Milk

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Milk

Milk

Organic, raw, cow, almond, soy, rice, omega-3 fortified, breast or none?  What kind of milk to you give your kids?  For my mother, the answer was easy:  I was not excused from the table until I drank all my cow milk.  But new data is changing the age-old recommendation that kids need three glasses of cow milk per day.  The internet is full of moms with passionate milk advice, but I found they raised more questions than answers.  So here what I came up with when trying to decide what milk to buy for my family:

  • Two 8-ounce glasses of cow milk per day is about right: New research out of Canada shows that kids who drink more than 2 glasses of cow milk per day are at risk for anemia, or low iron levels.  Anemia is associated with behavioral problems and poor school performance.  Kids who drink less than 2 glasses of milk per day are at risk for low calcium and vitamin D levels.
  • Organic milk isn’t worth the extra price: I’ll admit it, for nearly ten years I bought organic, hormone-free milk.  I was scared by recombinant bovine growth hormone.  I was worried about pesticides on the grass the cows eat.  I didn’t like all the antibiotics given to milk cows.  But after studying years of research on organic milk, here’s what the American Academy of Pediatrics concluded: “There is no evidence of clinically relevant differences in organic and conventional milk.” If you, like me, have spent lots of money on organic milk, don’t feel too bad.  The report also says: “Several studies have demonstrated that organic milk has higher concentrations of antioxidants and polyunsaturated fatty acids.  However, it is important to recognize that the composition of milk is strongly related to what cows eat. This differs by time of year (outdoors in the summer, indoor forage in the winter) and whether the farms are high or low input.” [http://pediatrics.aappublications.org/content/early/2012/10/15/peds.2012-2579]
  • Chocolate milk probably isn’t worth the bribe: If you look in the milk cooler at our local public elementary school, there’s plenty of chocolate, vanilla, and strawberry milk and a few lonely white milks hiding in the upper corner.  Adding sugar and artificial flavor to milk may seem like a worthy trade-off to get kids to actually drink it.  But the more we understand that milk is not a perfect food, the more I wonder if sugary, flavored milk is really worth the protein, calcium and vitamin D.  For my kids, the answer is no.  We pack a water bottle in their lunch boxes.
  • Omega-3-fortified milk isn’t worth the price: Kids do need omega-3 fatty acids, which are naturally occurring in breast milk and usually added for formula.  Once they transition off breast milk or formula, I recommend supplementing unless you really do convince your kids to eat enough fish, walnuts and other foods that are naturally high in omega-3’s.  [Vitamin Wars].  But the high price of omega-3 fortified milk doesn’t make it worthwhile for me.  It’s cheaper to just give supplements.
  • Only breast milk or formula for babies:  Infants under 12 months of age are at risk for microscopic bleeding in the intestines if they are started on cow milk too soon.  This bleeding can cause anemia.  More commonly, cow milk causes constipation and results in a very irritable little one.  What about almond, soy, and rice “milk”?  Have you ever noticed that these products carry a warning that states, “Not intended as an infant formula”?  Almond, rice and soy milk do not offer the nearly-complete nutrition offered by breast milk and formula.  I once cared for an infant who was admitted to the hospital with rickets after she was fed almond as a natural alternative to formula.  As always, remember that breast is best for babies.  Do you have the breastfeeding blues [link to article]?  Are you struggling with breastfeeding?  Consider supplementing by syringe feeding.
  • Almond milk isn’t a great alternative:  Almond gets an A+ on taste and makes fabulous non-dairy ice “cream,” but it isn’t a great source of protein, calcium and vitamin D.  Although commercial almond milk is usually fortified with calcium and vitamin D to match the calcium and vitamin D content of dairy milk, the American Academy of Pediatrics warns that people absorb the nutrients in milk and milk products better than they do those in plant-based milks.
  • The science is unclear on soy milk: Soy milk is a protein-rich white drink made from the soy bean, and it is usually fortified to have nutritional content similar to cow milk.  But the internet is full of theories that suggest that the phytoestrogens—plant estrogens–in soy milk increase cancer risk.  Still others claim that drinking soy milk during childhood reduces lifetime cancer risk.  I haven’t been able to find any sound published research that supports either side of this debate.  But soymilk is still a plant-based milk and hence has the same nutrient absorption problems as almond milk.
  • Forget the rice milk: Rice milk has recently been shown to have such high levels of arsenic [link to arsenic article]that it is not recommended for children under five years of age.  It also has very little protein.  My third child is allergic to milk and soy, and so after he was weaned from breast milk we gave him rice milk about twice a day.  So I was horrified to read this research… being a good mom is not about being perfect, it’s about trying your best to do what’s right.
  • Raw milk isn’t safe for babies and pregnant moms: Raw milk, or unpasteurized milk, makes tasty cheese and yogurts, but it can contain harmful bacteria.  The CDC reported that unpasteurized milk is 150 times more likely to cause food borne illness and results in 13 times more hospitalizations than illnesses involving pasteurized dairy products.  Anyone can become ill from the bacteria found in raw milk, such as Listeria.  But pregnant women and infants are especially prone to the serious ramifications of Listeria infection.
  • You don’t HAVE to drink milk: Are you vegan?  Or perhaps you subscribe to the philosophy that cow milk is intended for baby cows.  Or maybe you are still worried about hormones, bacteria, or pesticides in cow milk.  In any case, you and your kids don’t have to drink milk.  There are many other great sources of protein, calcium, and vitamin D.  Sometimes it’s just hard to get kids to eat leafy green vegetables and fish.

