Chapter 4: Nutrition and Food Service
4.3 Requirements for Special Groups or Ages of Children
4.3.1 Nutrition for Infants
220.127.116.11: Feeding Cow’s Milk
The facility should not serve cow’s milk to infants from birth to 12 months of age, unless provided with a written exception and direction from the infant’s primary health care provider and parents/guardians. Children between 12 and 24 months of age can be served whole pasteurized milk (1). Children 2 years and older should be served low-fat (1%) or nonfat (skim, fat-free) pasteurized milk (1). With proper documentation from a child’s primary health care provider, reduced fat (2%, 1%, nonfat) pasteurized milk may be served to those children who are at risk for high cholesterol or obesity after 12 months of age (2).
Milk provides many nutrients that are essential for the growth and development of young children. The fat content in whole milk is critical for brain development as well as satiety in children 12 to 24 months of age (3). For those children whom overweight or obesity is a concern or who have a family history of obesity, dyslipidemia, or early cardiovascular disease, the primary health care provider may request low-fat or nonfat milk (2).
It is not recommended that children consume cow’s milk in place of human (breast) milk or infant formula during the first year after birth (1,4). Some early care and education programs have children between the ages of 18 months and 3 years in one classroom. To avoid errors in serving inappropriate milk, programs can use individual milk pitchers clearly labeled for each type of milk being served. Caregivers/teachers can explain to the children the meaning of the colored labels and identify which milk they are drinking.
TYPE OF FACILITYCenter, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS18.104.22.168 Categories of Foods
22.214.171.124 Care for Children with Food Allergies
126.96.36.199 Precautions for a Safe Food Supply
Holt K, Wooldridge N, Story M, Sofka D. Cow's Milk / Children's need for. In: Bright Futures: Nutrition. Chicago, IL: American Academy of Pediatrics; 2011: 69
Oldfield B, Misra S, Kwiterovich P. Prevention of cardiovascular disease in pediatric populations. In: Wong ND, Amsterdam EA, Blumenthal RS, eds. ASPC Manual of Preventive Cardiology. New York, NY: Demos Medical Publishing; 2015:184–194
Singhal S, Baker RD, Baker SS. A comparison of the nutritional value of cow’s milk and nondairy beverages. J Pediatr Gastroenterol Nutr. 2017;64(5):799–805
American Academy of Pediatrics. Why formula instead of cow’s milk? HealthyChildren.org Web site. https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Why-Formula-Instead-of-Cows-Milk.aspx. Updated November 21, 2015. Accessed January 11, 2018
Content in the STANDARD was modified on 05/30/2018.