I'm Thirsty! Choosing Healthy Drinks for the zero to five crowd.

Host: Dr. Jennifer Hunter, Assistant Director for Family and Consumer Sciences Extension, University of Kentucky 

Guest: Dr. Courtney Luecking, Extension Specialist for Nutrition and Health

Episode 30, Season 2

0:02 Welcome to Talking FACS; what you need to know about family, food, finance and fitness. Hosted by the University of Kentucky Family and Consumer Sciences Extension Program, our educators share research knowledge with individuals, families and communities to improve quality of life.

0:21 Dr. Jennifer Hunter: Hello and welcome back to Talking FACS. This is your host, Dr. Jennifer Hunter, Assistant Director for Family Consumer Sciences Extension at the University of Kentucky.

Today, I'm pleased to have joining me, Dr. Courtney Luecking, Assistant Extension Professor for Dietetics and Human Nutrition. Welcome, Courtney.

0:37 Dr. Courtney Luecking: Thank you. Look so happy to be here.

0:39 Dr. Hunter: Today's topic is about healthy drinks for our little ones from the very earliest zero to five years of age. And I think for our parents or even grandparent listeners, that this is something that's kind of a big deal, because if you're eating out or even eating at home and sometimes our kids don't always ask for the healthiest of options. And just helping us understand more about how to make those healthy choices for our little ones.

So, thank you for joining us and sharing. And we'll just kick off a little bit about what in general are the recommendations for healthy drink choices.

1:17 Dr. Luecking: Yes. So, it's interesting. These recommendations were just released this fall. And they came from a group of the leading experts of nutrition professionals and medical professionals for our young children.

1:31 Dr. Hunter: That just blows my mind that there wasn't general recommendations before now.

1:35 Dr. Luecking: I totally agree. But I think it's really timely and really important because over the recent years, we've just really been starting to see more and more evidence about the importance and effects of what children are eating and drinking early in life.

A fun fact is that our flavor preferences start to develop before we're even born. And so, thinking about what mothers are consuming when they're pregnant and then more importantly, what children are consuming once they're born in those first five years can have short term impacts on their growth and development and longer term impacts on their health and even their habits and preferences.

2:14 Dr. Hunter: So, I think we could do an entire podcast on that topic, because just the amount of questions that just popped into my head, as you were mentioning that. But I do just have one that I'm going to need answered now. So, does that mean mom is a picky eater while pregnant, that the little one is also more likely to be a picky eater?

2:32 Dr. Luecking: You know, it could be. I don't know that the complexity of that has been studied. But for example, mothers who consumed carrots or carrot juice during pregnancy and while they were nursing, those infants were more likely to have positive responses when exposed to that flavor of carrot juice as an infant. And so, it's not destiny, but it can definitely impact children's preference.

2:56 Dr. Hunter: The reason I asked is that –

2:58 Dr. Luecking: Not that it’s personal or anything.

2:59 Dr. Hunter: Not that it was personal. The reason I asked is that I do tend to be somewhat of a picky eater in life. And my husband push me really hard with both of our kids about eating a balanced and healthy diet and a wide variety of diet when I was pregnant with them. And I will say that both of my kids will eat anything, which always really surprises me. I'm like, “Where did these children come from because that's not that's not me.” But they will eat a wide variety of diet.

But that was the reason I asked because he pushed me really hard to make certain that I wasn't just being a super picky eater because he kept saying, “I think that can make a difference. I think you can make a difference.”

3:40 Dr. Luecking: Your husband was a wise man.

3:43 Dr. Hunter: But back to our healthy drinks.

3:44 Dr. Luecking: Yes.

3:43 Dr. Hunter: Why do we need recommendations?

3:48 Dr. Luecking: We need recommendations because children are not consuming the types of drinks that they need to be to have that healthy growth and development. And there was a lot of confusion among caregivers. So, whether that's parents, maybe grandparents, parenting children and caregivers outside of the home and even policymakers.

So, that's where this grouping of organizations came together and really saw the value and importance for having standard guidelines. So, not that one organization had these recommendations and another organization told you something else, but to really get rid of the confusion and have everyone on the same page of, “What do we know at this point in time?”

