Ask the Expert – Choosing the Right Milk for Your Toddler

by Naveen Agarwal

in Ask The Expert

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

This week, Registered Dietitian Jill Castle suggests a few alternatives to cow’s milk for your toddler if you are concerned about introducing dairy products.

JillCastle

Jill Castle, MS RD LDN

Question: I am hesitant to give cow milk to my 15 month old daughter because I have heard that there are many problems with dairy. What other options do I have?

Answer:

Choosing which milk to feed your baby is an important decision, and one that requires thoughtful consideration.  With the plethora of milks available on the commercial market, it is often confusing to know which milk is appropriate for your child.  And many of these milks advertise their health benefits and are largely targeted at the adult.  The younger toddler (aged 1-2 years) continues to have unique nutritional requirements that are different from those of older children and adults, such as higher fat requirements, adequate protein and vitamins, and sufficient calories for growth. Additionally, liquid milk still provides the majority of nutrition (up to 60-70% of total caloric intake) in a given day for the younger toddler.

After a year of drinking breast-milk or infant formula, most emerging toddlers are ready to make a transition.  The gold standard, whole cow’s milk, has been the fluid milk of choice for many years, and many generations, and remains so in the eyes of the American Academy of Pediatrics (AAP).  Whole cow’s milk, when included with a variety of foods, can support the growth and development of children over one year of age. Whole cow’s milk contains about 150 calories per 8 ounces and is a good source of calcium, protein, fat, and Vitamins A and D.

Soy milk is an alternative to cow’s milk, readily available, and is utilized frequently for children who are intolerant or allergic to cow’s milk, or who are following a vegan diet.  Soy milk is fortified with calcium and Vitamin D, and can provide adequate protein and calories for the growing toddler. Soy milk is processed to match the nutrient content of cow’s milk and often, sugar is added to mask the bitter tasted of the soy bean.  Research indicates that ~40% of children who are allergic to cow’s milk are also allergic to soy milk.

Rice milk is used in children who are allergic to both cow and soy milks, and also may be used with the vegetarian child.  Caution should be used when choosing rice milk for the younger toddler, as it contains low amounts of protein, fat, and calories.  Some research has shown evidence of growth failure in young children consuming rice milk due to its poor protein, fat, calorie, and vitamin/mineral content.  If it is necessary for your young toddler to consume rice milk, be sure to consult with your Registered Dietitian (RD) or your pediatrician (MD) so that proper attention can be given to assuring your child’s liquid and solid food intake will meet their nutritional needs.

Hemp milk is yet one other milk available in stores.  Hemp milk is a grain milk, from the cannabis plant, and contains many nutrients found in cow’s milk.  The flavored hemp milks (150 calories/ounce) are similar in caloric content to whole cow’s milk and soy milk, however, the unflavored variety (100 calories/ounce) is considerably lower in calories.  Protein and fat content are lower than cow’s milk, but higher than other grain milks.  Hemp milk can be a nutritious part of your toddlers diet when coupled with a variety of foods.

Nut milks, such as almond milk, also tend to be deficient in protein and fat when compared to the unique nutrient needs of the younger toddler.  Caution should be used in introducing nut milks to the toddler before the age of three, due to risk of allergic reaction.

Young toddlerhood is an important time for establishing healthy eating habits and is also a critical time for adequate nutrition, specifically fat, protein, and calories.  As the younger toddler is in the process of being introduced to new foods and establishing eating patterns, a nutritious milk is an important component of the daily diet.  Evidence of steady growth and acceptance of a variety of solid foods are good indicators that your young toddler is receiving adequate nutrition from all food sources.

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Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

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  • Alina

    Our daughter has a sensitivity to dairy so she drinks hemp milk. One thing we have done to increase the caloric content is mix in coconut oil/juice, olive oil or flax seed oil. So that is definitely an option with rice milk and hemp milk.

  • Alina

    Our daughter has a sensitivity to dairy so she drinks hemp milk. One thing we have done to increase the caloric content is mix in coconut oil/juice, olive oil or flax seed oil. So that is definitely an option with rice milk and hemp milk.

  • Reed2500

    My daughter was 2 1/2 months premature and has reflux. She is allergic to milk protein and at 12 months we slowly and unsuccessfully transitioned in/out of whole milk and goat milk. Then to soy. But I have breast cancer in my family and now have read questions about so much soy milk in a young toddler and a possible link. Should I continue with formula? She was on Nutramigen or Neocate Jr, or another toddler formula for adequate nutritional needs for her age? ???

