Letter

I recently received a letter from the local health visiting team containing my son's 1 year review, it asks if I have any concerns about his development and there is a list of expected developmental milestones such as does the child recognise their own name, can they sit unsupported, do they eat a varied and balanced diet, - all good stuff, then amongst everything it says the child should have "500ml of cows milk per day".

Regardless of whether one consumes meat and dairy or not, that is an un-healthy quantity of milk for such a young child, so I wrote the following letter:

To Whom It May Concern:

I am enclosing this letter together with my son’s 1 Year Development Review as I am gravely concerned about one of the points on the “Expected range of development for children aged 1 year of age” list.

Under the section about Diet and Health it is suggested that a 1 year old child should be consuming 500ml of cows milk per day. This concerns me greatly for the following reasons;

The WHO recommends that infants (male and female) of 1 year consume 1.14g protein per kg in weight (the recommended consumption reduces to 1.03g/kg by 1½ years and 0.97g/kg by 2 years of age. If an infant consumes 500ml of (whole) cows milk per day they will be consuming 17g protein per day (3.4g/100ml source: The dairy Council http://www.milk.co.uk - Nutritional composition of milk) from milk alone in addition there will be protein in almost everything that the child eats. This is more protein than a child weighing 14kg at 1 year needs per day (less than 2% of boys weigh that much at 1 year) Source: WHO recommended safe levels of protein in Infants and children page 176 of Protein and amino acid requirements in humans http://whqlibdoc.who.int/trs/WHO_TRS_935_eng.pdf

500ml of whole cows milk contains 590mg calcium, according to the Food Standards Agency children between ages 1 and 3 require about 350mg calcium per day (297ml of milk would provide this, however assuming the child has a varied diet they would not even need this amount of milk, breast milk (which is recommended by the WHO and DOH till a child reaches 2 years contains 25% of the amount of calcium of cows milk but is a better source as it is more easily assimilated into the human body), cooked spinach, parsley, dried figs, almonds (for example in smooth almond butter), un-hulled sesame seeds (for example dark Tahini) are also very good souces as are many other seeds, nuts, beans, tofu and green leafy vegetables.

There is a significant increase in the risk of developing juvenile diabetes – this is due to the casein (protein) in the cows milk that is not recognised by the human body and therefore the body produces an immune response, casein has the same amino-acid sequence as the Beta cells in the pancreas, so the body may start destroying the Beta cells in the pancreas thus causing diabetes type 1.
Sources: Lancet Medical Journal June 1999, American Journal of Clinical Nutrition 1990; 51:489-91
“Early cow milk exposure may increase juvenile diabetes risk by about 1.5 times” – Diabetes Care 1994; 17 (1):13
Babies who are fed whole cow's milk during the second six months of life may experience a 30% increase in intestinal blood loss and a significant loss of iron in their stools." Paediatric 1992; 89 (6): 1105-1109 – The bleeding may reduce after 1 year however people who consume large amounts of dairy are still more prone to iron deficiency (anaemia). “Cow’s milk is a common cause of iron deficiency. It contains less iron than many other foods and also makes it more difficult for the body to absorb iron from other foods. Cow's milk also can cause the intestines to lose small amounts of blood.” (Source: http://www.nlm.nih.gov/medlineplus/ency/article/007134.htm - A service of the U.S. National Library of Medicine)
Too much protein increases the levels of uric acid in the blood and to neutralise the excess acid calcium is leached from the bones. "Dietary protein increases production of acid in the blood which can be neutralized by calcium mobilized from the skeleton." American Journal of Clinical Nutrition, 1995; 61 (4)
The only reason I can think of for the recommendation of such large quantities of milk in a small child’s diet is to increase the calories/fat, however a balanced diet should be capable of supplying adequate calories and fat, not to mention better proportions of monounsaturated and polyunsaturated fats to saturated fat – the quantities of milk you are recommending give 12g saturated fat, 5g monounsaturated fat and 0.5g polyunsaturated fat. Oils, nuts, seeds, olives and avocado are all good sources of fats with appropriate proportions of saturated fats to mono and polyunsaturated fats. I think it is well known that a child’s diet will impact their health and diet choices for life, so surely ensuring that more appropriate dietary advice should be given?
My son in addition to receiving an average of 4 breastfeeds, consumes around 200ml of fortified soya milk (Alpro Junior 1+) per day and we have a very varied vegan diet. I asked for a referral to a dietician before we started weaning and she agreed that our family diet was adequate to provide all appropriate nutrients for my son. I will admit that my views on the suitability of milk as a food is biased, I have been a vegan for many years, I have enjoyed very good health as a result and my choices for becoming and staying vegan have primarily been health based – based on my own research, based on science. As you can see everything I have quoted is from well respected official sources and medical journals. I appreciate that many families have very poor diets that are anything but varied and balanced, however it would be more appropriate in my opinion to educate such families in balanced diets than hoping that including 500ml of milk will supply their lack of good nutrition.