Because we know that research is constantly going on and maybe we'll tweak some recommendations over time. But getting rid of that confusion and giving people sound advice for what to offer and what to avoid for children during those earliest years.

4:43 Dr. Hunter: Where do the recommendations actually come from?

4:45 Dr. Luecking: These were developed by experts at the Academy of Nutrition and Dietetics. They are an organization of nutrition professionals. The American Academy of Pediatrics. So, think about those pediatricians that you go to for your children. The American Academy of Pediatrics Dentistry, because as we’ll talk about what we put in our mouth, food or drink can have a big impact on our teeth and our oral health. And then the American Heart Association. And this was all under the leadership of the Healthy Eating Research Group, which is a leading research organization.

5:19 Dr. Hunter: And in a nutshell, can you just share a little bit with us about what the recommendations actually state for what our youngest children should and probably maybe more importantly, should not be drinking?

5:31 Dr. Luecking: Yes, these are general guidelines. So, I will kind of say that every child is different. But by and large, these guidelines will be appropriate for a majority of the children and to support healthy habits now, that will carry into the future.

And in general, water and milk are going to be the best drinks for children. They help them stay hydrated, particularly water. And milk also can provide additional nutrients like protein, calcium and vitamin D that are important for development of bones and teeth.

And when you think about milk, we're talking about infants as well as 5 year olds in this age range. And so, what type of milk that is will really depend on the child's age. So, those under a year, milk refers to breast milk and or infant formula. And then older children, one year of age or older, that can refer to cow’s milk or even plain fortified soy milk. So, that's what children should focus on, drinking.

You brought up the {indistinct 6:31}.

6:32 Dr. Hunter: The “should not.”

6:33 Dr. Luecking: Should not. And there are definitely those as well. By and large, children should not have any sort of sugar sweetened drinks. This can be a little tricky. Sometimes drinks are called fruit drinks; we might think of those as juice. But fruit drinks are generally just a sugar sweetened beverage. And other examples of these include flavored milk. So, a lot of us like chocolate milk or strawberry milk; it's a little bit tastier.

There are also there's a big market for toddler milks or formulas. These are marketed as a transition between infant formula to transitioning to milk or other things. Those are not as nutritionally sound or even regulated for safety reasons like infant formulas.

Sports drink. So, often times when kids are active, we might think they need PowerAde or Gatorade or and more often than not, that is not the case. Living more in the south, we have to think about tea. So, that’s sweet tea.

7:30 Dr. Hunter: True.

7:31 Dr. Luecking: But tea and coffee and energy drinks especially, it’s also the caffeine factor; that's not going to be good for our young children to consume. And you may say, “Well, we like flavor drinks. So, we {indistinct 7:43} diet or light drinks that have more of these artificial sweeteners. Kids really don't need those either.

And then there's a lot of -- this could probably a whole separate podcast, but plant-based milk. Those are really, really popular now. And not all plant-based milks like almond milk or oat milk or hemp milk are created equal in terms of offering the nutrients that kids need during that critical phase of growth.

So, really wanting to try to limit it to either fortified soy milk or a cow’s milk. So, drinking milk or water, avoiding sugar sweetened beverages.

8:21 Dr. Hunter: Excellent. And I think you mentioned a little bit earlier about caregivers and grandparents. And that's one thing that we struggled with when our kids were little, that I feel like when maybe my husband and I were young, that it was not necessarily any healthier, but potentially more acceptable to give to juice.

So, we really struggled with the grandparents of saying that we prefer milk and water and please do not give juice. And it really was a struggle there, especially when our oldest was little. By the time our second one came along, they had gotten in line with their wishes. But there just does seem to be maybe some education and transition or conversations that parents need to have with caregivers about preferences for four drink choices.

9:04 Dr. Luecking: Most definitely. I think it's can be a tough conversation, but as a primary caregiver, it's important to feel confident in expressing your needs and your wishes and asking for others to follow in line.

