How to choose the best type of milk for your baby & toddler

Knowing what to type of milk to transition your baby onto can be a tricky choice. As parents, we always want our little ones to be consuming the healthiest option to allow for proper growth and development. However, we are hearing a lot about what the healthiest option could really could mean. Questions I hear that often come up include:

Are humans meant to drink another animal’s milk?
Do we really need dairy in our diet?
What if my child has an allergy or intolerance to milk?

These questions are all valid and worth discussing. While the answers to some of these (like do we really need dairy in our diet), can be elaborated on in another blog post, we know that traditionally, cow’s milk has been the most nutritionally well-rounded choice. However, for many parents the decision is not always as easy as that. Many families want to provide their child with a milk alternative for various reasons, including allergies and intolerances, for cultural/religious reasons, because they are following vegan diets, or simply because their baby doesn’t like it! In these cases, it becomes absolutely crucial for your little ones to have a safe milk substitution. So let’s break down the different milk options and their benefits.

Breastmilk

Let’s start with the basics. The World Health Organization recommends continued breastfeeding until 2 years of age to help meet nutrients needs for toddlers. If you’ve decided that you’re going to continue to breastfeed after 12 months… amazing! Keep that going and know that there is no need to introduce another type of milk if your toddler is nursing about 4 times per day. The quantity usually consumed in 4 nursing sessions is enough to meet their calcium needs and provides them with tailored nutrition. If your baby/toddler is breastfeeding any less than 4 times a day, then I would look to see if they’re getting 1-2 servings of dairy products a day to cover their calcium needs (see the section below on “do we even need milk?”). If they’re not consuming dairy products (or not enough), I’d highly consider adding in another milk at mealtimes to provide the additional nutrients or speak with a dietitian about supplementation. 

Cow’s Milk – The Traditional Choice

By 12 months of age, (and once your baby is successfully eating iron-rich foods at least twice a day and assuming you’ve weaned off breastmilk), is when I start recommending introducing whole (3.25%) cow’s milk to your baby going on toddler. This is because full fat cow’s milk is a nutritional powerhouse that contains high levels of fat, protein, Vitamin D, calcium, and Vitamin A. Cow’s milk has always been a readily available and cost effective option, and ensures that babies get all the above mentioned nutrients in sufficient quantities throughout their day. Children up to two years of age need a high amount of fat in their diets to help maintain healthy weight gain as well as to absorb Vitamin D and A into the body. It’s also a great and easy way to get enough calcium in the diet to support healthy teeth and bone growth, as well for muscle control.

Giving cow’s milk to a baby before 12 months of age is not recommended, as it’s such a dense concentration of protein and minerals, which can be hard on your baby’s kidneys. Your baby’s digestive system also can’t properly digest cow’s milk protein that early, and because it doesn’t contain enough iron, too much cow’s milk can also put your baby at risk for iron deficiency. However, once your baby hits one year of age, they are well adapted to handle it just fine and can incorporate as part of a balanced and nutritious diet. It’s always good to start at a slow pace when introducing cow’s milk. This way, you can allow your baby to adjust to the influx of nutrients and proteins coming from cow’s milk. After 2 years of age, you can speak to your pediatrician or dietitian about offering reduced fat milk or milk alternatives regularly, if that’s what you all regularly drink at home, however I personally think the fat is important for all growing kids and isn’t typically needed to reduce.

Organic, Grass Fed, Both?

Now, there may be a bit of a debate on whether to go with conventional, organic, or grass fed milk choice for baby/toddler. Generally speaking, we want to avoid antibiotics or growth hormones added into milk, and luckily, in Canada, we have rules around this that ensure all dairy products produced (organic or not) are completely free of both of these nasties! If a cow happens to get sick and is required to be given antibiotics, her milk is removed from the supply system for a regulated period of time. Organic means that the cow’s are fed organic (natural) feed, that they are generally allowed greater outdoor grazing access. If the cow is sick, any milk the cow’s produce while taking antibiotics is kept out of the milk supply for an even longer period of time than with conventional milk. In the U.S., the guidelines for antibiotics and growth hormones are not the same unfortunately, so you will need to purchase organic dairy products to ensure your baby is not getting any antibiotics in their system.

In terms of grass fed products, I do recommend them if it fits into your budget and you have access to them, as grass fed cow’s have a superior diet quality which yields in a higher amount of a brain healthy fat called CLA (conjugated linoleic acid) and also is higher in omega-3 fatty acids. Don’t worry if you can’t get your hands on it though! Regular Canadian dairy milk or organic milk is just fine!

