By Barton Schmitt, MD, FAAP
Young children can be picky eaters. But what happens when your toddler refuses everything but milk?
For many parents, that's when worries about childhood nutrition begin. But there are ways to break the habit of what health providers call "milk dependency."
Here are practical tips to help your little one begin eating fruits, vegetables, lean protein, whole grains and more—all essentials for healthy growth and development.
Signs that your child could have a milk dependency habit
Milk is their favorite (or their only) food.
They drink at least a quart of milk (32 ounces) each day.
They aren't hungry when mealtime rolls around.
They show little interest in solid foods.
They still ask for milk in the middle of the night.
They prefer a bottle, not a cup.
They cry or throw tantrums if they can't get milk.
How much milk is too much for toddlers?
Whether it comes from the breast or bottle, toddlers typically love milk. Nursing or sipping from a bottle or cup offers feelings of comfort and safety. Milk tastes good and it's easy to swallow. However, it is also high in calories and fills little ones up quickly. For all these reasons and more, the American Academy of Pediatrics (AAP) recommends daily milk intake of no more than 16 to 24 ounces (473 to 750 mL) after your child's first birthday.
If your child screams and cries whenever you offer anything but milk or juice, what can you do? Tough question, since parents know they shouldn't force kids to eat specific foods. But a milk-only diet is unhealthy, even if your toddler's weight falls within normal range.
How milk dependency affects your child's health
It sets up a harmful cycle of overly selective eating. The longer your child consumes only milk, the longer they will reject anything but smooth, soft foods. This rules out crunchy, chewy options like fruit, vegetables, whole grains and proteins that build healthy brains and bodies. (Also see "Ask the Pediatrician: How do I help my picky eater try more healthy foods?")
It promotes tooth decay. When teeth are constantly bathed in milk or juice, cavities can develop. Natural sugars in these drinks feed the bacteria responsible for decay. Even though "baby teeth" eventually fall out, early cavities hurt—and they are 100% preventable.
It can lead to iron-deficiency anemia. Cow, goat and breast milk are all low in iron. Growing kids need the iron found in other foods such as red meat, lentils, tofu, and dark, leafy greens like spinach.
Higher risks for obesity. Children who love milk tend to drink too much of it. Because milk and formula have about 20 calories per ounce—more than most foods—a milk-dependent child may gain weight faster than one eating a range of foods. Developing an early taste for high-calorie foods and consuming only favorites can set the stage for poor adult health.
Improving your toddler's milk-centric diet
Reducing milk intake is the only way to cure your child's dependence on milk. Expect screaming, tears and arguments at first. Through it all, keep in mind that you're doing what's best and healthiest for your child.
Gradually reduce milk intake for one week until your toddler consumes no more than 16 ounces (about 500 mL) per day. This provides enough calcium for strong bones while encouraging your child to try other foods.
Offer milk with meals only, and only after your child eats some solid food.
Don't give milk as a snack or treat. (Also see Building Balanced Snacks to Feed Toddlers.")
Don't give your child a bottle before bed or naptime. Helping your little one learn to self-soothe without milk should begin around 4 to 6 months. If you notice sleep problems, offer a bottle filled with water.
Making water your child's preferred drink
Water delivers a host of benefits for your child now and throughout life. It's calorie-free, so it doesn't curb their appetite. It hydrates the whole body and rinses teeth in between meals, helping to prevent cavities. Here are tips for making the switch.
Offer water only between meals (no milk).
Replace bottles with sippy cups. (This is a healthy step to take between 6 and 12 months, regardless of your child's food preferences.)
Keep a cup of cool water handy so your child can drink anytime.
If your child has a condition that makes bottles necessary, fill them with water.
More tips to break the milk dependency habit
Do not rescue your child with milk. They may skip a few meals in protest, but hunger will lead them to try new foods.
Trust that your child will eat. The brain's hunger center tells us when we need fuel. This urge is key in overcoming milk dependency.
Remember that your role is to choose
what foods and drinks to offer your child. They get to choose
how much they eat and drink.
Offer solid foods your child may already like. Introduce new choices, focusing on one new food at a time.
Some little kids need softer foods at first. Watch how your child chews and swallows and make adjustments as needed.
Consider vitamins. An age-appropriate multivitamin twice a week can help round out your child's nutrition while their diet improves. Add an iron supplement if your child isn't eating iron-rich foods such as meat, tofu or beans. Talk with your child's pediatrician.
Advice to promote healthy eating in kids at all ages and stages
Avoid pressure around food. Don't force your child to eat certain foods or dictate how much they eat. Trust that they will take in the fuel they need.
Don't punish them for refusing a bite of something new. Tell them you're offering it because you think it's delicious, but let them choose. (You can always try again.)
Avoid deal-making and lecturing. This turns food into a source of stress for everyone. Constant battles can make a child's eating habits even worse. No one wins in a power struggle involving food.
When to talk with your child's doctor
After following these new routines for about a month, your child's milk dependence will begin to heal. It may even be gone for good! Bonus: your stress levels will ease up, too.
Be sure to consult your pediatrician if:
Your child's reliance on milk does not change within a month of following this advice
They don't eat many more solids after about 2 months
You feel your child needs to see the doctor
You have other questions or concerns
Remember
Milk dependence is common among toddlers and preschoolers. Don't blame yourself—but do take steps to correct it. Brace yourself for a few battles, but trust that your child will feel hungry enough to begin trying a variety of foods and drinks. If you're still worried, ask your pediatrician or family doctor for additional advice.
More information