What are the AAP recommendations for protein?

According to the American Academy of Pediatrics (AAP), more than half of dietary protein is used to support a child's growth and development from six months to 13 years of age. The specific AAP recommendations for protein vary significantly across different pediatric age groups, requiring caregivers to understand these changing needs to ensure optimal health.

Quick Summary

The AAP provides age-specific guidelines for protein intake for infants, toddlers, and children, emphasizing balanced nutrition from high-quality sources like lean meats, dairy, and plant-based foods.

Key Points

• Age-Specific Needs: Protein requirements vary significantly by age, with infants needing an adequate intake that later evolves into a recommended dietary allowance for older children.

• Balanced Intake: The AAP emphasizes a balanced diet rather than focusing on excessive protein, noting that high-protein intake is not always healthier.

• Quality Sources: A mix of high-quality animal proteins (lean meat, fish, eggs, dairy) and plant-based proteins (legumes, nuts, soy) is recommended.

• Risks of Excess Protein: Excessive protein, especially from supplements, can strain the kidneys and liver, and has been linked to dehydration and unwanted weight gain.

• Vegetarian Planning: For vegetarian and vegan diets, combining complementary plant proteins from different sources (like grains and legumes) ensures a complete amino acid profile.

• Normal Growth: Pediatric protein needs are generally met through a typical, healthy diet without the need for supplements, with growth being a key indicator of adequate nutrition.

The Importance of Protein for Growing Children

Protein is a crucial macronutrient that provides the building blocks for every cell, tissue, and organ in a child's body. It plays a vital role in immune function, hormone production, and maintaining fluid balance. For infants and young children, a significant portion of dietary protein is dedicated to rapid growth. The American Academy of Pediatrics (AAP) provides comprehensive, age-specific recommendations to ensure children receive adequate amounts of this essential nutrient without overconsumption. These guidelines are based on Recommended Dietary Allowances (RDA) for daily intake and Acceptable Macronutrient Distribution Ranges (AMDR), which specify the percentage of total daily calories that should come from protein.

AAP Recommendations by Age Group

Understanding the AAP's specific recommendations for protein intake is key for parents and caregivers. The requirements are not uniform and decrease on a per-kilogram basis as children get older and their growth rate slows.

Infants (0 to 12 Months)

For newborns and infants, the primary source of protein is breast milk or formula.

• 0–6 months: Adequate Intake (AI) of protein is 9.1 grams per day. Human milk provides excellent protein, which is highly digestible and bioavailable for infants.
• 7–12 months: AI increases to 11 grams per day. As complementary foods are introduced, parents should offer balanced, protein-rich options like puréed meats, eggs, or lentils.

Toddlers (1 to 3 Years)

As children transition to solid foods, their protein needs continue to be met by a balanced diet.

• RDA: 13 grams per day.
• AMDR: 5% to 20% of total daily calories from protein.
• Serving Examples: The AAP suggests that toddlers receive two servings of protein per day. This could be a quarter-cup of lean ground beef or one egg, along with dairy and other sources.

Children (4 to 13 Years)

Protein needs increase with age, but the percentage of calories from protein stabilizes.

• 4–8 years: RDA is 19 grams per day.
• 9–13 years: RDA is 34 grams per day.
• AMDR: 10% to 30% of total daily calories from protein for both age ranges.

Adolescents (14 to 18 Years)

Adolescence brings another growth spurt and higher protein needs, with differences between sexes.

• Males: RDA is 52 grams per day.
• Females: RDA is 46 grams per day.
• AMDR: 10% to 30% of total daily calories from protein.

High-Quality Protein Sources for Children

A varied diet with a mix of animal and plant-based proteins is the best approach to meeting the AAP's recommendations. Quality matters, as some sources are more easily digested and contain all nine essential amino acids.

Animal-Based Protein Sources

• Lean Meats: Beef, chicken, and turkey are excellent sources of complete protein.
• Fish: Salmon, tuna, and other fish provide protein along with important omega-3 fatty acids.
• Eggs: A highly affordable and complete protein source.
• Dairy: Milk, yogurt, and cheese offer high-quality protein and calcium for bone health.

