What Should Your Young Children Be Drinking? (Pedcast)

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If you stroll through a grocery store or scan a coffee shop menu, it’s impossible to miss the ever-expanding array of non-dairy, mostly plant based “milk” options available. Given this, it’s no surprise that just last week, Dean Foods (the biggest producer of milk products in the U.S.) filed for bankruptcy. Things are definitely changing. But if the consumption of cow’s milk by children is diminishing, what does this mean for their long-term health? Is drinking cow’s milk essential to your children’s good health? And what about all those other beverages that your children drink have access to?   When is their consumption appropriate for your children?  Seems like the perfect time to delve into the current recommendations for your kids, and discuss the landscape of “milks”.


Musical Introduction


The New Report

The American Academy of Pediatrics recently released a consensus panel report that summarizes their beverage recommendations for children from birth to 5 years of age. Their report is important for two reasons: a significant portion of your children’s daily calorie intake comes from liquids and the drinking patterns they establish in their preschool years generally persist into later in their life. What your kids are drinking is important and deserves some serious thought.

But keep in mind that the panel’s recommendations do not address medical situations in which specific nutrient guidance is warranted to manage acute or chronic conditions. For those children, your child’s pediatrician or gastroenterologist needs to be consulted.


The Panel’s Recommendations:

Here is what this new report recommends for children without special medical conditions:


  • No water less than 6 months and then plain water encouraged after that.
  • Breast milk or infant formula are the only milks appropriate for children under 1 year of age.
  • No cow’s milk until 12 months, whole milk from 1-2 years of age, then 20 ounces daily of skim or 1% milk for 4 and 5 year olds
  • No Fruit juice under 12 months, then a maximum of 1/2 cup of 100% fruit juice for 1-2 year olds. For 2-5 year olds, a maximum of ½ to ¾ cup of 100% juice is allowed. No added sugar or flavors, of course. And read those labels carefully – added sugar is sneaky.
  • Additionally, they make it very clear that flavored milks, toddler milks, all sugar-sweetened beverages, low calorie/diet drinks, and caffeinated drinks are NOT recommended for children of any age. This is a no brainer! Don’t even think about it!


What is New in this Report?

What is new in this panel’s report?  Plant milks are not recommended for young children unless there the child has special medical circumstances. Here is a snippet from the report with the reasons given for this recommendation:

     An analysis (funding source not reported) compared cow’s milk with 8 common nondairy beverages (almond milk, cashew milk, coconut milk, hazelnut milk, hemp milk, oat milk, rice milk, and soy milk). The authors observed that cow’s milk has higher protein content and quality compared with all of the nondairy beverages analyzed, with the exception of soy milk. They also noted that although most of the plant milks were fortified with calcium and vitamin D (in equal or even greater amounts than those found in cow’s milk), there was a lack of evidence to indicate the bioavailability (meaning absorbability) of the nutrients added through fortification in these products. Finally, they observed that—unlike the detailed information available in the USDA National Nutrient Database for Standard Reference about the quantity of several micro nutrients in cow’s milk—similar data for most of the nondairy beverages was not available, which further complicated the comparison of their nutritional profiles with that of cow’s milk. They concluded that cow’s milk should not be removed from the diets of young children unless there is a medical indication, and that nondairy milk beverages should not be considered adequate nutritional substitutes for cow’s milk until nutrient quality and bioavailability are established.

In other words, as I interpret their report, since there is not sufficient evidence that plant based milks provide what children need at the current time, the AAP is sticking with good old cow’s milk.




Some thoughts going forward


Many parents in today’s contemporary America aren’t accepting that cow’s milk is a healthy nutrient for their children-hence the growing number of plant based milks that are being offered to families. Who’s right, the plant-based advocates or the nutrition experts? The medical establishment is convinced that cow’s milk is an essential nutrient source for healthy children. But I feel that these expert panels are ignoring the evidence that casein, one of the two proteins in cow’s milk, has been linked to diabetes, cardiovascular disease, iron deficiency, and even cancers when making their report. For more on this, listen to an integrative pediatrician rebut the health promoting effects of cow’s milk.  In my opinion, the reasons this panel cites against plant-based milks are not particularly convincing, and the evidence that cow’s milk consumption can be harmful was just ignored. Many parents are choosing not to follow these recommendations and are avoiding feeding their children milk from cow’s. Unfortunately, to date, evidence is lacking as to the appropriateness of plant based milks for children under 5 years. I will be keeping my eyes and ears open for further research on this timely issue and bring it to you when it becomes available. I hope that we will be in the not too distant future. Until that day comes, its three servings of good old cow’s milk that is recommended.


As always, thanks for joining me today. If you value the information you get from pedcasts, consider taking a moment to rate my podcast wherever you get your podcasts. This is Dr. Paul Smolen, you know, Doc Smo, hoping you take a moment to think, before serving your children something to drink. Until next time.

Many thanks to Sonya Corina Williams for her assistance in the production of this pedcast.