Baby Milk Recommendations Changed

There's been a major change in baby nutrition advice, but it's gone nearly unnoticed. This week, the American Academy of Pediatrics changed its recommendation that weaned babies be fed whole milk until they're 2 years old.

Inst ead, after weaning, kids at risk of being overweight -- or whose families have a history of obesity, heart disease, or high cholesterol -- should get reduced-fat 2% milk between 12 months and 2 years of age.

It's a big change. Because dietary fats are important for early brain development, whole milk was considered essential for weaned babies up to age 2 years. But recent studies have found that kids given reduced-fat milk developed normally.

After their second birthday, all kids should be switched to low-fat 1% milk, says AAP spokeswoman Tanya R. Altmann, MD. Altmann is also an advisor to the National Dairy Council, which represents the dairy industry.

"This is for children who are overweight or at risk of overweight, or with a family history of high cholesterol or early heart disease," Altmann tells WebMD. "Children do need a certain amount of fat for brain development. But children now are getting too much fat from other sources. Dairy is very important for child development. Children and adults who consume low-fat dairy products are healthier. So we still recommend three servings a day of low-fat milk over age 2."

The advice came as part of the AAP's recent recommendations for cholesterol screening for children. But the milk advice got lost in the uproar over advice to give cholesterol-lowering drugs to some kids as young as 8 years old.

That controversy quickly quelled when parents realized that the AAP suggested using medication only as a last resort for the less than 1% of kids with disastrously high cholesterol levels.

Parenting style reflected in how children are fed

Parents' general approach to raising their children is often apparent in how they manage their kids' diets -- suggesting that efforts to control childhood obesity need to consider family dynamics, according to researchers.

In a study of 239 parents of first-grade children, researchers found that parents who were strict in general also tended to have an "authoritarian" approach to their children's eating -- banning certain foods, for instance, or using pressure to get them to eat fruits and vegetables.

Similarly, parents who were generally "permissive" in what they let their children eat tended to have similar parenting styles.

In between these two groups, the researchers found, were "authoritative" parents. These parents set limits on their children's diets, but often used more positive approaches -- like following a healthy diet themselves -- to get their kids to eat well.

The findings show that parents' general styles are important in their children's diets, according to Dr. Laura Hubbs-Tait and colleagues at Oklahoma State University in Stillwater.

They also suggest that efforts to help obese children lose weight are "not likely to be successful" unless the underlying family dynamics are addressed, the researchers report in the Journal of the American Dietetic Association.

In general, experts recommend that parents use positive approaches to get their children to eat right -- by setting a good example with their own diets, for example.

But in this study, both the strict and permissive parents typically failed to serve as good dietary role models for their children.

"Due to the infrequency of healthy eating modeled by both permissive and authoritarian parents," the researchers write, "food and nutrition professionals might encourage both to begin more healthy eating -- for the sake of their own health and that of their children."

A lack of attention to family dynamics may help explain why child obesity treatment is often less than successful, according to Hubbs-Tait and her colleagues.

"Food and nutrition professionals who are implementing dietary change or obesity treatment programs need to include more complex approaches to behavioral change that include parenting styles and family dynamics," they conclude.