  • Reed2500

    Thank you – on top of it – last night she started refluxing so badly that the milk was coming out her nose once she fell asleep – her voice is so hoarse this last week – I knew she has reflux – she is on prevacid, but was nearly off it before we started leaving formula. Would using rice milk during the day and using a toddler formula for her minimum ounces work? She only drinks milk/formula and water – from a cup when not ready for a nap or bedtime – Thank you again.

  • Refluxmom

    Hello!
    It can be challenging to transition from infant formula to a toddler diet when your toddler has allergies. Infant formula provides a balance of nutrients. When you transition to a toddler diet, you need to find that balance in the foods your toddler eats and the beverages she consumes. You might need to consult your doctor to get advice on how to obtain the balance of nutrients, especially protein, vitamin D and calcium when you stop using infant formula. Sometimes you can use the other non dairy milks available such as soy milk or rice milk. Check and make sure these beverages have been fortified with the vitamins and nutrients found in milk. Some parents use a toddler formula-similar to an infant formula but made for the nutritional needs of a toddler over age 12 months.
    I am not too familiar with the use of soy milk for toddlers. Maybe someone else will add to this discussion.
    Jan Gambino
    The Reflux Mom
    http://www.refluxmom.com

  • http://www.justtherightbyte.com Jill Castle

    The appropriate milk for your young toddler will largely depend on how she is eating and progressing with solid foods. In general, alternate milks for this young age are lacking in fat, protein, and micronutrients such as calcium and Vitamin D. Trying alternate milks at this age can be nerve-wrecking because food intake can be so variable and unpredictable. However, children who eat a variety of foods and grow well may obtain their nutrients from complimentary foods and do fine with an alternate milk.

    Soy milks have been used as an alternative to cow's milk for a long time, and the research about their harm in children is inconclusive. The American Academy of Pediatrics supports the use of soy milk formulas/soy milk in young children who are intolerant and/or allergic to cow's milk protein. Remember, the use of soy milk does not have to be a “forever”–you have the freedom to change milks in the future, and may choose to do so as your daughter gets older.

    Since your toddler is still very young, and a former preemie, you might continue with her Neocate Junior, or consider use of a soy-based toddler formula (as long as she does not demonstrate intolerance/allergy to soy); either would be fine and would meet your daughter's nutritional needs. Consider these formulas an insurance policy whilst your daughter tries new foods and broadens her palate. Remember, adequate growth is the hallmark of good and adequate nutrition. And, you can always change her milk when you are confident that she is eating and growing well.
    Jill Castle
    http://www.justtherightbyte.com

  • JennMomof3

    I have a 12 month old who seems to be having some issues with transitioning to milk. She was on Similac Sensitive formula for her 1st year. When we tried to give her whole milk, she had very loose stool and vomitted. She also got a runny nose, cough, and ear infections that lasted for a month. So, we put her back on her formula for a couple of weeks and now have transitioned to whole milk lactaid. Now she is severely constipated, and again has the runny nose, cough, and ear infections. The pediatrician says she has a runny nose, cough and ear infections because she is in daycare. But, she was not sick except for one minor ear infection for the 1st 11 months of her life . . . and she was in daycare then also. I have a true milk allergy. My other two children are milk sensitive but can now tolerate small amounts of dairy (9 year old was on soy for the 1st 3 years of his life and our 5 year old was on Alumentum for 15 months and then lactaid). We were considering trying soy milk, but then were cautioned about estrogen in soy milk. I had never heard this and after some internet research I was a little concerned since our 9 year old does have ADHD. What about Almond milk? We are going on the assumption that she has a milk allergy since our pediatrician is just blowing all of this off as daycare related.

  • TwinToddlersDad

    Hi Jenn
    Milk allergy, or at least intolerance could be a real possibility although you can only be sure after testing. I do not have personal experience with cow milk alternatives such as soy milk, rice milk or nut milk like almond milk. Each has its own risks as explained by Jill in this article. You could try small quantities and watch for symptoms of allergy or other side effects.

    How about solid foods? At 12 months, she should be on solids. If dairy is an issue, you could use a balanced diet of solids to provide for protein, fat, vitamins and minerals.

    Good luck.

  • unhappybabies

    I’m surprised that goat’s milk is not mentioned in this article. Is goat’s milk fortified like soy and cow milks? How does goat’s milk rate?

  • Cowgirlkat04

    I would also like to know how goat milk stacks up, my son has been on it since he was 6 months old, he is allergic to cow milk and didn’t tollerate soy formula very well either.

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