Clinical Reference Systems: Pediatric Advisor 10.0

In October 1992, a well-known pediatrician recommended that children over 2 years old and adults not drink cow's milk. The American Academy of Pediatrics and the American Medical Association both strongly disagree with this extreme statement. Here are the reasons the benefits of drinking cow's milk outweigh the risks.

THE BENEFITS OF COW'S MILK

Dairy products are an inexpensive source of protein. They are a convenient source of calcium. In addition, they often taste good. These benefits of milk haven't changed.

THE RISKS OF COW'S MILK

1. Bleeding from the intestines during infancy

   The intestines of some babies may bleed if they drink cow's milk during their first year of life. This slow leakage of blood from the lining of the intestine can cause iron deficiency anemia. For this reason, pediatricians no longer recommend giving cow's milk to children during their first year of life.

2. Food allergies

   About 1% of children are allergic to the protein in cow's milk. When they eat or drink milk products, they may develop hives, diarrhea, wheezing, or other allergic symptoms. These children need to avoid cow's milk products.

3. Lactose intolerance

   Lactose is the sugar found in milk. Some children and many adults have a condition called lactose intolerance and have bloating and diarrhea when they eat or drink milk products. You can prevent these symptoms by adding lactase drops to the milk. (Lactase is an enzyme that helps people digest the sugar in milk.)

4. Heart disease

   Children with strong family risk factors for early heart attacks should avoid cow's milk products because of the high amounts of cholesterol and saturated fat in milk. You can reduce this risk by giving your child skim milk or 1% milk.

5. Diabetes

   One study has suggested that a reaction to the protein in cow's milk could trigger the onset of diabetes mellitus. A later study showed no correlation. This theory is not a reason to give up milk.

PRECAUTIONS FOR CHILDREN WHO AVOID MILK

Children and adults who need to avoid drinking milk or eating food made from milk must supplement their diets with calcium. Children who don't get enough calcium every day may develop rickets, which leads to soft bones and short stature. Also, these children do not store enough calcium to prevent osteoporosis during late adulthood.

Some vegetables such as broccoli and kale contain relatively high amounts of calcium. However, it would be extremely difficult to eat enough broccoli and kale each day to get enough calcium. Therefore, children who are not eating or drinking milk products should take calcium supplements. They are available without prescription in liquid, chewable, and tablet forms. Calcium-fortified orange juice is also available and contains as much calcium per ounce as milk products.

RECOMMENDATIONS

• During the first year of life children should either be breast-fed or be given iron-fortified formula.
• Give whole cow's milk to children 12 to 24 months old.
• After 2 years of age children should drink low-fat milk. If they are overweight, they can drink skim milk.

Consuming milk products in moderation is not harmful.