Milk has no place in school lunches

In a June 24 op-ed in The Hill, registered dietitian Susan Levin opened a much-needed debate about the National School Lunch Program’s inclusion of milk—a product she argued is harmful to children’s health.

I’m a pediatrician, and I see children on a daily basis whose health has been negatively impacted by dairy intake. As an advocate for children’s health—and also as a father—I know how critical it is to reexamine whether milk is needed in schools.

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The question we should be asking is this: How do nutrition policies that promote milk actually affect our country’s young people, particularly those who are most vulnerable to chronic diseases?

As Levin pointed out, randomized controlled studies on chronic illnesses like cancer are difficult to do ethically, and most observational research has been done in adults. We know that diet-related chronic diseases will affect a large percentage of children later in their lives, but in my daily practice I see the more immediate effects of milk consumption. And they are not pretty.

For starters, milk is one of the most common causes of allergies and sensitivities in children. Eczema (dry skin), constipation, abdominal pain, gastroesophageal reflux disease, and even acne are several of the everyday woes that bring uncomfortable children and distraught parents to my office. Limiting and sometimes eliminating dairy products is one of the first steps in the treatment of these conditions.

Children who consume cow’s milk are also at a higher risk of iron-deficiency anemia; not only do dairy products interfere with the absorption of iron, but they can induce a reaction in the bowel that causes blood loss. The link between milk protein and gastrointestinal blood loss has been confirmed for decades. Newborns can have difficulty tolerating milk when they are exposed to cow’s milk protein through their mother’s breast milk, resulting in a condition called allergic colitis, which causes bloody stool.

Yes, these health effects are gross. Perhaps that’s why they’ve been left out of the debate concerning milk’s place in school lunch. But no factor is more ignored—or more common—than lactose intolerance. The symptoms of lactose intolerance usually aren’t present until later in life, but people with lactose intolerance generally develop it during childhood. According to National Institutes of Health statistics, two out of three Americans cannot properly digest lactose, and rates of lactose intolerance are especially high in Asians, Blacks, Hispanics, and Native Americans. I see this often, and my first recommendation to any patient with lactose intolerance is to eliminate dairy. There is almost always an immediate and drastic improvement in their condition.

The dairy industry is incredibly successful at pushing milk, and as the National Milk Producers Federation president and CEO Jim Mulhern admits, “the feds go way beyond just encouraging children to drink more milk.” The U.S. Department of Agriculture actually helps organize massive marketing campaigns to boost milk and cheese sales. This explains why my patients are often shocked when I tell them that despite what they’ve heard, dairy is a risky food.

Through aggressive marketing, the dairy industry has contributed to another culprit of childhood obesity: flavored milk. I believe the added sugar in strawberry and chocolate milk greatly influences the risk for childhood obesity and cavities. Not to mention, milk’s cousin cheese is sprinkled throughout every school lunch making it impossible for any child to avoid dairy and its potential repercussions.

The dairy industry claims that children need to drink more milk to obtain essential nutrients. Milk was never a staple in my diet and it is not in my son’s, and we’re as healthy as can be. Calcium, vitamin D, potassium, and protein can easily be obtained from plant foods such as leafy greens, fortified nondairy milk, and beans. Far less likely to cause a negative reaction, these foods also contain less fat (even compared with low-fat milk) and offer protective benefits against chronic diseases later in life. It’s about time they be included in large quantities in the school lunch line.

I hope the mission of the National Milk Producers Federation is to improve children’s well-being and not to push a risky product for profit. It’s up to Congress and the American people to realize that milk is not essential and can even harm our health—and to decide who to trust with our children’s health.

Porras is a pediatrician in Silver Spring, Maryland.

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