QUESTION

I grew up on milk, but my vegan friends are telling me that it’s unhealthy for us. Should I tell my daughter to stop giving milk to my grandchildren?

ANSWER

Humans have been drinking milk for millennia, and it’s a dietary staple in many parts of the world. But recent concerns about health risks, such as from growth hormones, antibiotics and saturated fat, have raised questions about whether drinking milk is a good idea—especially for children, who are at a vulnerable stage of their development.

Milk has long been considered by many to be a wholesome source of nutrition—particularly calcium, vitamin D and protein—for not many calories. Children in particular are urged to drink it as one of the best ways to ensure strong bones in adulthood.

It’s true that many of the essential nutrients children need for optimal growth and development are available in other foods. However, unless a child is vegan, lactose-intolerant or willing to down large quantities of Swiss chard and sardines, milk is probably the easiest, most concentrated way to get those vitamins and minerals into his/her growing body.

Milk for Strong Bones?

As for milk being the dietary guardian of our bones, that claim has been revised. A recent large study from Harvard University found that higher milk consumption during adolescence did not, in fact, decrease risk for hip fracture in later adulthood. We now know that healthy bones depend on many diet and lifestyle factors of which dairy can be a part, but it is not the only player.

The bottom line is that even though milk doesn’t merit perfect food status, neither should it be demonized. Whether to give dairy to children or not is really a matter of preference. As long as a child doesn’t have an allergy or intolerance, it’s fine to include an appropriate amount of dairy as part of a varied, healthy diet—with one important exception…

  • Children under age one should not consume cow’s milk. Infants’ digestive systems haven’t matured sufficiently to handle cow’s milk proteins. Cow’s milk can irritate infant intestinal linings and cause bleeding, putting young babies at risk for developing iron-deficiency anemia. The American Academy of Pediatrics (AAP) recommends that babies be breast-fed for the first six months or given formula…and given breast milk or formula to drink until age one. (Formula based on cow’s milk is OK because the milk has been altered to mimic breast milk.) Once a child is able to eat finger foods, it’s usually OK to introduce yogurt or cheese—separately. But hold off on milk until age one.
  • Don’t let milk replace other foods. Kids have tiny tummies, and filling up with milk means less room for leafy greens, fruits, legumes, nuts and other sources of protein and other healthy foods. Also, drinking too much milk may lead to the calcium in milk interfering with iron absorption. Finally, too much milk can lead to excess weight gain. A study of nearly 9,000 four- and five-year-olds from University of Virginia found that children who drank three or more servings of milk daily were more likely to be overweight than children who drank up to two daily servings. But too much of any food can lead to weight gain.

Low-fat milk vs. whole milk. Because developing brains need a certain amount of fat, including saturated fat, AAP recommends that one-year-olds should drink whole milk. AAP then recommends switching to reduced-fat or skim milk at age two to reduce risk for obesity and elevated cholesterol.

However, whether whole milk or low-fat/reduced-fat milk is better for young children is still under debate. Several studies, including one from University of Virginia School of Medicine that looked at two-to-four-year-olds, have found that children who continue drinking whole milk tend to be slimmer. The thinking is that whole milk makes children feel more satisfied, which results in them consuming fewer calories overall. A 2016 study of 2,745 children ages one to six from University of Toronto published in The American Journal of Clinical Nutrition found that those who drank whole milk had lower BMIs and higher levels of vitamin D than those who drank 1% milk.

In the end, whether a child gains too much weight depends on what is eaten in the whole diet. So either kind of milk can be OK. A good compromise may be choosing reduced-fat milk.

  • Include varieties of dairy. Yogurt contains probiotics, which have many health benefits, and cheese is a good concentrated source of protein. So the two to three daily servings of dairy that a child needs (depending on age) might be one-half cup to one cup of milk for breakfast…a cheese stick at lunch…and one-half cup to one cup of plain or low-sugar yogurt for a snack. Opt for milk and dairy products that are free of rbGH, a synthetic growth hormone (also called rbST), if possible.

Can’t Drink Milk?

Children who are allergic to dairy, lactose-intolerant or vegan can still get their calcium, vitamin D and protein from other foods. Just keep in mind that milk provides eight grams (g) of protein and 300 milligrams (mg) of calcium per cup, so you’ll need to replicate that.

Plant-based milks—such as almond, oat and rice milks—should be avoided, as they are less nutritious than cow’s milk and often contain added sweeteners and artificial flavorings. Even if these milks are fortified, it is not known if the added nutrients are as absorbable as they would be when naturally occurring. The exception is soy milk, which is the preferred alternative for children who can’t drink cow’s milk. But be sure to choose a brand that is unsweetened.

Nondairy sources of calcium. Swiss chard (101 mg calcium/cup), broccoli (31 mg calcium/ ½ cup), sardines (with bones, 92 mg/two sardines), canned salmon (with bones, 78 mg calcium/ounce), almonds (75 mg calcium/ounce), chickpeas (77 mg calcium/cup) and dried figs (45 mg calcium/ounce) are all good sources of calcium. Calcium-fortified orange juice provides 500 mg of calcium per cup. Mixing it up is the best way to make sure children get a sufficient variety and quantity of nutrients to support their developing bodies’ needs. Canned salmon finger sandwiches, almond butter spread on crackers, broccoli flowerets to dip in hummus and rainbow-colored baby chard salad are great ways to make these foods kid-friendly.

Bottom line: Milk still “does a body good.” Kids don’t have to have milk, but they also don’t need to fear it. Getting the same nutrients from other sources is fine—so long as they get all the nutrients and enough of them.