Should Your Child Switch to Low-Fat Milk After Two?
For decades, parents have been told that once their child turns two years old, it’s time to switch from whole milk to low-fat or skim milk to help prevent obesity and support heart health. However, as nutrition research evolves, it is time to re-evaluate these guidelines and see if there have been any new findings.
As nutrition research has transitioned from looking at a single nutrient and how it benefits the human body, and instead, focused more on how whole foods work to benefit our body, the role of dairy foods, especially dairy fat, is being thoroughly researched.
Dairy fat has been under the microscope in recent years, and the findings are surprising: most research does not show a negative relationship between full-fat dairy and heart or metabolic health. In fact, many studies show the opposite, suggesting a neutral or even protective effect on children’s growth and long-term cardiometabolic outcomes.
What Do the Guidelines Say?
The AAP says that consumption of non- or low-fat dairy products is recommended as a strategy to lower the risk of childhood obesity. The AAP recommends that children stay on whole milk until they are two years of age, and then low-fat (1%) or skim milk afterward (1).
However, the American Academy of Family Physicians reports that “Although the AAP supports considering reduced-fat milk for toddlers who are at risk of obesity or cardiovascular disease, early introduction of reduced-fat milk may ultimately increase the risk of obesity (2).”
These differences highlight a key point: nutrition recommendations are evolving, and evidence continues to build in support of full-fat dairy for many children.
Well, What Does the Research Say?
Over the past decade, several large studies have taken a closer look at how the fat content of cow’s milk impacts children’s growth, body composition, and long-term health. Interestingly, much of the evidence points in the same direction, children who drink whole milk often have better health outcomes than those who drink low-fat or skim milk.
A 2020 study followed young children and found that those who consumed higher-fat milk actually had lower body fat than children who drank reduced-fat milk. Then, the same research team expanded on this work in 2021, analyzing data from over 2,700 children aged 9 months to 8 years. They discovered that for every 1% increase in milk fat consumed, children had slightly lower BMI z-scores. In practical terms, kids who drank whole milk had 16% lower odds of being overweight and 18% lower odds of obesity compared to those who drank low-fat milk (3,4).
Their earlier 2016 study also reported another interesting benefit: children who drank whole milk had higher vitamin D levels and lower BMI. Since vitamin D plays an essential role in bone growth, immune function, and overall development, this was an important finding for young children’s health (5).
These results are echoed by other studies as well. Multiple studies have found that higher milk fat consumption was linked to lower odds of severe obesity, even with examining nearly two decades of U.S. national data (6,7).
Lastly, a 2022 follow-up study found that children who consumed higher-fat milk in early childhood ‘did not experience greater adiposity or adverse cardiometabolic outcomes’ a decade later. This means that, over the long term, whole milk in early childhood wasn’t linked to increased risk of obesity or metabolic disease.
Now that’s a lot of research! Let’s step out of the weeds for a moment and talk about what all of this actually means for us as parents.
When we look at these studies together, the takeaway is surprisingly consistent: children who drink whole milk are not at higher risk for obesity or poor heart health, and may actually benefit from the extra fat. The dairy fat found in whole milk appears to support healthy growth, better vitamin D levels, and overall metabolic balance.
So… Should You Switch?
Unfortunately, there is no one-size-fits-all answer!
If your child:
- Is growing well
- Eats a balanced diet
- Doesn’t have excessive weight gain or a family history of early cardiovascular disease
Then continuing with whole milk may be appropriate and even beneficial. However, if your child is experiencing excessive weight gain or consuming more calories than needed, your pediatrician or pediatric dietitian may suggest trying low-fat milk.
All in all, it doesn’t mean every child needs whole milk forever, but it does mean that switching to low-fat milk at age two isn’t automatically the healthier choice many of us once thought it was. Instead, it’s about looking at the whole child; their growth pattern, appetite, eating habits, and family history.
