Mom Question:

My daughter is 3 years old and small so my pediatrician has recommended keeping her on whole milk.  She drinks 5 to 6 cups per day and I think it is affecting her allergies.  How much is too much milk?

Dr Kilbane:

Kids need about 16 to 24 ounces of milk per day.  The American Academy of Pediatrics recommends whole milk until age 2, then skim or 1%.  In the case of your daughter, it’s important to remember milk can be very filling.  If I am worried about the weight gain of a young child, I advise parents to keep milk intake less than 24 ounces but at least 16 ounces per day. 

The nutrients kids need from milk are calcium, vitamin D, and fat.  The fat in milk is ok, but there are plenty of other foods that contain the good healthy omega-3 fats such as fish, avocado, walnuts, almonds, olive oil, and flax seed.  Non-dairy foods high in calcium are:  green leafy vegetables, broccoli, sesame seeds, celery, almonds, and oranges.  Vitamin D is a little more challenging because the only foods which naturally contain it are cold water fish, shrimp, eggs, and foods fortified with vitamin D like milk, soy milk, cereals, and juices (and of course we also obtain vitamin D through sun exposure).  There is nothing magical about milk it simply facilitates getting these nutrients into kids who won’t eat some of the foods I have listed

If you suspect your daughter is allergic to milk, take her off all dairy for 2 weeks (milk, cheese, cottage cheese, ice cream, pizza, etc.).  If her runny nose, nasal congestion, and eczema clear up, then I would keep her off dairy for 3 to 6 months.  When re-introducing it, monitor her symptoms, if they return, stay off the milk for another 6 months.  Most kids outgrow their milk allergy by the time they are 5 or 6 but it can often be sooner. 

Vitamin D

There is a lot of research currently extolling the virtues of vitamin D and recently the American Academy of Pediatrics came out with a new Recommended Daily Allowance (RDA) for kids.  All infants, children, and adolescents need 400 international units per day.  Polyvisol and Trivisol are liquid vitamins for babies which contain exactly that amount.  They can be purchased from most pharmacies and are easy for young children to take.  All kids (and most adults) should be on some type of a vitamin D supplement.  I recently had my own vitamin D level checked and found it to be well below normal!