Most children under the age of 5 should avoid plant-based milk, according to new health guidelines about what young children should drink. Plant-based milk made from rice, coconut, oats or other blends -- with the exception of fortified soy milk -- lack key nutrition for early development, according to guidelines released on Wednesday by leading health organizations.
They should also avoid diet drinks, flavored milks and sugary beverages and limit how much juice they drink, the guidelines said.
Plant-based milk is made from rice, coconut, oats or other blends that lack key nutrition for early development, according to the Healthy Eating Research guidelines. The recommendations come from a panel of experts with the Academy of Nutrition and Dietetics, the American Academy of Pediatric Dentistry, the American Academy of Pediatrics and the American Heart Association.
Limiting plant-based milk was a key change based on drinking trends.
"In the last five to 10 years there has been an explosion of interest in plant-based milk. More and more parents are turning to them for a variety of reasons and there's a misconception that they are equal somehow to cow or dairy milk, but that's just not the case," said Megan Lott, who helped develop the recommendations as the deputy director of the Healthy Eating Research.
She said most plant-based milk doesn't deliver enough of the key nutrition, like vitamin D and calcium, that growing children need in this vital developmental stage.
"The guidelines do make an exception if a child has a dairy or cow milk allergy or is lactose intolerant or has religious rules or lives in a house that keeps a vegan diet, in that case, the parents should definitely consult with their pediatrician or dietitian," Lott said.
Even as a registered dietitian, Lott said she had to look closely at what would work for her child. Her son is almost 3 and has a severe allergy to cow's milk. Based on his normal eating pattern, she had to figure out what kind of milk substitute can fill in the nutritional gap.
"What works for my son may not be the same for another young child, it's based on individual needs and why we talk about the need for parents to talk to the child's pediatrician or dietician about it," Lott said.
Guidelines about what drinks to avoid
A few other drinks to avoid, according to the guidelines, include low-calorie and zero-calorie drinks.
"We are finding more and more of these artificial sweeteners showing up in food marketed to young children and there is no research on these substitutes that show they cause harm, but there's really no research showing that they are safe," said Lott.
With children being in a vulnerable developmental stage, it's good to be cautious, she said.
Toddler milk and flavored milk is also off the menu. In the past, recommendations allowed some wiggle room on flavors, suggesting that chocolate milk would be better than no milk at all, Lott said, but the committee shifted its thinking. She noted this is a key age when a child develops a taste preference and it's more important to create healthy habits early.
Still off the menu for young children are sugar-sweetened beverages and caffeinated beverages, such as soda.
The other key change involves juice. The guidelines recommend children under 1 year old drink no juice at all. For age 1 to 3, it's no more than half a cup a day, and for children who are 4 and 5 it's no more than half-cup to 3/4 a cup a day.
What children should drink
The guidelines say babies need only breast milk or infant formula and once they are 6 months old, small amounts of water. Children should stick to milk, water and occasionally drink juice.
The guidelines recommend children between the age of 1 and 2 years old drink two to three cups of whole milk a day. At age 2 and 3 they should drink no more than two cups of skim or low-fat milk a day. For age 4 and 5 they should drink no more than two and a half cups of skim or low-fat milk a day.
For water, it's a half-cup to a cup for 6- to 12-month-old children, one to four cups a day for ages 1 to 3, and one and a half to five cups a day for 4- and 5-year-olds.
"When some parents walk into a grocery store they may be overwhelmed by the options, but in daily life, the key message is, what we recommend is doable, even if it does take some persistence and cooperation," Lott said. "There are lots of opportunities to make great improvements in a child's nutrition for parents here."