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Cow's milk and children

Milk and children; Cow's milk allergy - children; Lactose intolerance - children

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If your child is under 1 year old, you should not feed your baby cow's milk, according to the American Academy of Pediatrics (AAP). This is because cow's milk doesn't provide enough of certain nutrients such as vitamin E, iron, and essential fatty acids. Also, it's hard for your baby to digest the protein and fat in cow's milk. It is safe though, to give cow's milk to children after they're 1 year old.

A child who is 1 or 2 years old should only drink whole milk. This is because the fat in whole milk is needed for your child's developing brain. After 2 years old, children can drink low-fat milk or even skim milk if they are overweight.

Some children have problems from drinking cow's milk. For instance, a milk allergy may cause:

• Belly pain or cramping
• Nausea and vomiting
• Diarrhea

A severe allergy can cause bleeding in the intestines that can lead to anemia. But only about 1% to 3% of children under 1 year old have a milk allergy. It is even less common in children who are older than 1 to 3 years.

Lactose intolerance occurs when the small intestine does not make enough of the enzyme lactase. A child who is lactose intolerant can't digest lactose. This is a type of sugar found in milk and other dairy products. The condition can cause bloating and diarrhea.

If your child has one of these problems, your health care provider may recommend soy milk. But many children who are allergic to milk are also allergic to soy.

Children usually outgrow allergies or intolerances by the time they are 1 year old. But having one food allergy increases the risk for having other types of allergies.

If your child can't have dairy or soy, talk to your provider about other food options that will help your child get enough protein and calcium.

The US Department of Agriculture recommends the following daily amounts of dairy for children and teens:

• Under 2 years old: 1? to 2 cups (c) (400 to 480 milliliters [mL])
• 2 through 8 years old: 2 to 2½ c (480 to 600 mL)
• 9 through 18 years old: 3 c (710 mL)

1 c (240 ml) of dairy equals:

• 1 c (240 mL) of milk
• 8 ounces (oz) (240 mL) of yogurt
• 2 oz (56 grams) of processed American cheese
• 1 c (240 mL) of pudding made with milk

References

Centers for Disease Control and Prevention website. Fortified cow's milk and milk alternatives. www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/cows-milk-and-milk-alternatives.html. Updated May 20, 2022. Accessed July 19, 2023.

Marion G, Venter C. Management of food allergy. In: Leung DYM, Akdis CA, Bacharier LB, et al, eds. Pediatric Allergy: Principles and Practice. 4th ed. Philadelphia, PA: Elsevier; 2021:chap 35.

Parks EP, Shaikhkhalil A, Sainath NN, Mitchell JA, Brownell JN, Stallings VA. Feeding healthy infants, children, and adolescents. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 56.

US Department of Agriculture website. How much dairy, including milk should my child drink? ask.usda.gov/s/article/How-much-dairy-should-I-provide-for-my-child-under-the-age-of-two-How-much-milk-should-my-child-drin. Updated November 8, 2022. Accessed July 19, 2023.

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Review Date: 7/1/2023  

Reviewed By: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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