Nothing is more faddish and occupies more wasted and painful discussion that what little babies and young children should drink. New recommendations on this subject issued by the bigwigs (The Academy of Nutrition and Dietetics, the American Academy of Pediatric Dentistry, the American Academy of Pediatrics, and the American Heart Association) are no exception. Since babies start out drinking their entire diet, “drinking” often also means “eating.” Titled “Healthy Beverage Consumption in Early Childhood,” (1) these recommendations “are based on the best available evidence, combined with sound expert judgment, and provide consistent messages that can be used by a variety of stakeholders to improve the beverage intake patterns of young children,” according to the authors. The evidence for these recommendations as well as the consequences of following or not following them is small. Still, they self-importantly say, “it is imperative to capitalize on early childhood as a critical window of opportunity during which dietary patterns are both impressionable and capable of setting the stage for lifelong eating behaviors.” But the rules are as complicated and conditional as ever and anyway nobody is going to do it.
Since I am a pediatrician I am forced to spend my valuable time contending with this stuff. So in the spirit of this folly and because misery loves company here are the main recommendations boiled down as hard as I can: – Breast milk or formula for the first 12 months.
– Water is not necessary for the first 6 months and can be increasingly introduced after 6 months when solid foods can be started.
– Whole, pasteurized milk from 12 to 24 months unless weight gain is excessive or there is a family history of obesity, then skim milk.
– No 100% fruit juice until after 12 months although whole fruit is preferred and then no more than 1/2 cup per day.
– For plant-based milks like soy milk – never mind it’s too complicated – “in consultation with health care provider.”
– No flavored milk like chocolate or strawberry… No “toddler milk.” No sugar-sweetened drinks. No low calorie or caffeinated drinks.
There you have it. But am going to have to drink an adult beverage to deal with it.
John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- firstname.lastname@example.org or phone-354-6605.