How Much Milk Is Too Much Milk?

A child between 1-5 years of age should not be given more than 500 ml (2 cups) of milk per day

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A healthy growth (height and weight) of children is the most important aspect for parents. The physical  growth is dependent on several factors like nutrition, physical activity, calorie intake from our daily food. In India, milk is widely considered as a solution to all health problems. Moreover it is considered as wholesome food.

Milk is good source of protein, calcium, phosphorus, and vitamin A. It is inexpensive and easily available in every household. Every country has a different guidelines for milk consumption for their children.

Recent studies by Indian Academy of Pediatrics (IAP) suggested that if child is between 1-5 years of age, he or she should not be given more than 500 ml (2 cups) of milk per day. 

Various researches have been conducted to study the effect of milk consumption and its effect on height/weight of the child. These studies have concluded that milk does have positive benefits to height. But, associations between prolonged bottle-feeding and excessive milk intake has cause an imbalance of nutrients by insufficient intake of nutrients that milk does not contain or lacks, may occur. In addition, cow’s milk in infants and toddlers has adverse effects on iron stores leading to iron deficiency anemia (IDA) and also affect neuro development in children.

Taking milk more than required dietary amount based on age or sex results in surplus energy.  The surplus energy provided by milk was stored as fat causing weight gain by increasing the total calorie consumption and increases protein intake. High protein intake during infancy and early childhood was associated with an increased risk of obesity. When a direct relationship exists between milk intake and the growth or nutritional status of children, more specific recommendations on milk intake are essential.

As paediatric haematologist, we often see children in our OPD practise with excessive milk intake and we usually find iron deficiency anaemia, specifically in these children more often. There are more than one reason for this association: low iron content of cow’s milk, low iron bio availability for absorption, inhibition of iron absorption due to high amounts of the calcium and casein provided by milk, and occult intestinal blood loss.

Especially toddlers, the preference for food and beverages increases, often resulting in the refusal of healthy iron-rich foods and replacement with significant amounts of milk and fruit juices. Since stomach is already filled with volume of milk, child lacks in nutrients and vitamins which milk fails to provide and affecting 360 growth of the child. Children eventually become pale, obese, irritable, dull and lacks energy for any physical activity. 

To supervise the milk intake of toddlers, national guidelines made to provide an optimal growth of children. Despite of our traditional or societal beliefs, for the best interest of the child aged 1-5 years of age, should not be given more than 500 ml of milk (2 cups) per day.