St. Christopher's Pediatrician Gives Tips on Ending the Milk Strike

Calcium and vitamin D are two important nutrients that children simply cannot afford to skip. Unfortunately, that is exactly what some one-year-old children do when transitioning from breast milk or infant formula - they refuse to drink cow's milk.

It's a dilemma that some pediatricians have labeled as "the milk strike."

Dr. Eileen Tyrala, a pediatrician and baby formula specialist at St. Christopher's Hospital for Children, says m:ilk strikes can go on for a long time. "Realizing that it's not as sweet as breast milk or formula, some children flat out reject cow's milk," she says. "Unfortunately, it can be the start of lifelong pattern of not drinking milk. However, it's crucial that children get the calcium and vitamin D their bodies need. In this case, parents must use other ways to incorporate both calcium and vitamin D-rich foods into their child's diet."

Guidelines for vitamin D intake in children have recently been increased by the American Academy of Pediatrics. According to the American Dietetic Association, Vitamin D has been found to play a role in the prevention of diabetes, high blood pressure and heart disease. In addition, they say that both calcium and vitamin D are important for building strong bones and muscles.

"These nutrients are abundantly found in milk," says Tyrala. "Parents of children who won't consume at least three servings of milk or other dairy products per day, can try the following:

• Add small amounts of strawberry or chocolate flavoring to milk to increase its appeal
• Offer flavored yogurt as a snack
• Offer children cheese products, such as cottage cheese or mozzarella string cheese, or add cheese to sandwiches
• Switch to calcium-fortified orange juice, breads and breakfast cereals
• Add dark green vegetables to meals. High-calcium vegetables include spinach, broccoli and peas

Tyrala says that although there is additional sugar in flavored milk, it does not cancel out the nutritional benefits of milk. Concerns about the extra sugar intake are valid, particularly if the child is overweight. For this reason, I recommend using low fat milk and only half of the suggested amount on flavoring product. Low fat milk has the same nutritional benefits of whole milk, except there is less fat and fewer calories.

Tyrala adds that younger kids and babies with inadequate calcium and vitamin D intake are at an increased risk for weaker bones and even rickets. Rickets is a bone-softening disease that causes severe bowed legs, poor growth, muscle pain and weakness. If adequate quantities of calcium and vitamin D cannot be obtained in a normal diet, supplements are an option.

St. Christopher's Hospital for Children is a 189-bed pediatric hospital located in Philadelphia. The hospital provides a wide range of pediatric medical and surgical specialties through its affiliation with Drexel University College of Medicine and Temple University School of Medicine. With a medical staff of more than 270 pediatric specialists, St. Christopher's is a Regional Level I Pediatric Trauma Center and provides programs such as kidney and bone marrow transplantation, minimally invasive surgery, and open heart surgery for the children of the greater Philadelphia area and from around the world. The hospital is fully accredited by the Joint Commission, the nation's oldest and largest hospital accreditation agency.