Whole, skim or soy? Get the details on milk consumption in kids.
Updated: Dec 7, 2021
Milk 411
Introduction of milk and the transition to milk at one year brings about many questions for parents. What is the best type? how much? and when? are all real thoughts that go through your mind. Before we dive in I want you to remember that this is one of those things that there is no "right or wrong" way of doing it. The recommendations that are provided regarding milk are just that, recommendations. These are often times in pediatrics coming from the American Academy of Pediatrics who is the main pediatrics organization that offers guidance on pediatric health topics. You always are the ultimate decision maker for your family and you need to do what works best for you. My goal is to provide you education on the why so that you can make the best decision for YOU.
Facts
Before we get started I wanted to bring up an important point. Milk (cows milk or milk alternative) should never be a childs primary form of nutrition or calories. Prior to 1 year their primary nutrition is coming from breastmilk or formula and after 1 year their primary nutrition is coming from the food that they eat.
Age 1 and under
Milk consumption under the age of 1 is not recommended. Why is that? Milk contains proteins that infants are not able to effectively break down in their gut. Consumption of milk can lead to tiny bleeds in their guts that over time can lead to anemia. Their digestive system is still maturing throughout this first year.
Dairy in the forms of yogurt and cheeses, however, is definitely acceptable and recommended at this age (once they are cleared by their provider to have solid foods). This is a great way to introduce dairy products as well as add in some extra calcium and protein to their diets.
But what about milk alternatives at this age? As a general recommendation, the only drinks that they need at this age are their breastmilk or formula and water. Milk alternatives are filling and if you are offering them glasses of these products, they are likely not going to be consuming their necessary amount of formula or breastmilk or other solid foods that are needed for growth and brain development.
Age 1 to 2 years
At this age, the general recommendation is transitioning off of formula and making solid foods the main nutrition. You may be thinking, "but what about the term transitioning to whole milk?". This term actually should instead be "introduction of whole milk". Remember, milk is NEVER intended to be the primary thing. It is just a supplement to diet.
The goal for children in this age group is approximately 2 servings of dairy per day. This can be in the forms of dairy products and milk. A good maximum amount of milk is between 16 - 24 oz per day. Remember those milk proteins we discussed earlier? They continue to play a role in older kids if milk consumption becomes too much. If milk is consumed in excessive amounts (generally in excess of 30 or more oz) it may lead to iron deficiency anemia.
A common question in this age group is "what type of milk". For most children the recommendation is whole milk from 1-2 years of age. First, whole milk is fortified with vitamin D. Vitamin D is needed to allow our bones to absorb calcium so that our bones can grow and become strong. Second, vitamin D contains extra fat that is needed for brain development. Reduced fat cows milk are typically not recommended because they are not fortified with vitamin D and are low in fat. Milk alternatives such as soy, almond, oat, coconut, goat may be something you have used or considered for your child. These alternatives are okay for you to use if you choose. Many of these alternatives have options that are fortified with vitamin D, so that should be something you look for. Another thing to keep in mind is that the nutritional components including fat, calcium, protein and iron vary across the types of milks. There really isn't one that is totally comparable to whole milk, therefore, you should choose on that is similar and that your child likes and make up the missing component in their diet.
Another question that I frequently get in this age group is, how do I introduce the milk? Let's explore some ways to introduce:
Cold turkey. Go straight from formula or breastmilk and start cows milk once you have finished out your stock at home.
Mix milk into bottles/cups of formula or breastmilk. Slowly increasing the ratio of milk in the bottle until it is all milk.
Do a combination of the two drinks until your supply of formula or breastmilk is gone.
* Some kids do not mind the taste of milk and this introduction is seamless. Other kids immediately recognize the difference and may have a tougher transition and may take some time to get used to it.
Some tips on when to offer milk:
You can offer milk with meals either during, midway through or after. Some children fill up on their milk and have no interest in meals if they are offered milk at the beginning of the meal. If this is your child, you may want to wait until halfway through or after the meal to offer the milk and stick to water in the beginning.
Offer milk during snack times.
Offer milk in the morning or before bed if they are used to these times of taking a bottle. It is recommended that they drink their milk out of a cup and to brush teeth if milk is consumed before bedtime to reduce risk of cavities.
Age 2 and up
At this age the general recommendation is to transition to a lower fat milk. They no longer are needing the added vitamin D or fat content that is present in whole milk. I often recommend to transition to whatever you typically purchase for your family.
At this age the goal of dairy intake is about 2.5 to 3 servings per day. Again, milk intake should not exceed 24 oz.
Important final points
Breastfed babies can and should continue to consume breastmilk until you and your family are ready to stop. This information is in no way saying that breastmilk should be discontinued. Dairy products including milk can be incorporated into your childs diet in addition to breastmilk. I recommend viewing the table below to make sure that your child is getting the daily recommendations.
Is there such a thing as "too much milk?". Yes! Too much milk can lead to iron deficiency anemia. It can also cause your child to have decreased appetite for solid foods because it is filling when offered prior to meals. And lastly, dairy is the most common culprit for constipation.
Children with milk protein allergy generally are able to consume dairy products including whole milk at 1 year of age.
Always speak with your childs medical provider regarding your child and their specific situation.
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