Do we even need milk at all?

Short answer…no. But is it a super convenient form of calories and nutrients for babes and toddlers with generally smaller appetites and finicky eating? Yes. Here’s the thing…there is no pressure to offer milk to your baby after 1 year. Some toddlers don’t like it, and others don’t drink enough (when moved onto an open cup) to be able to consider it a significant enough nutrition source. 

When you look at the recommended servings of dairy per day for toddlers, it’s really only two servings/day. Assuming offering dairy products is ok for you, you can make that up those servings any which way you like! Not only through milk, but how about yogurt? or cheese? or kefir? Honestly, as long as your child gets two servings of full fat dairy (in general) a day, they’ll be ok to more easily meet their calcium, protein and fat needs a day.

If your toddler isn’t eating dairy, then special considerations need to be made to get enough calcium in the diet. Protein and fat can usually be more easily achieved than calcium (via other foods), but there is always a way to make to happen with a little help. My Feeding Toddlers course is a great resource to get a breakdown of high calcium, protein and fat foods (as well as other nutrient lists) that will help you identify how many of each type of food are needed to make up nutrient needs. Working closely with a dietitian in general is a good idea to have your toddler’s diet assessed and get recommendations for supplements, if needed.

Comparing Cow’s Milk to Other Milk Alternatives

As was mentioned above, babies up to two years of age need good sources of protein, fat, vitamin D, and calcium. I’ve put together this table comparing the major nutrients found in cow’s milk versus the most common milk alternative (all unflavoured).

• Cows Milk = Natrel 3.25%
• Almond Beverage = Blue Diamond Unsweetened Original 
• Coconut Beverage = Silk Unsweetened Original
• Hemp Beverage = Hemp Yeah Unsweetened Original 
• Soy Beverage = Silk Unsweetened Original 
• Goat Milk = Liberte 3.25%
• Rice Beverage = Natura Unsweetened Original
• Cashew Beverage = Silk Unsweetened original
• Oat Beverage= Earth’s Own Unsweetened Original
• Ripple Milk = Ripple Foods Unsweetened Original

If you compare the nutrient profiles of the most common milk substitutions to regular cow’s milk, you will see there are many variations in what each has to offer. Let’s take a closer look:

Almond Beverage

Almond beverage is one of the most commonly substituted milk alternatives for babies and children who can’t have cow’s milk. It’s a tasty option that works well in many recipes as well as when consumed on it’s own. Although almond milk is close in nutrient content to cow’s milk, it is still not close enough to meet a baby’s needs! Protein levels in almond milk are significantly lower than in a serving of cow’s milk and the fat content also isn’t there to support the absorption of vitamin D or provide healthy calories. With almond milk, there isn’t usually a concern about the levels of calcium and vitamin D as most companies will often fortify their products with these important nutrients. So all in all…think of almond milk as a liquid calcium supplement! You will need to make sure you are offering enough protein and fat via other foods in the diet to make up for what’s not being received through milk.

Coconut Beverage

Coconut beverage is a watered-down version of canned coconut milk and contains less fat per serving. However, note that coconut beverage contains almost no protein, but calcium and vitamin B12 are comparable to cow’s milk. There’s very little Vitamin D, but it can be offered through a Vitamin D supplement. So, in the end I would say coconut beverage is not really close enough to cow’s milk to recommend using it regularly as a substitute. 

Hemp Beverage

Hemp beverage looks pretty good when it comes to the amount of fat and protein it provides. It’s especially unique in that it contains a good source of omega-3 fatty acids, which are important for brain development in young babes. Unfortunately, it still has it’s cons, in that it’s largely lacking Vitamin D, calcium and Vitamin B12. So ensuring you provide your toddler with a bit extra Vitamin D supplementation, as well as either a calcium supplement or multiple foods high calcium and B12 a few times a day is recommended.

Soy Beverage

The milk alternative that is closest to cow’s milk of course, is soy milk. There are many pro’s to this milk – high protein, moderate fat, a good amount of vitamin D and vitamin B12. However, the main issue I take with soy milk is that soy contains phytoestrogens, which mimic estrogen in the body. Although studies are not entirely conclusive as to whether or not these phytoestrogen significantly affect our hormone levels in our bodies, I would avoid drinking soy milk daily as the main source of liquid nutrition. Soy milk can definitely be used in conjunction with another type of milk if your baby can’t tolerate cow’s milk, I just wouldn’t offer it as a main beverage. Another quick note – often times if it’s cow’s milk protein your baby is allergic to, there can be high cross-reactivity to the protein in soy milk as well, so be careful about that when trying it out initially. Nearly half of all children with a cow’s milk allergy may also be allergic to soy protein!

