Joanna Dolgoff, MD--

Recently, America’s school lunch menus have been under fire and parents are becoming increasingly concerned about the state of their children’s health and well-being.  Federal law, under the School Lunch Act, provides nutritional guidelines and criteria to which schools must adhere.  These guidelines include the amount and type of foods the cafeteria must offer, in addition to placing limits on nutrients like saturated fat, cholesterol and sodium.  Specifically, school lunches must provide 1/3 of the Recommended Daily Allowance (RDA) for protein, calcium, iron, vitamin A, vitamin C, and 1/3 of the Recommended Energy Intake (REI) for calories.  In addition, the cafeteria must offer 5 components as part of a school lunch, of which three of the five must make their way onto the child’s lunch tray.  These include a starch, meat (or meat substitute), fruit, vegetable and milk.  There are similar guidelines for schools that serve breakfast as well.  These guidelines are especially important because many children eat the majority of their meals at school.

Milk contributes a good portion of nutrients to school lunches.  It is a valuable, nutrient-dense source of protein, calcium and vitamin D, all of which are important for achieving adequate nutrition and optimal growth in school-age children.  However, whole milk can significantly contribute to the saturated fat and cholesterol content of a meal.

According to the American Academy of Pediatrics (AAP) whole milk and other full-fat dairy products are only appropriate for children under the age of 1-2 years old. Children under two, who are in a stage of rapid growth and brain development,  have high energy and dietary fat requirements.  They need the extra fat that whole milk contains.

Everybody else, however, should choosing low fat dairy products, including skim milk.  In fact, the AAP states that no child over the age of two should be drinking whole milk.  Skim milk is identical to whole milk in terms of nutritional value, but is markedly lower in saturated fat, cholesterol and calories.  Diets high in saturated fat are associated with increased risk for obesity, heart disease and certain cancers.  Saturated fat intake causes harmful buildup in the arteries and blood vessels of healthy individuals, starting in young children.  It is important to begin healthy eating habits as a child and to continue making healthy choices throughout life.

A good portion of a child’s learning happens through modeling.  That is, by watching their parents or other caregivers’ actions, they learn how to be an adult.  This is especially important when it comes to eating:  your food preferences as an adult are closely related to the foods you saw your parents eating.  But what happens when your child is eating 2 out of 3 meals a day at school, plus a snack?  Because they are eating so many meals outside the home or the care of their parents, kids are increasingly reliant on teachers, caregivers and cafeteria staff to guide them to make healthy choices and model healthy eating behaviors.

The fact is, the people who are responsible for serving food to or eating with your children usually receive no formal nutrition education.  In most cases, a position as a preschool classroom aide or a kitchen worker requires a high school level education.  Regardless, whatever their educational background, it is a common misconception for people to think that whole milk has a nutritional advantage over skim milk.  It is also very common that parents encounter teachers or caregivers who have different beliefs than their own when it comes to feeding their child.  Especially when you’re talking about the welfare of a child’s health, when a parent feels one way but their caregiver feels another way, this can create some tension.  A well-meaning day care worker just may not be aware of or understand the reasons why full-fat milk can be dangerous, even for young children.  Parents often have a difficult time getting this message across but should continue to be an advocate for their child’s health.

In situations like this, as a parent you have the right to decide what your child does and does not eat.  You can stress this issue to the teacher in a polite way while still standing firm.  If needed, refer them to an appropriate resource, such as www.MyPyramid.gov, the American Academy of Pediatrics, your pediatrician, or even a local dietitian for further advice on this matter.  Your child’s health comes first!

Joanna Dolgoff, M.D. is a pediatrician whose practice solely deals with child and adolescent weight management. A graduate of Princeton University, she completed her education at NYU School of Medicine and finished her Pediatric Residency training at Columbia Presbyterian's Children's Hospital of New York. She has previously worked as a private practice pediatrician, helping children reach their weight loss goals. A Board Certified Fellow of the American Academy of Pediatrics, Dr. Dolgoff is also the proud mother of two children. She is the author of Red Light, Green Light, Eat Right (Rodale/ 2010). Click here to learn more about Dr. Dolgoff's Weigh Child and Adolescent Weight Management Program.

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