The image of milk as a wholesome drink for children, promoting growth and strong bones and teeth, remains rooted in our images of child health – which is largely why the idea of taking away free milk for under-fives was quickly vetoed by David Cameron. Milk is still recommended for young children, despite controversies over the fat and saturated fat content of whole milk and arguments over hormone contents, lactose intolerance, milk allergy and a range of other suggested health disadvantages.
In the UK in the pre-school years, milk is still a major provider of energy and nutrients: children under three obtain about a quarter of their energy and protein from the milk they drink, two-thirds of their intake of calcium, at least half of their intake of the B vitamins riboflavin and vitamin B12 and the mineral phosphorus, a third of their intake of vitamin A and significant amounts of folate and vitamin D.
It can be argued that these nutrients are available in other foods, and some may not be in short supply in the diets of many young children, but it is difficult to unpick the contribution that free milk for under-fives might play in their overall diet – not least for those children from households where other food and drink choices may not be optimum. As safety nets go, milk provided in childcare settings may well be one of the cheaper ones we can offer.
If we can't say for sure how important subsidised milk might be in the diets of children who spend time in childcare settings, we can consider the impact of taking it away. Some will continue to serve milk and pay for it themselves, but there is at present limited advice to childcare settings on what, and how much, food and drink are needed by pre-school children.
This is something the current Advisory Panel on Food and Nutrition in Early Years hopes to correct when it offers its recommendations to the Department of Education later this year.
Current evidence suggests that many settings offer too little energy to children, possibly as a result of fears over rising obesity, but possibly to limit costs, and many smaller settings may replace milk with water (most health professionals recommend milk and water as the drinks that do not damage children's teeth) adding to this dilemma.
Hungry children leaving childcare and returning home in a culture where milk is seen as "less important" are likely to be given fruit-based drinks, perceived and marketed as "healthy alternatives", but these can damage teeth (with or without sugar in them), offer few other nutrients and will habituate children to sweet-tasting drinks. We already live in a culture where soft drinks dominate: it is sobering to remember that more than 80% of our young people drink sweetened soft drinks regularly, with average intakes among teenage boys somewhere around 138 litres a year – 60,000 empty calories and a lot of sugar-swilled teeth.
Messages encouraging young children to drink milk are about more than just whether milk matters to an individual's nutritional intake or to whether children living in poorer circumstances can be proven to benefit from it: we need to think about what message taking the subsidy away might send in an environment where the high profit margin, heavily marketed alternatives are already pernicious enough.
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