The question:
At what age is it safe to start a child on regular milk? If 1 percent, 2 percent, full-fat or nonfat best? Should we try to get organic milk? Also, what are the signs of lactose intolerance?

The Pediatrician Answers:
For the majority of children, whole cow milk can be started at about one year of age. The American Academy of Pediatrics (AAP) recommends the use of whole milk until the age of two years to assure adequate fat intake in the diet for the developing nervous system. After about two years, milk fat content can be decreased to low or nonfat milk. Certainly by school age, nonfat milk is preferred for most children.

If you feel strongly about potential pesticide exposure or the use or non-use of growth stimulants in dairy cows, you may opt for organic milk (but it tends to be somewhat more expensive). Milk does need to be pasteurized; raw milk can contain dangerous infectious agents.

Lactose intolerance runs in families and can begin expressing itself during the toddler years. People who are lactose intolerant generally find that they get very "gassy" and can have loose stools and abdominal pain if they consume milk. They generally can tolerate a certain small amount of milk without becoming symptomatic, but this varies with the individual. Many lactose-intolerant people can drink Lact-Aid milk.

Linda Shaw, MD, FAAP

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