And your point about juice is a really good one. So, a lot of times and I think growing up, juice was offered to me as a healthy alternative. And it's not to say that kids can't or shouldn't have any juice. But the bottom line is that they don't need it.

Instead, we want to try to encourage whole fruit. So, instead of drinking apple juice, offer an apple. Instead of offering orange juice, offer an orange or maybe the Mandarin oranges or the cuties. That whole fruit is going to provide more nutrition and it will be more satisfying than juice.

But if you choose to offer juice, there's a couple points that I do want people to be aware of.

9:58 Dr. Hunter: Okay.

9:59 Dr. Luecking: Really make sure that the label says “100 percent fruit juice.” If not, it's probably one of these fruit drinks that just has a lot of added sugars. You can also think about if you're going to offer 100 percent fruit juice, you can dilute it with a little bit of water.

So, a little bit can go a long way. So, maybe if you're going to serve half a cup of fruit juice, which is generally the recommended limit for young children on any given day, you could think about doing maybe two ounces of juice and then adding the rest water.

10:31 Dr. Hunter: That was one of our sneaky things that we did, as parents when our kids were little, is that we would cut the juice significantly with water. Just so I guess maybe they felt like they had a little flavor or a little taste of this, but they were still getting predominantly water.

10:46 Dr. Luecking: Yes. And a fun little alternative to the juice would be to offer plain water, but then infuse it.

9:53 Dr. Hunter: Infuse the fruit.

10:54 Dr. Luecking: Yes.

10:55 Dr. Hunter: And that's fun, too, because they like to see the orange slice float or the kiwi float and to see that in there. So, that's fun for our kids as well. But I think they would probably choose the fruit infused water, just to see the fruit in their water because it's fun to look at.

11:10 Dr. Luecking: Yes. And I had some kids call it spa water -

11:13 Dr. Hunter: Oh, of course because it's fancy water.

11:14 Dr. Luecking: - at child care center. They got to – It's fancy. It's fancy water.

11:16 Dr. Hunter: Exactly.

11:17 Dr. Luecking: Yes.

11:18 Dr. Hunter: That’s a good point. Maybe we should start calling it spa water at home.

11:20 Dr. Luecking: Spa water. Yes.

11:22 Dr. Hunter: Yeah. My oldest would roll his eyes at me, but our youngest might think that that's kind of fun.

11:27 Dr. Luecking: Yeah.

11:28 Dr. Hunter: So, I do want to circle back. You mentioned a little bit about the age of the child and recommendations in terms of milk and type of milk, if that was breast milk or infant formula or cows, milk, etc. and then you also talked about water. Could you share with us specific recommendations about what and how much to drink depending on a child's age?

11:49 Dr. Luecking: Yes. Good point. That recommendations will depend on the child's age. They'll start to change, particularly around that one year mark.

But in general, infants from birth to about six months only need breast milk or infant formula. And you want to avoid any other type of liquids or foods. Because these are going to provide everything that the infant needs during that point.

Once children transition to that 6 to 12 month age range, they're still going to need mostly breast milk and or infant formula, but they're going to also start eating solid foods. And when they do, that's an appropriate time to start to introduce a little bit of water.

I always like to think about introductions of foods and drinks, not only is just nutritional value, but also practicing in their learning skills of how to use a different type of cup, for example.

12:43 Dr. Hunter: Right. And so, that's one thing when you say to start introducing sips of water, you're not necessarily talking about giving them a bottle of water.

12:50 Dr. Luecking: Right.

12:51 Dr. Hunter: But more so a sippy cup that they can just learn how to hold the cup or put it to their mouth or how their tongue works with it.

12:58 Dr. Luecking: Get used to the consistency. Get used to -- it will taste different than breast milk or formula. And in general, the children aged 6 to 12 months may only need up to a half a cup or a cup of water throughout the day. And you most definitely want to avoid juice or other drinks at this time.

Once kids turn one, they have to start to have a little bit more flexibility. Children may continue to drink breast milk. At that point, though, you can start to introduce cow’s milk. Or if you have any concerns about allergies, you can check with your child's care provider about any appropriate alternatives, for example, a fortified soy milk.

