Should Young Children Drink Milk?

Leading pediatric organizations including the American Academy of Pediatrics (AAP), Academy of Nutrition and Dietetics (AND), American Academy of Pediatric Dentistry (AAPD) and American Heart Association (AHA) have provided recommendations on beverages served in the first five years of life.

The easiest way to summarize the guidelines is to say for children 1 year and older, cow’s milk and water are the only recommended beverages. Here’s the breakdown:

• Under 6 months: Only breastmilk and/or formula is recommended
• 6-12 months: Starting solids but continue some breastmilk and formula. Introduce 1 cup of water in a cup during meals
• 12-24 months: 2 to 3 cups of whole cow’s milk per day. Give water for thirst
• 2-3 years: 2 cups of low-fat or skim cow’s milk per day. Water for thirst
• 4-5 years: 2.5 cups of low-fat or skim cow’s milk per day. Water for thirst.

Why is the recommendation limited to so few beverages?
The consensus recommendation focuses on those beverages necessary during this important time period of growth and development. It does not include other beverages to avoid competition from unnecessary foods in order to help solidify healthy eating behaviors and ensure a growing child’s tiny tummy gets the nutrition it needs.

The milk recommendations are consistent with current Dietary Guidelines for Americans and AAP recommendations.

I thought plant-based beverages are healthier. Do the guidelines talk about that at all?
Because the majority of plant-based beverages (except for fortified soy beverage) do not support adequate intake of key nutrients found in cow’s milk, they should only be consumed with a doctor’s advice if a child has an allergy or specific dietary requirement. According to the beverage recommendations in the consensus statement, plant-based beverages are never recommended under 1 year of age.

My kids don’t like white milk. Can I just give them flavored milk instead?
This part of the guidelines focuses on learning. Children are born with a preference for sweet and salty, but through repeated exposures to other flavors they can learn to enjoy many foods and drinks. Only serving flavored milk reinforces the preference for sweet, making new flavors more difficult to accept, so it is not recommended in early childhood. Once a child is older, parents and caregivers can re-evaluate things with the help of a pediatrician or dietitian.

Is juice OK?
Juice is not a necessary part of a child’s diet. Whole fruit is preferred, but you may serve juice to kids 12 months and older. No more than half cup per day of 100% juice is recommended.

So I can’t give my kids chocolate milk?
No, that is not the case. The guidelines focus on what we want to regularly serve our children to establish taste patterns. Occasional flavored milk or 100% juice should be treated like a “sometimes” option, but not a daily occurrence.

What about other recommendations?
The guidelines also emphasize that the following things are never recommended under 5 years:

• Caffeinated beverages
• Sugar-sweetened beverages
• Beverages with low-calorie sweeteners
• Raw milk
• Toddler formulas

What does learning have to do with what my kids drink?
For the first time, guidelines are based upon learning. We know that food preferences and eating behaviors are shaped depending on what foods are offered and how food is presented in the first few years of life. That means that what and how kids eat now can affect them for the rest of their lives. This paper goes into more detail.

That’s a lot of pressure! Is this really true?
A child’s brain doubles in size the first year of life, and by three years, the brain has reached 80% of its adult volume. Learning happens through repetition of patterns or actions that create new and stronger connections in the brain. These connections lay the foundation for their thoughts, reactions and habits in adulthood. Read more here.

There is so much information when it comes to nutrition! Who do I listen to?
Everyone has an opinion about what you should feed kids, even when there is no medical indication to adopt a special diet. This consensus statement was written in collaboration with the AND, AAPD, AAP and AHA, so everyone agrees!