Milk does a child's body good, but choosing the right type can make a parent's head ache.
As reports of childhood obesity rise, we asked registered dietitian Sarah Krieger, a children's hospital consultant in St. Petersburg, Fla., and spokeswoman for the American Dietetic Association, to share guidelines she is giving families.
Question: Why is milk important for children?
Answer: It contains so many nutrients that children need to grow. Calcium is obvious, but milk is also high in potassium - it has more than bananas - phosphorus, protein, vitamins like B12 and D and magnesium.
Q: What is the right milk for what age?
A: Birth to age 1 is breast milk or formula. Age 1 to 2 is the only time that whole milk is necessary; the fat content is needed for the brain when it's developing rapidly. What's interesting, though, is that, in our children's hospital, I'm seeing obesity in 1- to 2-year-olds is rising.
Q: If fat helps a brain develop, would it make sense to give a child higher-fat milk if obesity isn't a problem?
A: It's better to choose plant-based sources of fat. My son just turned 2. He's just the 32d percentile on growth. I still switched him to low-fat milk. Heart disease is on both sides of our family. You can develop heart disease even if you're not overweight. So get fats from olive oil, avocados, and peanut butter rather than saturated fat from animal products, ice cream, butter, and sour cream. If we teach kids to love full fat, they're going to. It's easier to teach them right from the beginning.
Q: Some older kids aren't getting enough milk?
A: The kids who I see are pretty consistent with national stats. All the girls are getting much less than the daily requirement of milk. Boys are a little bit closer but still less. The recommended amounts are 3 cups over age 9, 2 cups for ages 2 to 3. There's a change from 2010 guidelines for ages 4 to 8. In 2010 it was 2 cups; now it's 2.5 cups. A serving equals 1 cup milk or yogurt, 1.5 ounces of cheese, 1 cup fortified soy milk. Kids aren't getting enough potassium, calcium, and magnesium. Two ways I can get teens to drink milk are in smoothies and yogurt parfaits, with low-fat granola and fresh fruit. Mozzarella or low-fat cheddar sticks are nice because they're portion-controlled, usually 1 ounce.
Q: Do we reduce liquid milk in their diet if they eat a lot of yogurt and cheese?
A: The trick with yogurt is you have to look at the nutrition label. If the calcium and Vitamin D are equivalent to a cup of milk, go for it. But some have a lot of gelatin, which means less calcium, and some have added sugars or artificial sweeteners.
Q: Milk also has sugar. Is it good sugar?
A: Unfortunately, the sugar grams on labels do not differentiate between added sugar and natural sugar, or lactose.
Q: What are the best substitutes for cow's milk?
A: For some ethnic groups that do not digest lactose well, there are lactose-free milks. Soy milk is very similar to cow's milk in the calcium content, because they add it.