Goat Milk

Goat milk is a wonderfully close match to cow’s milk’s nutritional profile. However, if the reason you aren’t feeding your child cow’s milk is because you would like to avoid animal products, then this obviously doesn’t solve the problem. In addition, be careful if your child has an allergy or intolerance to cow’s milk. Even though cows and goats are different animals, there is a high chance the body will mistake the two protein structures and therefore about 90% of those with a cow’s milk allergy also cannot drink goat’s milk. Otherwise, this is definitely the way to go for a milk alternative that’s an easy substitution!

Rice Beverage

Rice beverage has essentially non-existent levels of protein. Furthermore, rice is known to contain high levels of inorganic arsenic, which is listed as the World Health Organization’s 10 chemicals of major public concern. For this reason alone, I would never recommend using a rice cereal for your baby on a daily basis, and because of the lack of nutrients it contains, it should also not be used as a main source of drinkable nutrition.

Cashew Beverage

Cashew beverage is lacking in important nutrients such as protein and fat. As you can see, it has been fortified with calcium, vitamin D, and vitamin B12. However, as mentioned above you would need to offer a meal containing a fat rich food so that the vitamin D is absorbed. So, like almond milk, think of cashew milk as a liquid calcium supplement!

Oat Beverage

Oat beverage contains some fat and protein and a good amount of vitamin B12. However, you’re just NOT getting enough of most of the important nutrients needed for good growth and development. You’ll need to give your toddler more vitamin D supplement to make up for there not being enough in oat beverage, as well as either a calcium supplement or several foods high in calcium. 

Ripple Milk

As you may have noticed, there is a milk substitution on the chart above that matches or surpasses cow’s milk’s nutritional benefits: Ripple milk. Ripple milk is a 100% plant based milk that is derived from pea protein. It is low in sugar, high in protein and contains more calcium than cow’s milk. I highly recommend this product if you are choosing an alternative to cow’s milk – BUT – only if you are living in the United States! Unfortunately in Canada, regulations don’t allow for the same fortification in non-dairy alternatives, meaning that it’s not fortified in Vitamin D and calcium. However, it’s still a great low sugar and a good source of protein and fat, so as long as you supplement the Vitamin D in your baby/toddler’s diet and focus on calcium via other means, it can work great!

So, What’s My Suggestion?

If and when choosing a milk substitution for your baby, it is best to consider whether or not you can make up for the missing nutrients via diet. Consider the following:

Is my baby a good eater? Is he or she very picky? Does she need extra calories via fat in milk?
Can I offer supplementing foods with the missing nutrients consistently?
What is realistic for my family’s lifestyle?

Some parents may have an easier time with choosing a substitution that doesn’t have as much, for example, protein, fat or Vitamin D as cow’s milk, since these are usually found in other foods like high fat cheeses and yogurts, meat, fatty fish and/or vegetarian protein options. Providing your child with these options daily will help them get the levels of nutrients that are necessary for proper growth and development. However, I should say this: it is often easier said than done! It can be hard to make sure you are being consistent in giving your child enough of these foods (and that they will actually eat them)… and these are not nutrients you want to be skimping on! So I caution you to be very deliberate about feeding your child these options if they aren’t getting cow’s milk. Supplements can be used to help in these situations where getting nutrition through food isn’t an option.

If you’re not sure if you’ll be able to successfully and consistently accomplish this, my suggestion is simple – keep your baby on formula or breastmilk until up to two years. If the baby is already on formula or breastmilk, they will be likely tolerating it well and are receiving the appropriate amount of nutrients they need. Then, at two years of age when it’s less critical, you can switch your child to your milk substitution of choice, keeping in mind the importance of continuing to make sure you supplement your child with an adequate amount of these nutrients via food. *A reminder that breastfeeding less than 4 times per day may require calcium supplementation.

One more thing – all toddlers should be on a Vitamin D supplement no matter what type of milk they are drinking, including breastmilk (although if drinking cow’s milk, they will require less supplementation). We talk all about this, along with all your toddler’s nutrition needs in my Feeding Toddlers online course. Check it out and get on your way to raising a healthy and food loving toddler!