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When Tiffany Branton runs out of whole milk for her 20-month-old son, Alex, she offers him the 1 per cent milk she and her husband drink. But since whole milk is the gold standard for babies under 2, she stocks up again immediately.
"If I gave him something with less fat I don't think he'd notice," she says. "But until he's 2, I'll give him whole milk and then talk to his doctor."
The Toronto mother is following the current guidelines most doctors and dietitians prescribe. The Canadian Paediatric Society, for instance, recommends offering whole milk to babies from the age of nine months, at the earliest, until they reach 2.
But parents may start seeing the dairy aisle in a different light if a major new medical statement about reduced-fat dairy products gains momentum.
The American Academy of Pediatrics is pushing for cholesterol testing for children as young as 2 to identify those at risk of heart disease. And for children as young as 1 who are considered at risk of becoming overweight or obese - and therefore at risk of high cholesterol and heart disease - the academy is in favour of reduced-fat dairy products, such as 2 per cent milk, to replace whole milk, which is 3.25 per cent fat.
The AAP updated its cholesterol policy for the first time in 10 years last week. But if the bloom is off whole milk for kids at risk, what might this shift mean for healthy kids like Alex? Will word get out that 2 per cent is no longer taboo?
If a parent wants to try out reduced-fat dairy on their one-year-old, "I'd say go for it," says Jatinder Bhatia, a pediatrician and professor at the Medical College of Georgia and a member of the AAP's nutrition committee, which contributed to the policy.
While Dr. Bhatia suggests parents discuss any such change with a pediatrician, he says whole milk should not be sacrosanct. As the ideal, it "came from when we didn't have any choices, when whole milk was the only transition from breast milk or formula."
The new AAP guidelines report, released in the journal Pediatrics, points to a continuing Finnish study called the Special Turku Risk Intervention Program, which introduced 1.5 per cent cow's milk to babies after 12 months of age and has found no adverse effects on growth or neurological function in the children. The LDL or "bad" cholesterol was lowered for boys and the prevalence of obesity in girls was decreased, compared with a control group.
Whole milk is already under fire from those who treat children with high cholesterol. Brian McCrindle, a pediatric cardiologist at the Hospital for Sick Children in Toronto, says, "The problem with milk is the fat in milk is saturated fat. That's one of the big ones that causes your cholesterol levels to go up.
"Kids are getting enough fat from other sources. They don't need to get the bad fat from milk." While he doesn't treat children under 2, Dr. McCrindle tells the kids he sees to drink only skim or 1 per cent milk. He says he would feel comfortable with suggesting 2 per cent for a healthy child under 2.
"The primary reason kids drink milk is to get the calcium," he says. "So do they really need all that extra fat? No."
Dr. McCrindle is part of a team working on new guidelines around childhood risk factors for heart disease and how to manage them for the U.S. National Institutes of Health. They hope to release their recommendations in the fall.
The Canadian Paediatric Society continues to recommend whole milk until the age of 2 but allows that 2 per cent "may be an acceptable alternative provided that the child is eating a variety of foods and growing at an acceptable rate."
About 15 per cent of Canadian infants are on 2 per cent milk around one year of age, the CPS reports.
Proponents of whole milk argue that 50 per cent of babies' diets come from fat. It's generally thought babies should have whole milk because it provides energy, it's dense and it carries fat-soluble vitamins, says Janis Randall Simpson, a registered dietitian and professor in the department of family relations and applied nutrition at Guelph University. She and a colleague have developed a nutrition screening tool to determine kids who are at high risk of being overweight or obese starting at the age of 3.
While studies have shown reduced-fat diets seem to be fine for children at risk of becoming overweight or obese, other children should stick to whole milk, says Dr. Randall Simpson. She's concerned that news of the AAP recommendation could spread too fast.
"People don't read all the in-between lines," she says. "They might just read, I don't need to buy homo milk for my child."
But Dr. Bhatia says breaking down taboos around reduced-fat diets for babies is an important step in the fight against childhood obesity.
"We have an epidemic on our hands. It's going to take a while. Change is always not easy."
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The milk debate
As part of a new cholesterol policy, the American Academy of Pediatrics came out in favour of reduced-fat dairy products, such as 2 per cent milk instead of whole milk (at 3.25 per cent fat) fro children considered at risk of becoming overweight or obese.
2% MILK
15
The percentage of Canadian infants who are on 2 per cent milk around one year of age, according to the Canadian Paediatric Society.
1
The age at which the American Academy of Pediatrics now recommends the use of reduced-fat dairy products, such as 2 per cent milk, for children at risk of becoming overweight or obese.
WHOLE MILK
9
The age, in months, babies can be offered dairy foods with 3.25 per cent fat or higher, according to the CPS.
2
The age until which whole milk is recommended by Canadian pediatricians. Two per cent is considered safe after the age of 2.
