Gurumommy is welcoming back our pediatrician, Lawrence Kagan MD FAAP and his column, ‘from the doctor’. Dr. Kagan’s pediatric practice, Westside Pediatrics, is located conveniently at 12301 Wilshire Boulevard Suite 120 in Brentwood, CA (www.WSPeds.net, 310-979-7337). Today Dr. Kagan discusses nutrition.
Yes, but as is true with everything in life, only in moderation. Breastmilk is undoubtedly natures perfect nutrition for a growing baby (and cow’s milk based formula the next best substitute), so it is very logical for parents to assume the same holds true for cow’s milk. The American Academy of Pediatrics recommends introducing cow’s milk at one year of age. While I agree that milk is an excellent vehicle to deliver calories and calcium to a growing child, milk too often becomes a majority component of a toddler’s diet. Their tummies are small and milk is quite filling. Most children are quick to drink their milk and ignore the food on their plate. In an age of childhood obesity and high cholesterol, it is extremely important that we focus on eating a variety of healthy foods. Further, cow’s milk is actually an intestinal irritant. Overindulgence can result in microscopic blood loss into the stools and a resulting iron deficiency anemia (reduced number of red blood cells and oxygen carrying capacity). On rare occasion this anemia can be profound and dangerous, but mild anemia is common and has been shown to decrease intellectual growth and hamper school performance. With this in mind, no child should drink more than 3 cups (24 ounces) of milk in one day. We could also discuss milk allergies and lactose intolerance, but let’s not J because I don’t want to over discourage the use of milk. Milk is a healthy food worth including in a balanced diet.
So, how much milk does a toddler actually need? They actually don’t NEED any. The goal is to deliver calories, calcium, and Vitamin D which can be accomplished with cheese, yogurt, salmon, tofu, spinach, beans, broccoli, peas, brussel sprouts… Not to mention all the calcium fortified cereals and supplements. That said, most kids like milk and will benefit from it in reasonable quantities.
My thoughts on nutrition in a nutshell:
- Offer many small meals a day
- Encourage a variety of healthy foods
- Starting at one year of age, use whole cow’s milk fortified with omega-3 (DHA)
- Offer 1 to 2 cups of milk per day (8 – 16 ounces)
- Up to 3 cups (24 ounces) is perfectly safe, but may reduce the intake of other important foods
- At 2 years of age, transition to 2% reduced fat milk fortified with omega-3 (DHA)
- Discuss with your pediatrician transitioning to 2 % earlier if there is a family history of obesity or high cholesterol
- Avoid juice, soda and fried foods
- Use children’s supplements daily including omega-3, a multivitamin and probiotics
- Enjoy dessert on special occasions
- Don’t use food as a reward
A healthy diet is of paramount importance to a child’s development. From immune function to cancer to osteoporosis, early eating habits have implications throughout our lives. I encourage all parents to make an extra effort when it comes to what we feed our kids.