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Growing kids need their milk


Kathy Kolasa


Kathy Kolasa

Wednesday, December 6, 2017

Q My daughter-in-law enjoys drinking all the new “milks” you find in the store. I think she needs to feed her baby cow’s milk. What do you think? — J.A., Greenville

A You didn’t give your grandchild’s age, but Catherine Thriveni, a Brody medical student, will share the recommendations for infants, children and teens. It’s important to understand what nutrients your child needs and gets from drinking milk.

It seems like a well-accepted rule that growing kids need their milk. In fact, milk and other dairy products are key sources of calcium and vitamin D, the building blocks of strong bones and teeth. Milk is also a great source of protein, which is important for a child’s muscle growth, brain development, and immune function. But with the wide variety of options — whole, reduced-fat, low-fat, skim, soy, almond, rice and other plant “milks” now available in the store — it can be difficult to know which choice provides optimal nutrition for your child.

For infants younger than 12 months old, the American Academy of Pediatrics recommends only breast milk or iron-fortified infant formula. Neither cow’s nor plant milks are recommended. Studies have shown that the consumption of cow’s milk by infants can lead to iron deficiency anemia, causing babies to feel weak, tired and irritable.

For children 1-2 years of age, whole or reduced-fat (2 percent) milk is recommended. Because dietary fats are important for early brain development, whole milk has classically been advised in this age group. However, recent studies have shown that children this age given 2 percent milk did develop normally. So if a child is at risk for becoming overweight or if there is a family history of heart disease or high cholesterol, 2 percent milk is the best option. Plant-based beverages, including soy milk, are “inappropriate alternatives to cow’s milk in the first two years,” said a joint statement issued by Dietitians of Canada and the Canadian Paediatric Society.

After children turn 2, they should receive two to three 8-ounce servings of low-fat (1 percent) or fat-free (skim) milk each day. Adolescents accumulate almost half of their total lifetime bone mass at this age and need a good source of vitamin D and calcium, so they are encouraged to consume three or more servings of low-fat milk or dairy products every day.

What about the non-cow’s milk alternatives? Soy milk is fortified with calcium and vitamin D and with about the same amount as in cow’s milk. Soy milk also is comparable to cow’s milk in its protein content; an 8-ounce glass of soy milk provides 7 grams of protein, while cow’s milk provides 8 grams. And unsweetened soy milk has roughly the same calories as skim milk or about 80-90 calories per 8-ounces. Some people worry about the plant estrogens called isoflavones found in soybeans. But the American Academy of Family Physicians states, “there is no conclusive evidence from animal, adult human or infant populations that dietary soy isoflavones adversely affect human development, reproduction or endocrine function.”

Individuals who are lactose intolerant or parents who adhere to a vegan diet can comfortably feed their baby fortified, full-fat soy milk after 2 years of age. If your child is younger than 2 and you want to feed him or her a plant-based milk, be sure to speak with your pediatrician first. Even after age 2, low-fat and non-fat soy milks are not recommended for growing toddlers because they seem to contain insufficient fat and calories. That is likely to be true of the other plant milks.

Compare the Nutrition Facts labels. Almond milk is also fortified with calcium and vitamin D in amounts like cow’s milk. As a bonus, one 8-ounce cup of unsweetened almond milk contains only 30 calories, as compared to 90 calories in a cup of skim milk. However, while almonds themselves are a great source of protein, almond milk has only 1 gram of protein per glass.

There are many nutrients found naturally in milk that aren’t in plant “milks” as well. So almond milk is not recommended as the primary beverage for infants or toddlers. Rather, it may be a good option for older children who are already eating foods and getting adequate dietary protein and nutrients.

Finally, it is important that children limit their milk intake to two to three servings per day. Excessive consumption of milk can inhibit iron absorption from other foods and fill children up so that their diet is imbalanced — both of which can lead to iron deficiency anemia. The additional calories can also increase children’s risk for obesity, which makes them more likely to develop diabetes, heart disease, sleep apnea and asthma later.

A baby should not be put to bed with a bottle. Milk and formula contain sugar that, when left in the mouth for extended periods of time, can be broken down by bacteria and turned into acid that leads to tooth decay.

While no form of milk is without its benefits and drawbacks, we recommend speaking to your pediatrician regularly to make sure your children are obtaining adequate amounts of calcium, vitamin D and protein and all the nutrients needed for their health.

Professor emeritus Kathy Kolasa, a registered dietitian nutritionist and Ph.D., is an Affiliate Professor in the Brody School of Medicine at ECU. Contact her at kolasaka@ecu.edu.