New Guidelines Say Kids Should Only Drink Milk and Water Until Age 5. But Is That Really Practical?

There’s a lot of advice out there about how parents should raise their kids. There are screen-time limits, advice for sneaking in more vegetables, and guidelines about sugar, but when was the last time you really thought about what your kids drink?

In a new unprecedented census, a group of large health organizations released updated drink guidelines for children under 5 years old. The Academy of Nutrition and Dietetics, American Academy of Pediatric Dentists, American Academy of Pediatrics, and American Heart Association have joined together in a new campaign called Healthy Drinks, Healthy Kids to recommend that kids only drink water and milk (formula and breast milk too) until age 5. And don’t even think about serving juice or chocolate milk before kindergarten!

The updated guidelines are designed to lower the amount of sugar and empty calories younger kids consume and establish healthy drink habits early. But are these new guidelines actually more healthy — and more importantly, are they realistic for parents?

According to new research, what kids drink from birth to age 5 sets a precedent for their health for years to come. Simply choosing when and how much water kids drink as well as what types of milk they have — and whether juice is a part of their diet — is reported to have a big impact on habits as well as health. But as most parents will tell you, juice boxes and chocolate milk are nearly impossible to avoid — especially if you’ve got kids in school.

The list of drinks for infants (0 to six months) to avoid is long; basically until 6 months of age, breast milk or formula provides all the hydration babies need. Once babies start solids (around six months), water introduced at mealtimes will help with hand-eye coordination and prevent constipation.

After age 2, the recommendations get a little less clear — especially around milk for toddlers and preschoolers. Between the ages of 1 to 2, most kids switch from formula or breast milk to whole milk and water for hydration. The long-standing advice has been to switch 2-year-olds from whole milk to lower-fat milk (reduced or low-fat). This recommendation has long been considered outdated — growing kids need fat in their diets for brain development and it’s certainly fine if they get it from unsweetened milk.

Still, Healthy Drinks, Healthy Kids suggests that the type of milk you choose for toddlers should be based on family history. The thought is that if you have a family history of heart disease or obesity, your kids should only drink lower-fat milk after age 2, but there’s very little research to back this advice and it might be unrealistic and unhealthy if your kid is contently getting healthy fats from whole milk.

Ultimately, there are lots of factors to consider when choosing a milk for your kids. Everything from allergies to dietary preferences can influence whether your toddler gets whole milk or oat milk. But Healthy Drinks, Healthy Kids takes a strong stance against plant-based milks (think: oat, soy, or almond) claiming that “evidence indicates that many plant-based/non-dairy milk alternatives lack key nutrients found in cow’s milk.” If your kiddo has an allergy that requires a non-dairy alternative, what should you do?

Most of Healthy Drinks, Healthy Kids advice boils down to consulting with your pediatrician about your family’s particular needs, which most parents likely already know to do.

Healthy Drinks, Healthy Kids seems mostly focused on weight as a marker for health, which should create pause for any parent, as weight isn’t the only indicator for health. It is helpful to have a quick, reassuring number to know if your kids are getting enough water (one to four cups a day depending on age and activity level) and whether they should skip on chocolate milk (this is on HDHK’s avoid list, but the occasional glass isn’t detrimental to their overall health), but these “new” guidelines should still be viewed with healthy skepticism.

If you have true concerns about your kid’s hydration, your family doctor or seasoned school nurse is a much more nuanced resource.