Parentpedia

What Experts Say

Most pediatricians raise a glass to milk because unless a child is allergic or intolerant, it's the most convenient way to send a whole lot of key nutrients down the hatch. Milk contains carbohydrates, protein, fat, calcium, and zinc, as well as vitamins A, B2, B12, and D.

Most experts agree that kids can switch from infant formula or breast milk to whole cow's milk when they reach 1 year of age. Before this age, cow's milk is more likely to cause an allergic reaction and is tough for babies to digest -- and it's not the best source of iron. The Holistic Pediatric Association, however, prefers breast milk over cow's milk for a longer period, until children reach 18 to 24 months.

Once you switch to cow's milk, the U.S. Food and Drug Administration, the Centers for Disease Control, and other health experts advise parents to buy only pasteurized milk, which has been heated and processed to kill bacteria. Raw milk, they warn, may harbor contaminants and micro-organisms that can cause food-borne illness.

Among pasteurized milks, should you choose organic or conventional? Some experts, including William Sears, M.D., advise parents to go organic. Sears argues that we can't be sure that pesticides (consumed by cows in feed), antibiotics (given to keep cows healthy), and hormones (to stimulate milk production) don't make their way into conventional milk.

The Center for Science in the Public Interest is also pro-organic milk for children, to avoid ingestion of pesticide residues. The American Academy of Pediatrics (AAP), however, offers no position. "There?s a lack of evidence that there is any harm to humans from BSH [bovine growth hormone], and no proven benefit of any kind from organic milk or infant formula," says Frank R. Greer, M.D., chair of the AAP committee on nutrition.

Then there's the fat content to consider. The conventional wisdom is that toddlers need the fat in whole milk for healthy growth and brain development until age 2. Your pediatrician may advise switching to lowfat milk as early as 18 months of age if your child is a heavy milk drinker or if he or she has concerns about your baby's weight.

However, if your child is allergic to milk or can't tolerate lactose, the sugar in milk, your pediatrician will recommend a substitute. The digestive symptoms associated with lactose intolerance (bloating, cramping, nausea, gas, diarrhea) don't usually surface until your child is 3 years or older. Milk allergies are outgrown by the vast majority of children by the time they start first grade.

Tips to Help Introduce Store-Bought Milk

• Watch for signs of a milk allergy (hives, trouble breathing, vomiting), or if your baby seems lactose intolerant (meaning it's hard for your baby's body to digest lactose). Contact your pediatrician if your child suffers any of these symptoms.
• If your child turns up his nose at milk, try mixing it with breast milk or formula (whichever he's used to), and gradually shift the ratio until you?re using all cow's milk.
• If your child isn't a big fan of milk, offer whole milk flavored with vanilla, chocolate, or strawberry. Despite the additional sugar and calories, flavored milk is better than no milk, says the AAP's Dr. Greer, and you can adjust by watching calories elsewhere in your child?s diet.
• Your 12- to 24-month-old needs two cups of milk per day for adequate calcium, vitamin D, fat, and other nutrients, yet too much of it can interfere with iron absorption. Experts vary in opinion on the limit; some set the bar at 16 to 24 ounces per day, others at 24 to 36 ounces.
• If you choose organic milk, look for the USDA green and white organic seal that certifies it has been produced and handled using renewable resources, and without conventional pesticides, certain fertilizers, antibiotics, growth hormones, genetic engineering, or irradiation.