories vs 120 is a pretty impressive change. Just cutting out juice would save the above child over 2100 calories per week!!!

downs syndrome baby boy child drinking

"Give me more mommy."

I am sure that you have heard, eat the fruit rather than drink the juice. Kids can see a significant change in their body mass index just be doing this one step. By eating the fruit they will get the nutritional value for much less calories, if there was any true nutritional value in the juice in the first place.

Children should never be encouraged to lose weight unless advised by their pediatrician to do so. The main goal is to maintain a weight while they grow taller. This is why the body mass index is helpful as it puts weight in relation to their height. If you look at a growth chart, you will see that if a child were to maintain their weight as they get older they would cross into lower percentiles. We want to halt the acceleration of growth that is making them surpass into higher and higher percentiles.

A Juice “Bonus”

Another fun present that too much juice can give your toddler is diarrhea. Juice typically contains sorbital. Some of you may recognize this name as it is the sweetner used in sugar-free candies. You and your toddler can’t digest this form of sugar and when it is left in your GI tract it also draws in water and thus you end up with diarrhea.

What Does This Mean For A Child With Down Syndrome

child with down syndrome sticking tongue out

All done. And very happy.

Children with Down syndrome are at risk for obesity. For one, they usually have a slower metabolism (meaning they will not need as many calories to maintain their weight) and two they tend to be less active due to either physical restrictions or there is nothing offered for them to do.

I don’t know about you but we faught for Noah to gain weight at the beginning, and I find it slightly funny that we will eventually be changing our view of trying to keep weight off of him. We as parents have to make a major mental change when it comes to our child’s weight. Hmm, maybe that is another reason our little guys struggle with weight 🙂

Some of your ears might have perked up with the idea of juice causing diarrhea. Juice can be a helpful tool with constipation as well. The juices that are most helpful tend to be apple and pear (and yep they have a high level of sorbitol). However you should use juice in limitation to help with constipation, 4 oz or less per day. The better way to help is that once a child is able to eat fruits and vegetables to use that rather than juice to help with constipation.

Has your child tried to drink out of one of these juice boxes, or tried a straw?  How did it work for you?  Also, how much juice do you allow your little one to drink?

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  1. Noah is beautiful and perfect in every way. Made just as he was meant to be. I can’t say I know what it’s like to be the parent of a differently abled child, because I don’t. My friend, Candace, just had a baby girl (Violet), who was born with Trisomy 21. Another friend of ours, Renee, made me cringe when she said “How unfortunate…I’m so glad my kids don’t have anything wrong with them.” (both of her children are obese and poorly behaved). I clearly and calmly stated “There is nothing “wrong” with Violet, she came just as she was meant to.”. I should’ve told her that overfeeding her children and raising them to be spoiled brats is more wrong than any child with special needs could ever be, but, I held my tongue. She’ll learn soon enough.

    I can’t say it’s going to be easy for Candace or even Violet. The truth is, it won’t be. I can only say parenting isn’t easy, period and it’s never ever unfortunate to be a parent. Seeing Noah learn and succeed takes the stigma people associate with Downs Syndrome and throws it out the window. Thank you so very much for sharing precious little Noah with us. He’s truly a gift in every sense of the word. I’ll be sending the link to this site to both of my friends. It will give Candace hope and reassurance that Violet will go far in life and be just as good (even better if you ask me) as any other child. It may also give Renee a little needed lesson in humility. Keep posting, please! My husband and I love Noah’s videos!

    • Hey Kim, thanks for your comment!

      I’m quickly learning how many people are just uneducated when it comes to Down syndrome (and other things like it.) When Noah was born I knew almost nothing about Down syndrome, and so I can completely understand.

      That was one of the reason s we wanted to start his website, to help educate the world. The videos, the posts, the pictures; we want to give people an inside look at what raising a child with Down syndrome is like. I’ve found many people to be surprised to learn that our family is much more “normal” then they expected.

