Guidelines Suggesting Children Avoid Plant-Based Milks: A Closer Examination
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COMMENTARY
Guidelines Suggesting Children Avoid Plant‑Based Milks: A Closer Examination Nicholas S. Wright1 · Morgen Smith2
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Recent Healthy Drinks, Healthy Kids (HDHK) guidelines state children between 12 and 24 months need to be consuming 2–3 cups a day of whole fat cow’s milk, and less of all other beverages except water. Guidelines explicitly state plant-based milks should be avoided (with the exception of soy milk). We agree that in the first 12 months the optimal food for childhood growth is breast milk, with formula used where needed. However, after weaning, milk of any kind is not required, and should not be relied upon as a main source of calories. Children will be fine with water and a healthy balanced diet. Whether cow’s milk should be consumed is beyond our scope here, however it is clear that plant-based milks can easily be included in day-to-day use post-weaning. Used in this fashion plant-based milks can be less harmful than dairy milks; at least for certain groups. Although cow’s milk is rich in calcium, it does not appear to clearly reduce fractures, but consumption carries risks including: a potential association with type 1 diabetes mellitus onset; anemia in toddlers; lactose intolerance; cow’s milk protein allergy; and infantile colic. Adverse effects from normal consumption must be compared against risks from plantbased milks, which are problematic mainly when used inappropriately in otherwise unbalanced diets; e.g. with inadequate solid foods. Despite limited evidence of serious harms from consumption of plant-based milks, HDHK provides vigorous recommendations, especially by comparison to guidelines with more evidence to support their stance (such as processed meats causing colorectal cancer). Keywords Nutrition · Breastfeeding · Cow’s milk · Plant-based · Guidelines
Significance What is already known on this subject? Dietary guidelines from prominent organisations can be extremely useful, especially for primary care providers and patients. The recent guidelines Healthy Drinks, Healthy Kids have stated, amongst other things, that children need to regularly be consuming cow’s milk from 12 months old onwards, but avoid plant milks except fortified soy. What this study adds? Here we reflect on the recent guidelines and why there seems to be a gap between common * Nicholas S. Wright [email protected] Morgen Smith [email protected] 1
Royal New Zealand College of General Practitioners, 50 Customhouse Quay, Wellington 6011, New Zealand
Plant Based New Zealand Health Charitable Trust, Gisborne, New Zealand
2
practice and the recommendations. The necessity of cow’s milk in the diet is questioned, and the harms of plant-based milks are briefly reviewed. After reviewing the recent “Healthy Drinks, Healthy Kids” (HDHK) guidelines from the Academy of Nutrition and Dietetics (AND), the American Academy of Pediatric Dentistry (AAPD), the American Academy of Pediatrics (AAP), and the American Heart Asso
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