But in general, toddlers will need one to four cups of water each day, and they may need anywhere between two to three cups of milk per day.

Again, we want to try to avoid that 100 percent fruit juice. But if you do choose to offer it, limit it to no more than one half cup per day.

13:55 Dr. Hunter: I do have a question about the soy milk because you've mentioned a couple times a “fortified soy milk.” Is there soy milk on the market that is not fortified?

14:04 Dr. Luecking: That's a great question. Most products are fortified at this point. We would also want to look for plain. I should add that because a lot of our –

14:44 Dr. Hunter: As flavored?

14:45 Dr. Luecking: As flavored. We can have chocolate, we can have vanilla or who knows, even pumpkin spice during the fall.

14:20 Dr. Hunter: True.

14:21 Dr. Luecking: But so, yes, fortified, typically that means they're going to have nutrients added in that weren't typically there. So, calcium, vitamin D, those are kind of the biggest ones that are going to be present in cow’s milk that wouldn't necessarily be there in soy milk, but that make them more equal in terms of the nutrition that they offer.

14:40 Dr. Hunter: Okay, good to know. Because I was just curious because I just think of soy milk as soy milk and it's somewhat similar to how we just think of cow’s milk as cow’s milk, but we don't necessarily think about it being fortified.

14:53 Dr. Luecking: Yes. Yes. And then kind of as we transition into those toddler/preschooler years, they can continue to drink about one to four cups of water per day and maybe about two cups of milk each day.

Once kids turn two, you can swap whole milk with a lower fat milk like skimmed milk. Again, they don't need that 100 percent juice. But if you do, continue to limit it to about half a cup a day or less.

15:20 Dr. Hunter: Excellent. All good information. As our kiddos get older, and I know that this wasn't particularly part of today's topic, but did those general recommendations stay the same of about the time they reach four or five; that’s what we would expect kind of on through adolescence?

15:36 Dr. Luecking: Fluid needs can really change, depending on the individual. So, whether a child or an adult is male or female, what is the weather like that day? Think about summers in Kentucky compared to winters. You’re going to be sweating more. Or how active are people? Are they out and running and getting sweaty and therefore needing more hydration or are they more sedentary and need less hydration?

And as they grow, they're gaining weight as well. So, they have a bigger body mass and a majority of our body weight is fluid. And so, the more we weigh, we'll need more fluid to stay hydrated.

So, they stay fairly similar, I would say, in the types of drinks and then the amount will change a little bit as they get old.

16:19 Dr. Hunter: And the types would be true for us as adults as well that our first choices should be water and or milk.

16:26 Dr. Luecking: Exactly. I love my coffee and so I would hate to -- So, there are differences in adults consuming caffeinated beverages as opposed to that the tiny humans in our lives.

But in general, I think these recommendations are great for adults as well, because what it's doing is really cutting out a lot of extra energy intake that our bodies may not necessarily recognize. We could put down 12 to 24 ounces. So, 24 ounces is like three cups of soda, pretty easily. Whereas it would probably -- or even juice, if we think about. It would be harder to consume three apples, for example.

17:03 Dr. Hunter: Certainly. Certainly. If someone would like more information about the types or amount or drink choices for children, do you have a recommendation for them to reach out to?

17:14 Dr. Luecking: Yes, there's a great website. It's friendly for caregivers, it's friendly for policymakers and even our professionals. And that is healthydrinkshealthykids.org.

17:28 Dr. Hunter: Wonderful. And we will link that in the show notes for our listeners if they want to go back and reference it later.

Courtney, thank you so much for joining us today and talking healthy drink choices. My kids always love it when we record podcasts about healthy food or healthy choices because we get to go home and have that conversation tonight at dinner.

17:47 Dr. Luecking: Oh, wonderful.

17:48 Dr. Hunter: So, they just love all my colleagues {indistinct 17:51}. Thank you, Courtney.

17:54 Dr. Luecking: My pleasure.

17:56 Thank you for listening to Talking FACS. We deliver programs focusing on nutrition, health, resource management, family development and civic engagement.

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