A nurse is collecting data from the guardian of a toddler during a well-child visit. The guardian expresses concern to the nurse because his child has a poor appetite, but drinks a quart of milk each day. The nurse should identify that this practice places the toddler at risk for which of the following conditions?

A. Celiac disease: Celiac disease is an autoimmune disorder triggered by gluten ingestion that damages the small intestine and impairs nutrient absorption. While it can cause poor appetite and growth issues, high milk intake alone does not cause or increase the risk for celiac disease. Diagnosis is based on genetic susceptibility and gluten exposure, not dietary patterns. B. Lactose intolerance: Lactose intolerance results from deficiency of lactase, leading to diarrhea, bloating, and abdominal discomfort after dairy consumption. Drinking large amounts of milk may exacerbate symptoms if the child is lactose intolerant, but intolerance is not caused solely by high milk intake. C. Acute renal failure: Acute renal failure is typically caused by severe dehydration, infection, toxins, or obstruction and is not related to high milk intake in a toddler. Daily consumption of milk, even in large quantities, does not precipitate acute renal failure in a healthy child. D. Iron-deficiency anemia: Excessive milk intake can displace iron-rich foods from the toddler’s diet and interfere with iron absorption, increasing the risk for iron-deficiency anemia. Milk is low in iron, and consuming more than 24 ounces per day can contribute to inadequate dietary iron intake and subsequent anemia in toddlers.