Plant-Based Protein Sources

• Legumes: Beans, lentils, and chickpeas are rich in protein and fiber.
• Soy Products: Tofu, tempeh, and edamame are complete protein sources.
• Nuts and Seeds: Almonds, peanuts, and sunflower seeds offer protein and healthy fats. Caregivers must be mindful of choking hazards for young children.
• Whole Grains: Some grains, like quinoa, are complete proteins, while others, like brown rice and oats, contain smaller amounts.

Potential Risks: Too Much Protein

While protein is essential, parents are often surprised to learn that protein deficiency is rare among U.S. children, and that excessive protein intake can have negative health consequences. Excess protein can place an added burden on a child's kidneys and liver, potentially leading to dehydration and other issues. One study found an association between high dairy protein intake in the first two years of life and an increased risk of becoming overweight later in childhood. Consuming more protein than needed also means excess calories, which can lead to weight gain. The AAP and other experts warn that protein supplements are generally unnecessary and potentially harmful for children.

Protein Source Comparison

Feature	Animal-Based Protein Sources	Plant-Based Protein Sources
Complete Amino Acids	Most sources contain all nine essential amino acids in sufficient quantities.	Most individual sources are incomplete, requiring combinations (e.g., rice and beans) to provide all essential amino acids.
Digestibility	Generally highly digestible (over 95%).	Often lower digestibility (70–80%) compared to animal proteins.
Nutrient Density	High in protein, iron, and zinc.	High in protein, fiber, and various vitamins and minerals, though some are less bioavailable.
Associated Health Risk	Processed meats are associated with an increased risk of cardiovascular disease.	Associated with a reduced risk of cardiovascular disease.

Nutritional Planning for All Diets

For vegetarian or vegan families, meeting protein needs requires thoughtful planning. Plant-based proteins often lack sufficient levels of one or more essential amino acids. However, this is easily remedied by combining different plant proteins throughout the day. For instance, grains are typically low in lysine, while legumes are low in methionine; eating them together, like in rice and beans, provides a complete protein. Vegans also need to ensure adequate intake of Vitamin B12, as it is only naturally found in animal products. Consulting a pediatrician or registered dietitian can help families plan a balanced, nutrient-rich vegetarian or vegan diet for children.

Conclusion

The AAP recommendations for protein provide a clear and evidence-based framework for pediatric nutrition. By prioritizing a variety of high-quality protein sources from both animal and plant-based foods, parents can easily meet their child's needs. The focus should be on balanced, whole-food nutrition rather than supplements or excessive amounts, which are rarely necessary and may pose health risks. This approach ensures children receive the right amount of protein to support their incredible growth and development journey.

Additional information on macronutrient distribution ranges can be found in the AAP's The Clinician's Guide to Pediatric Nutrition [https://publications.aap.org/aapbooks/monograph/734/chapter/11477417/Protein].

Frequently Asked Questions

How much protein do infants need according to the AAP?

The AAP recommends an Adequate Intake (AI) of 9.1 grams per day for infants aged 0 to 6 months and 11 grams per day for those aged 7 to 12 months. This is typically met through breast milk or formula.

What is the protein recommendation for a toddler?

For children aged 1 to 3 years, the AAP sets the Recommended Dietary Allowance (RDA) at 13 grams per day. The Acceptable Macronutrient Distribution Range (AMDR) for this age is 5% to 20% of their total daily calories.

Can children get enough protein from a plant-based diet?

Yes, children can get enough protein from a vegetarian or vegan diet by consuming a varied mix of plant proteins. Combining foods like legumes and grains helps ensure they get all essential amino acids.

Is too much protein bad for a child?

Yes, excessive protein intake can be harmful. It can overwork a child's kidneys and liver, lead to dehydration, and potentially cause weight gain if it results in excess calories.

Are protein supplements recommended for children?

The AAP does not recommend protein supplements for children, as most children in the U.S. consume more than enough protein through a normal, balanced diet. Supplements can lead to excessive intake and health risks.

What are good sources of protein for a picky eater?

For picky eaters, good protein options include hard-boiled eggs, yogurt, cheese sticks, nut butters (spread thinly to avoid choking), and hummus.

What protein sources should be limited for children?

The AAP advises limiting processed meats such as deli meats, bacon, sausage, and hot dogs, as they are associated with an increased risk of cardiovascular disease due to higher levels of saturated fat, sodium, and nitrates.