Milk Matters

An important part of a toddler's diet, milk provides calcium and vitamin D to help build strong bones. Toddlers should have 500 milligrams of calcium and 400 IU (International units) vitamin D (which aids in calcium absorption) a day.

The calcium requirement is easily met if your child gets the recommended two servings of dairy foods every day, but this amount provides only half of the vitamin D requirement. The American Academy of Pediatrics (AAP) recommends vitamin D supplementation of 400 IU per day if a child is drinking less than one liter (about 4 cups) of milk a day.

In general, kids ages 12 to 24 months should drink whole milk to help provide the dietary fats they need for normal growth and brain development. Reduced fat (2%) milk may be given if overweight or obesity is a concern, or if there is a family history of obesity, high cholesterol, of heart disease. After age 2, most kids can switch to low-fat (1%) or non-fat milk. Your doctor will help you decide which kind of milk to serve your toddler.

Some kids initially reject cow's milk because it doesn't taste like the familiar breast milk or formula. If your child is at least 12 months and having this difficulty, mix whole milk with some formula or breast milk. Gradually adjust the mixture over time so it becomes 100% cow's milk.

Some kids don't like milk or are unable to drink or eat dairy products. Explore other calcium sources, such as fortified cereals, calcium-fortified soy beverages, broccoli, and calcium-fortified orange juice.Meeting Iron Requirements

Toddlers should have 7 milligrams of iron each day. After 12 months of age, they're at risk for iron deficiency because they no longer drink iron-fortified formula and may not be eating iron-fortified infant cereal or enough other iron-containing foods to make up the difference.

Cow's milk is low in iron. Drinking a lot of cow's milk also can put a child at risk of developing iron deficiency. Toddlers who drink a lot of cow's milk may be less hungry and less likely to eat iron-rich foods. Milk decreases the absorption of iron and can also irritate the lining of the intestine, causing small amounts of bleeding and the gradual loss of iron in the stool.

Iron deficiency can affect growth and may lead to learning and behavioral problems. And it can progress to anemia (a decreased number of red blood cells in the body). Iron is needed to make red blood cells, which carry oxygen throughout the body. Without enough iron and red blood cells, the body's tissues and organs get less oxygen and don't function as well.

To help prevent iron deficiency:

• Limit your child's milk intake to about 16-24 ounces a day.
• Serve more iron-rich foods (meat, poultry, fish, enriched grains, beans, tofu).
• When serving iron-rich meals, include foods that contain vitamin C (tomatoes, broccoli, oranges, and strawberries), which improve the body's iron absorption.
• Continue serving iron-fortified cereal until your child is 18-24 months of age.

Talk to your doctor if you're concerned that your child isn't eating a balanced diet. Many toddlers are checked for iron-deficiency anemia, but never give your child a vitamin or mineral supplement without first discussing it with your doctor.