If you do choose to reduce the amount of milk in your family’s diet, consider what they will drink instead.  Try to increase water, and limit high-sugar drinks such as soda, sports drinks and juice.

Copyright 2013 Kathleen Berchelmann, M.D.

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7 Comments

  1. Dear Dr. Berchelmann,

    Regarding the statement: “It is important to recognize that the composition of milk is strongly related to what cows eat. This differs by time of year (outdoors in the summer, indoor forage in the winter) and whether the farms are high or low input.” ”

    I may be just another Internet mom with an opinion, but it is my understanding that cows are typically fed grains (corn, soybeans, etc) and not grass. If you want grass-fed milk you usually have to pay extra and the milk will be specially marked as such. I know because we go out of our way to get grass fed milk from a small specialty farm. Mass produced milk and organic milk are not necessarily grass fed milk.

    Grass fed milk is worth it because in my opinion it tastes better and fresher.

    Thanks, Sarah Beth the Internet Mom

    • p.s. I’m not posting to muddy the issue you are trying to clarify, but buying from the local farmer means yummier milk!

  2. My husband and all of his family and relatives grew up on raw milk, and no one ever was sick from it. My own family drinks 3 gallons every week! It is easier to digest than pasteurized/homogenized. If you are curious about it, there is a wealth of information and facts on studies at A Campaign For Real Milk: http://www.realmilk.com/ It is good to research before making a decision.

    As for the phytoestrogens in soy: “As for girls, an alarming number are entering puberty much earlier than normal, according to a recent study reported in the journal Pediatrics. Investigators found that one percent of all girls now show signs of puberty, such as breast development or pubic hair, before the age of three; by age eight, 14.7 percent of white girls and a whopping 48.3 percent of African-American girls had one or both of these characteristics. New data indicate that environmental estrogens such as PCBs and DDE (a breakdown product of DDT) may cause early sexual development in girls and a study in Puerto Rico implicated soy feeding as a cause of early menarche. The use of soy formula in the WIC program, which supplies free formula to welfare mothers, may explain the astronomical rates of early menarche in African American girls.

    Scientists have known for years that isoflavones in soy products can depress thyroid function, causing autoimmune thyroid disease and even cancer of the thyroid. While soybeans are relatively high in protein compared to other legumes, scientists have long recognized them as a poor source of protein because other proteins found in soybeans act as potent enzyme inhibitors. These “antinutrients” block the action of trypsin and other enzymes needed for protein digestion. In test animals, diets high in trypsin inhibitors depress growth and cause enlargement and pathological conditions of the pancreas, including cancer.

    For thousands of years, people all over the world have been consuming cow and goat milk, especially raw milk, with great health benefits. In the pharmaceutical age, there seems to be a push to buy anything that’s highly processed in the name of “safety” yet we are finding out that these things are not as safe as we deserve! As a Catholic Mom, I stick to the foods that God created naturally and I have very healthy and happy teenagers right now!

    • Catholicism is not an excuse for ignorance. Raw milk can and does make people deathly ill.
      People have DIED for centuries after consuming raw milk. Pasterization and homogenization save lives.
      If you want to expose your family to harmful bacterial infections, then that is your business. But don’t use you Catholicism as a reason to promote harmful ignorance.

      • Mari, the only ignorant person here is you… read the facts. There are more people who get sick from pasteurized milk than from raw milk. I don’t use my Catholic faith as an excuse for anything. You sound like a bigot!

        • PASTEURIZED milk has been the source of many widespread outbreaks. A total for some of the documented outbreaks due to PASTEURIZED milk over the past few decades is 239,884 cases and 620 deaths.

          The nation’s largest recorded outbreak of Salmonella was due to PASTEURIZED milk contaminated with antibiotic-resistant Salmonella typhimurium. The outbreak, which occurred between June 1984 and April 1985 sickened over 200,000 and caused 18 deaths. Disturbingly, the CDC did not issue a specific Morbidity and Mortality Weekly Report for this outbreak; information must be gleaned from other reports published in the FDA Consumer and the Journal of the American Medical Association.

          A 2004 outbreak in Pennsylvania and New Jersey involved multidrug-resistant Salmonella typhimurium infection from milk contaminated after pasteurization.

          Despite numerous outbreaks due to pasteurized milk, neither the FDA nor the CDC has ever issued a warning against consuming pasteurized milk. Pasteurization is not a guarantee; pasteurized milk is not sterile. The FDA permits the presence of up to 20,000 bacteria /ml and 10 E.coli/ml in milk after the pasteurization process has been completed.

          Because pasteurization destroys probiotics (good bacteria), any harmful bacteria present in the milk after pasteurization can and will flourish. On the other hand, published research shows that good bacteria and many other components in raw milk actually destroy pathogens added to the milk.

  3. makes me feel a bit better–my oldest son was allergic to milk & eggs until age 3, so he never developed a taste for cow’s milk or cheese. We can’t get him to drink it, no matter what bribes or treat withholding we attempted. He will eat some cow’s milk yogurt now, so we’ll have to be content with that. He used to love soy milk, but once his little brother started drinking milk from the same type of sippy cup as his “ahh” cup, he never touched it again. “Little” bro, on the other hand, will drink all the milk he can, given free reign on the fridge. It’s not even the vitamin issue as much that bothered me, it was the weight gain issue–our no-milk guy is a skinny stick who for a while had some weight gain issues, so finding “healthful” fatty/higher calorie foods was tough when milk/cheese were out of the equation.

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