Low-fat milk recommended for some toddlers

NEW YORK (Reuters Health) - Once weaned from breast-milk or formula, some babies as young as 12 months of age should be given reduced-fat (2 percent) milk instead of whole milk, according to newly revised guidelines issued by the American Academy of Pediatrics (AAP) this month.

Specifically, the new recommendation states that the use of reduced-fat milk "would be appropriate" for children between 12 months and 2 years of age who are at higher-than-normal risk of becoming overweight, or have a family history of high cholesterol, obesity, or heart disease.

"Previously, the recommendation had been for children between 12 months and 2 years of age to be on whole milk," Dr. Stephen R. Daniels noted in a telephone interview with Reuters Health. Daniels, of The Children's Hospital in Denver, is a member of the AAP's Committee on Nutrition that wrote the recommendation.

"The theoretical rationale for that was that children who were growing and developing may need an increased fat, and even potentially cholesterol intake, to support some development, especially neurological development," he explained.

The whole milk recommendation, he went on to say, was developed "at a time when there wasn't the kind of concern that we have now about childhood obesity."

Moreover, Daniels said, "we now have studies ... that show that starting a lower saturated fat diet even as young as age 6 or 7 months is associated with no adverse effects in terms of growth and development even carried out now to middle teenage years."

"When there is a concern about obesity or strong family history of obesity or cardiovascular disease, the new recommendation gives the pediatrician the option to consider using lower fat milk," Daniels said.

The new low-fat milk recommendation is part of a host of heart-healthy recommendations contained in the AAP statement "Lipid Screening and Cardiovascular Health in Childhood," which appears in the July issue of the AAP's official journal Pediatrics.

Among those recommendations, as previously reported by Reuters Health, children and adolescents should have their cholesterol level checked if members of their family have high cholesterol or heart disease, or if they do not know their family's health history. Cholesterol screening is also advised for children who are overweight or obese, or have high blood pressure or diabetes.

For these children, the first cholesterol check should take place after 2 years of age but no later than age 10. If their cholesterol levels are normal, repeat testing should be performed in 3 to 5 years, according to the guidelines.

Cholesterol-lowering agents, such as "statins," are now recommended for children over 8 years of age with high levels of "bad" LDL cholesterol. For younger children with unhealthy LDL levels, the focus should be on non-drug interventions, such as shedding excess weight, boosting physical activity levels, and adopting healthy eating habits.

SOURCE: Pediatrics, July 2008.