Thursday, January 14, 2010

On Milk: Dr. Saul Hymes Gives Us the Nutritional Scoop!

I've stated in previous posts my difficulties getting my son to drink milk. I began to wonder about the nutritional importance/significance of milk in a child's development. So I consulted my friend and pediatrician Dr. Saul Hymes.

Here's he had to say on the matter:
1. What kind of milk is recommended for children 12 months and up and why?

The AAP recommends breast milk up to age 1 and if that is unavailable, formula. After age 12 months, the recommendation is for 100% (whole) cow's milk. Children should not be given low-fat, skim, or fat-free milk until after the age of 2 as the fats are needed for healthy brain development. For children who are found to have a true cow's milk protein allergy (manifested either by true allergic symptoms (hives, wheezing, anaphylaxis) or by bloody stools or fatty, watery stools caused by a protein-losing enteropathy) there are alternatives such as soy or, as the incidence of cross-allergy between soy and cow's milk can be as high as 20-30%, there are 'formulas' for older children that use amino acids or pre-digested protein to avoid causing an allergic response.
2. What if a child refuses to drink milk? What should be done?

If a child refuses to drink milk one can try a few things. While the official recommendations of pediatricians do not include chocolate milk, many parents find that adding a very small amount of chocolate powder adds enough sweetness and flavor to help encourage kids to drink. However, between the age of 1 and 2, most children should be
transitioning to 1 8-oz container a day plus other dairy sources such as yogurt and cheese. If a child really will not drink milk, substituting an equivalent additional amount of yogurt or cheese should be perfectly adequate for fat, calorie, and calcium needs.
3. What is the importance of drinking milk for children?
As above, the importance of dairy is for fats for brain development, as well as being an essential source of calcium necessary fro proper bone and tooth development and thus proper growth. Additionally it is an excellent protein source--there really is no other good substitute. While soy milk and other soy products are used in the case of allergy, milk, cheese and yogurt are preferred, Even in children who are lactose-intolerant (different from milk-allergic), the AAP recommends a small amount of dairy (even ice cream if need be) to be added to the diet.

4. Is a child missing out if he/she doesn't drink milk at all?

As above, if a child is replacing that milk with an equivalent amount of cheese or yogurt
or other dairy milk-containing products, then no, they are not missing out. But without dairy, a child is definitely nutritionally deficient and it is unhealthy, for example, for a young child to be vegan entirely.
--Dr. Saul Hymes is a Clinical Fellow specializing in Pediatric Infectious Disease.


  1. Dr. Saul would not like me LOL.

  2. HA HA HA! Well, I posted on facebook that I don't agree with the deficiency statement. my best friend, Mint, is allergic to milk and couldn't/still can't eat a lot of things. But she is nonetheless healthy!

  3. There is a mommy group here for lifelong Vegan kids and they all seem really healthy and play kid's lacrosse and other sports and stuff. I asked my doc about it at T's 4-month checkup and she said the only issue is that milk subs are less fattening (not the soy yogurt though, it's more fattening lol) so just to make sure she gets healthy fats elsewhere.

  4. Cool! By the way, I LOVE soy yogurt!!! Actually the silk yogurts are awesome.

  5. YES they are. I used to only buy silk yogurt in San Diego but they don't sell the small individual cups up here (weird since we're like #1 for vegan population up here). They sell the big pint size vanilla one so I buy that for smoothies and stuff. I like the coconut milk yogurt that So Delicious makes since I try to limit my soy intake.

  6. Perhaps I overstated myself, Amanda, you are right--if a child is getting enough fats, and the right kinds, from soy or other foods then a vegan diet is more acceptable. However, there are many parents who do not do this or are not able to do this, and that's where these kids can run into trouble. The other part of my point, which didn't come across as clearly, was it is especially risky for young infants--under 1 year of age--to be vegan. Above that is a little less of an issue and above 2 even less so.

  7. Also, kids who are milk allergic can be given milk substitutes like special formulas that have the appropriate fats and sugars but none of the proteins--which is what causes the allergy.


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