At the end of the day, milk should complement a varied, balanced diet full of whole foods. So if your toddler is thriving, eating well, and developing normally, there’s no strong reason to rush into reduced-fat milk.
The Bottom Line
Current research suggests that whole milk is not linked to higher obesity risk and may even support healthy growth, vitamin D status, and metabolic health in children.
As a pediatric dietitian and a mom, I choose to continue offering whole milk to my children past the age of two. It aligns with the latest evidence and supports their overall nutrition needs during these important years of growth.
But remember: every child is unique. If your little one has a dairy allergy, you’re continuing to breastfeed beyond 12 months, or you prefer a plant-based alternative, there are plenty of other ways to meet your child’s calcium, fat, and nutrient needs.
If you’d like more evidence-based information on this topic, click the link here for our milk talk, or reach out for personalized guidance.
References
2- https://www.aafp.org/pubs/afp/issues/2018/0815/p227.html
3- Vanderhout, S. M., Aglipay, M., Torabi, N., Jüni, P., da Costa, B. R., Birken, C. S., O’Connor, D. L., Thorpe, K. E., & Maguire, J. L. (2020). Whole milk compared with reduced-fat milk and childhood overweight: a systematic review and meta-analysis. The American journal of clinical nutrition, 111(2), 266–279. https://doi.org/10.1093/ajcn/nqz276
4- Vanderhout, S. M., Keown-Stoneman, C. D. G., Birken, C. S., O’Connor, D. L., Thorpe, K. E., & Maguire, J. L. (2021). Cow’s milk fat and child adiposity: a prospective cohort study. International journal of obesity (2005), 45(12), 2623–2628. https://doi.org/10.1038/s41366-021-00948-6
5- Vanderhout, S. M., Birken, C. S., Parkin, P. C., Lebovic, G., Chen, Y., O’Connor, D. L., Maguire, J. L., & TARGet Kids! Collaboration (2016). Relation between milk-fat percentage, vitamin D, and BMI z score in early childhood. The American journal of clinical nutrition, 104(6), 1657–1664. https://doi.org/10.3945/ajcn.116.139675
6- White, M. J., Armstrong, S. C., Kay, M. C., Perrin, E. M., & Skinner, A. (2020). Associations between milk fat content and obesity, 1999 to 2016. Pediatric obesity, 15(5), e12612. https://doi.org/10.1111/ijpo.12612
7- Beck, A. L., Heyman, M., Chao, C., & Wojcicki, J. (2017). Full fat milk consumption protects against severe childhood obesity in Latinos. Preventive medicine reports, 8, 1–5. https://doi.org/10.1016/j.pmedr.2017.07.005
8- McGovern, C., Rifas-Shiman, S. L., Switkowski, K. M., Woo Baidal, J. A., Lightdale, J. R., Hivert, M. F., Oken, E., & Aris, I. M. (2022). Association of cow’s milk intake in early childhood with adiposity and cardiometabolic risk in early adolescence. The American journal of clinical nutrition, 116(2), 561–571. https://doi.org/10.1093/ajcn/nqac103
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Cinthia Scott is a Registered Dietitian (RD) and International Board Certified Lactation Consultant (IBCLC) with over 10 years experience in the field of dietetics. Cinthia focuses on ensuring optimal nutrition in the first 1000 days of life to ensure optimal growth and development as well as set the stage for long-term health. Cindy is an author, starting solids expert, and advocate for caregivers receiving evidence based education and support surrounding breastfeeding and starting solids.
Cinthia is co-author of the 101beforeone Starting Solids Book, “101beforeone -baby-led feeding cookbook,” and is the founder and owner of The Baby Dietitian LLC which is her private practice built to provide virtual 1:1 services for caregivers surrounding infant nutrition, toddler nutrition, and breastfeeding support. Cinthia is also the creator of the Starting Solids 101 Program which provides caregivers 1:1 support from a Pediatric Dietitian on how to provide optimal nutrition from the start and create healthy eating habits that will last their whole lifetime. To work with Cinthia, you can access her services here.
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