Choosing healthy drinks is just as important as choosing healthy foods. Many drinks have added sugar. When children consume drinks with sugar throughout the day, their risk for developing tooth decay increases.

This Brush Up on Oral Health tip sheet focuses on choosing healthy drinks and identifying drinks with added sugar. The tip sheet also discusses how Head Start staff can help parents prevent tooth decay by promoting healthy drink choices (e.g., milk, fluoridated tap or bottled water) and limiting drinks with added sugar.

Milk and Water Are Healthy Drink Choices

During a baby’s first year of life, breast milk is best. If an infant is not fed breast milk, the infant should be fed iron-fortified infant formula. The Consensus Statement. Healthy Beverage Consumption in Early Childhood: Recommendations from Key National Health and Nutrition Organizations recommends that children be fed whole milk until age 2, unless the child’s primary care provider recommends switching to reduced fat (1%) or nonfat (skim) milk sooner for medical reasons. Low-fat or nonfat milk and plain water are healthy drink choices for children over age 2. Children can begin drinking water at age 6 months.

Many Drinks Have Added Sugar

Parents often do not know that many drinks, like the ones listed below, have added sugar:

• Flavored milk, such as chocolate, strawberry, and vanilla milk
• Non-diet pop or soda
• Fruit drinks, such as fruit punch and juice cocktails
• Kool Aid
• Vitamin water
• Sweetened teas
• Energy drinks

Plant-based milks, such as rice, coconut, and almond milks, may be sweetened or unsweetened. Sweetened versions of these milks contain added sugar. Plant-based milks are not generally recommended for children under age 1 because they do not contain the same nutrients as cow’s milk. But they may be recommended by the child’s primary care provider if the child cannot drink cow’s milk for medical or dietary reasons.

Help Parents Make Healthy Drink Choices

Head Start staff can help parents prevent tooth decay by promoting healthy drink choices and encouraging them to limit drinks with added sugar.

• Encourage parents to give children water, ideally tap water with fluoride. See the Brush Up on Oral Health tip sheet, Encouraging Children to Drink Water. Some parents prefer to give children bottled water instead of tap water. It is important for these parents to know that the amount of fluoride in bottled water varies greatly. Most bottled water does not contain the right amount of fluoride to help prevent tooth decay. Some bottled water contains no fluoride.
• Educate parents that children should not be put to sleep with a bottle or sippy cup containing drinks with natural or added sugar. If parents put the child to bed with a bottle or sippy cup, it should contain only water.
• Share with parents infographics and videos from HealthyDrinks. Healthy Kids., which provide information on what drinks to give children from birth to age 5. Recommend them to take copies home and keep in their kitchen.
• Remind parents to give children ages 12 months and older no more than four to six ounces of 100% fruit juice per day. Encourage parents to give children frozen or fresh fruit that has been mashed or cut into bite size pieces instead of juice. If parents offer juice, tell them to serve it in a cup without a lid.
• Explain to parents that children under age 5 should not drink sugar-free drinks, like diet pop or soda. The carbonation that makes these drinks bubbly can wear away the outer covering of teeth. This makes a tooth’s outer surface thinner and more likely to develop decay.
• Share the Healthy Habits for Happy Smiles handout Choosing Healthy Drinks for Your Young Child to reinforce messages about healthy drinks for children.

Download a PDF version to print and share.

Last Updated: April 25, 2023