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Experts recommend kids under 5 drink only cow’s milk, water

Recommendations developed as part of unprecedented collaboration by top health and nutrition organizations.

Leading medical and nutrition organizations recommend breast milk, infant formula, water and plain milk as part of a new set of comprehensive beverage recommendations for children, depending on age. From birth to age five, the experts cautioned against beverages that are sources of added sugars in young children’s diets, including flavored milk (e.g., chocolate or strawberry) and low-calorie and sugar-sweetened beverages, in addition to a wide variety of beverages that are on the market and targeted to children such as toddler formulas, caffeinated beverages and plant-based/non-dairy milk varieties, which they say provide no unique nutritional value.

“Early childhood is an important time to start shaping nutrition habits and promoting healthy beverage consumption,” said Megan Lott, deputy director of Healthy Eating Research (HER), which convened the expert panel. “By providing caregivers, health care and early care and education providers, policy-makers and beverage industry representatives a clear set of objective, science-based recommendations for healthy drink consumption, we can use this opportunity to work together and improve the health and well-being of infants and young children throughout the United States.”

The recommendations were developed as part of an unprecedented collaboration by experts at the Academy of Nutrition & Dietetics (AND), American Academy of Pediatric Dentistry (AAPD), American Academy of Pediatrics (AAP) and American Heart Assn. (AHA) under the leadership of HER, a leading nutrition research organization, and with funding from the Robert Wood Johnson Foundation.

“From the time children are born through those first few years, beverages are a significant source of calories and nutrients and can have a big impact on health long into the future,” said Dr. Richard Besser, president and chief executive officer of the Robert Wood Johnson Foundation. “Families deserve clear and consistent guidance on what their young children should drink and what they should avoid. These recommendations from our country’s leading medical and nutrition organizations will help families raise healthy children.”

Dr. Natalie Muth, who represented AAP on the expert panel, said, “As a pediatrician, I know what a child drinks can be almost as important as what they eat, in terms of a healthy diet.”

Muth said this is especially true for very young children. “We know that children learn what flavors they prefer at a very early age — as young as nine months — and these preferences can last through childhood and adulthood. That’s why it’s important to set them on a healthy course, and this guide will help parents and caregivers do that.”

Nancy Brown, CEO of AHA, pointed out that nearly 40,000 people in the U.S. die each year from heart problems due to overconsumption of sugary drinks.

“This is unhealthy and unacceptable, and the seismic shift in our culture needed to change this status quo must start with our kids,” she said. “The American Heart Assn. is proud to endorse these guidelines and stand with parents, caregivers, medical professionals, restaurant owners and policy-makers who can help ensure a healthier future for our kids.”

To develop the evidence-based recommendations, HER conducted an extensive review of scientific literature, existing guidelines from national and international bodies and reports on early childhood beverage consumption. It also convened an expert panel of representatives from AAP, AHA, AND and AAPD and a scientific advisory committee whose members discussed and reviewed the preliminary and final recommendations. Panelists and committee members were experts in pediatrics, early childhood nutrition, dentistry and dietary and nutrition guidance.

“Choosing healthful beverages for children is just as important as choosing healthful foods,” said AND president Terri J. Raymond, a registered dietitian nutritionist. “These consensus recommendations provide a strong base for registered dietitian nutritionists and health care practitioners to help educate children and parents alike and create examples of healthy dietary patterns for children ages zero to five in order to support optimal physical and cognitive growth and development as well as overall health.”

The International Dairy Foods Assn. (IDFA) welcomed the research results and recommendations.

“Dairy milk is one of the healthiest things we can serve our kids, according to a panel of leading health experts who strongly recommend parents make dairy milk a key part of their child’s diet beginning at one year of age,” stated Cary Frye, IDFA senior vice president of regulatory affairs. “The experts conclude that cow’s milk — whole, low-fat and skim milks — offers a host of essential nutrients that young kids need to be healthy while recommending parents strictly limit or eliminate all other beverages.”

She added that IDFA members, "along with the dairy farmers who supply their milk, are proud of the role they play in improving the health and nutrition of Americans, including children, who consume our products. Giving our kids the opportunity to drink nutritious milk throughout the day is one of the best things we can do for their health and development.”

Frye highlighted that dairy milk is a “super-food” for kids that provides many essential nutrients, including protein, calcium, vitamin D and potassium. In fact, she said milk is the number-one source of protein in the diets of children ages 2-11 and is the reason dairy milk is in 95% of American homes today.

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