We appreciate these comments and recognize the value that may be present in some circumstances for using fruit juice in the medical management of patients with diarrhea or constipation. However, the recent recommendations1 for specific fruit juice maximum intakes are based on and should be considered to apply only to healthy children, not those who have disease conditions such as these. This exclusion of existing disease conditions, including diarrheal diseases, is implicit in routine dietary recommendations including those of the Institute of Medicine (Dietary Reference Intakes) and the Dietary Guidelines for Americans.
In addition, the use of fruit juice in this circumstance needs careful evaluation in relation to the risk of a parent using fruit juice excessively or a child becoming used to consuming juice after a minor illness and parents continuing to use it as a more significant part of the child’s diet. Further studies are required to determine more clearly any routine role for fruit juice in the management of diarrhea.
Overall, medical advice on rehydration management should be done by pediatricians in a setting in which the child is evaluated fully and the risks and benefits of specific interventions are considered.
We acknowledge that the recommendations in the statement may change as further investigations yield new information, but for now we consider it appropriate to leave the statement in its current form.
CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
- Heyman MB,
- Abrams SA
- Copyright © 2017 by the American Academy of Pediatrics