Organic, raw, cow, almond, soy, rice, omega-3 fortified, breast or none? What kind of milk to you give your kids? For my mother, the answer was easy: I was not excused from the table until I drank all my cow milk. But new data is changing the age-old recommendation that kids need three glasses of cow milk per day. The internet is full of moms with passionate milk advice, but I found they raised more questions than answers. So here what I came up with when trying to decide what milk to buy for my family:
- Two 8-ounce glasses of cow milk per day is about right: New research out of Canada shows that kids who drink more than 2 glasses of cow milk per day are at risk for anemia, or low iron levels. Anemia is associated with behavioral problems and poor school performance. Kids who drink less than 2 glasses of milk per day are at risk for low calcium and vitamin D levels.
- Organic milk isn’t worth the extra price: I’ll admit it, for nearly ten years I bought organic, hormone-free milk. I was scared by recombinant bovine growth hormone. I was worried about pesticides on the grass the cows eat. I didn’t like all the antibiotics given to milk cows. But after studying years of research on organic milk, here’s what the American Academy of Pediatrics concluded: “There is no evidence of clinically relevant differences in organic and conventional milk.” If you, like me, have spent lots of money on organic milk, don’t feel too bad. The report also says: “Several studies have demonstrated that organic milk has higher concentrations of antioxidants and polyunsaturated fatty acids. However, it is important to recognize that the composition of milk is strongly related to what cows eat. This differs by time of year (outdoors in the summer, indoor forage in the winter) and whether the farms are high or low input.” [http://pediatrics.aappublications.org/content/early/2012/10/15/peds.2012-2579]
- Chocolate milk probably isn’t worth the bribe: If you look in the milk cooler at our local public elementary school, there’s plenty of chocolate, vanilla, and strawberry milk and a few lonely white milks hiding in the upper corner. Adding sugar and artificial flavor to milk may seem like a worthy trade-off to get kids to actually drink it. But the more we understand that milk is not a perfect food, the more I wonder if sugary, flavored milk is really worth the protein, calcium and vitamin D. For my kids, the answer is no. We pack a water bottle in their lunch boxes.
- Omega-3-fortified milk isn’t worth the price: Kids do need omega-3 fatty acids, which are naturally occurring in breast milk and usually added for formula. Once they transition off breast milk or formula, I recommend supplementing unless you really do convince your kids to eat enough fish, walnuts and other foods that are naturally high in omega-3’s. [Vitamin Wars]. But the high price of omega-3 fortified milk doesn’t make it worthwhile for me. It’s cheaper to just give supplements.
- Only breast milk or formula for babies: Infants under 12 months of age are at risk for microscopic bleeding in the intestines if they are started on cow milk too soon. This bleeding can cause anemia. More commonly, cow milk causes constipation and results in a very irritable little one. What about almond, soy, and rice “milk”? Have you ever noticed that these products carry a warning that states, “Not intended as an infant formula”? Almond, rice and soy milk do not offer the nearly-complete nutrition offered by breast milk and formula. I once cared for an infant who was admitted to the hospital with rickets after she was fed almond as a natural alternative to formula. As always, remember that breast is best for babies. Do you have the breastfeeding blues [link to article]? Are you struggling with breastfeeding? Consider supplementing by syringe feeding.
- Almond milk isn’t a great alternative: Almond gets an A+ on taste and makes fabulous non-dairy ice “cream,” but it isn’t a great source of protein, calcium and vitamin D. Although commercial almond milk is usually fortified with calcium and vitamin D to match the calcium and vitamin D content of dairy milk, the American Academy of Pediatrics warns that people absorb the nutrients in milk and milk products better than they do those in plant-based milks.
- The science is unclear on soy milk: Soy milk is a protein-rich white drink made from the soy bean, and it is usually fortified to have nutritional content similar to cow milk. But the internet is full of theories that suggest that the phytoestrogens—plant estrogens--in soy milk increase cancer risk. Still others claim that drinking soy milk during childhood reduces lifetime cancer risk. I haven’t been able to find any sound published research that supports either side of this debate. But soymilk is still a plant-based milk and hence has the same nutrient absorption problems as almond milk.
- Forget the rice milk: Rice milk has recently been shown to have such high levels of arsenic [link to arsenic article] that it is not recommended for children under five years of age. It also has very little protein. My third child is allergic to milk and soy, and so after he was weaned from breast milk we gave him rice milk about twice a day. So I was horrified to read this research… being a good mom is not about being perfect, it’s about trying your best to do what’s right.
- Raw milk isn’t safe for babies and pregnant moms: Raw milk, or unpasteurized milk, makes tasty cheese and yogurts, but it can contain harmful bacteria. The CDC reported that unpasteurized milk is 150 times more likely to cause food borne illness and results in 13 times more hospitalizations than illnesses involving pasteurized dairy products. Anyone can become ill from the bacteria found in raw milk, such as Listeria. But pregnant women and infants are especially prone to the serious ramifications of Listeria infection.
- You don’t HAVE to drink milk: Are you vegan? Or perhaps you subscribe to the philosophy that cow milk is intended for baby cows. Or maybe you are still worried about hormones, bacteria, or pesticides in cow milk. In any case, you and your kids don’t have to drink milk. There are many other great sources of protein, calcium, and vitamin D. Sometimes it’s just hard to get kids to eat leafy green vegetables and fish.
If you do choose to reduce the amount of milk in your family’s diet, consider what they will drink instead. Try to increase water, and limit high-sugar drinks such as soda, sports drinks and juice.
Copyright 2013 Kathleen Berchelmann, M.D.
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