      I’d suggest forwarding our site (and our Facebook page: http://facebook.com/noahsdad.com) to your friends. Perhaps they just need a little education. 🙂

      And thanks again for the kind words and support about Noah’s video. It’s comments like that, that motive us to keep doing them. 🙂

  2. Yes! I agree with Kim. Thank you. What I would like to know is when or what age you introduced “juice” to Noah? If not juice, then what? Ever heard of Ultima Replenisher? It suppose to be all natural. Also, how did you come to discover the limitless juicebox? You are so lucky to be a pediatrician and get info. I sometimes worry that I might not get enough info or info at the right time. Do you use a website to keep up with things or do you just know? Finally I was wondering if you could provide a “milestones” blog for Noah and/or a generalization of what to expect from a child with DS at such and such age? I don’t know if I am explaining this right, but something that can show me where I might stand compared to Noah. Not so much in typical stuff Ike smiles, rolling, etc but rather physical therapy (when you started a certain exercise) or when you started a certain device (Ike drinking from a straw) or even when to check for something medically (like the CBC). Believe it or not I go to the doctors ( even the genetics doctor) or physical therapist and surprise them with questions because I saw something on your blog.
    Hope this makes sense. Thanks!

    • Hey Vanessa, I have been thinking about doing the very thing you are talking about. Give me a few days to work on it. Make sure your pediatrician has the AAP guidelines for children with DS. That is what I follow for my information on when to get tests and see a specialist. The developmental stuff I have learned on my own. I am going to post a resource page tonight that will have some developmental books to get that will help with home therapy. One of my favorite resources is the website mentioned. The resource post will be under the guide for DS:)

  3. Peds NP here–agree with the above 🙂 Beautifully written.

    Ellie drinks from the Munchkin straw cups. She does great with them and we started around 6 months of age but many parents wait. She can also drink from a regular straw but has more trouble–she is now almost 2yo. Ellie doesn’t drink juice, but she will drink applesauce and pureed vegetables through a straw to increase the strength those oral muscles.

    For the above commenters, here is a link to a developmental chart specific to Ds http://www.down-syndrome.org/information/development/early/?page=7 This website also has all sorts of other information about development and health as it pertains to individuals with Ds. Try hard not to compare you kids to other kids, even those with Ds–I know it is hard! I do it. I try hard to compare Ellie to Ellie. As in I compare what Ellie is doing now to what she was doing 3 months ago. It is hard not to compare, but all kids are different, with or without an extra chromosome.

    • I absolutely love that website. I have been reading it since a few weeks after Noah was born. Their developmental chart is AWESOME! It is much more detailed than what your pediatrician will likely provide 🙂 I have yet to read their reading system but I can’t wait to dig in.

  4. mammasnoop says

    my son is lactose intolerant and it was very hard to get him to drink water. There are vit.c fortified juices that are low in calories. It is all a matter of what is healthiest for your child. They need hydration to not become dehydrated and to keep their lazy bowels moving, so if you loose your method of hydration and don’t want to give them medication to get them “going”, use whatever method works for you.

    • @mammasnoop,

      Every child is unique, that’s for sure. 🙂

      Not everything will work with every child. That’s why it’s so important to make sure you and your pediatrician establish a plan for your child.

      What we post is what has worked for us, and not necessary every child.

      Noah also has an issue with pooping. He has a milk protein allergy, so we have to give him a special (and more expensive) formula, and sometimes milk of magnesia.

      It’s a journey (an extremely fun one!) for sure.

  5. Great post, Abbie! It really puts things into perspective when you mentioned that 2100 calories can be eliminated per week just by replacing juice with water. Wow! More parents need to read this…and not just parents of children with DS, all parents!

    Austin started with the honey bear cup. We tried the juice box and a few other straw cups too. He did really well with the honey bear cup and juice box. Now, he can pretty much drink out of any straw cup…but our personal favorites are: Playtex Straw cup and (surprisingly) Take N Toss Straw Cups.

    Austin isn’t a big fan of juice and actually enjoys drinking water. He usually has 1/4 juice 3/4 water with his afternoon snack and that’s all he will tolerate of juice. I guess that’s a good thing, although he’s a finicky eater…so we have to rely on Pedisure (1-2 a day…depending on how much he eats) to keep any sort of weight on him.

    It looks like Noah is doing well…so proud of him! I love reading updates and seeing his progress:)

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