Growth happens rapidly in infancy and childhood. Nutritional needs change just as quickly. In order to support the bones, muscles, blood and teeth that are developing, children need more nutrients relative to their size than adults. If a child refuses to eat certain foods, does not eat enough of a particular food type or has a poor appetite for a long period of time, he might be at risk for malnutrition. Children do not always tolerate cow's milk, and its absence in the diet might cause deficiency in certain nutrients.
Nutrition of Milk
Milk is categorized by the amount of fat it contains. It is sold as skim, 1 percent, 2 percent or whole, which contains at least 3.25 percent milk fat. Milk is usually fortified with vitamin D, a nutrient that is vital for bone health. In 100 g of milk, or 3.5 oz., there are 40 International Units (IU) of vitamin D. This same volume of milk contains 3.2 g of protein, 113 g of calcium, 44 g of vitamin B-12 and many other trace vitamins and minerals.
Recommendations
An article published in the November 2006 issue of "American Family Physician" stated that children younger than 2 years old should not be put on a fat and cholesterol restricted diet. After a child's second birthday, a diet with about 30 percent of calories from fat, primarily polyunsaturated fat, is sufficient. However, an article published in the "Journal of the American Dietetic Association" in January 2001 found no different in height, weight and percent body fat between toddlers who consumed 2 percent versus whole milk between the ages of 12 and 24 months. Toddlers should consume dairy products, such as milk, at least two to three times each day. Fruit juices, which often replace milk in a child's diet, should be limited to 100 percent fruit juices at 4 to 6 oz. per day.
Deficiency
Protein and vitamin D deficiency are the two most common forms of deficiency related to milk consumption. Kwashiorkor develops from extremely low dietary protein. Physical signs include edema, skin lesions, distension of the belly and thinning hair. Rickets is caused by vitamin D deficiency and is characterized by bowed legs and soft bones. Vitamin D deficiency develops in the absence of fortified milk and is aided by lack of exposure to sunlight and dark skin pigmentation.
Substitutions
Some children do not tolerate cow's milk and, therefore, require a milk substitute. It is crucial that attention is paid to the nutrient content of the substitute and that the levels of protein, vitamin D and calcium are comparable to that of cow's milk. If soy or rice milk is the desired substitute, make sure it is fortified with vitamin D and calcium. Rice milk does not have adequate amounts of protein, so it is important that children drinking rice milk consume other sources of protein.
References
- "American Family Physician"; Nutrition in Toddlers; Allen RE and Myers AL; November 2006
- "Pediatrics"; Severe Nutritional Deficiencies in Toddlers Resulting from Health Food Milk Alternatives; Norman F. Carvalho, et al.; December 2000
- "Krause's Food, Nutrition, and Diet Therapy"; L. Kathleen Mahan, et al.; 2000



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