Introducing your baby to milk is exciting! Here's how to know what type of milk works best for your babe's diet.

Introducing cow’s milk or alternative milks to your kids can be a daunting and confusing task! Like so many things with feeding your little (and parenting!), there are seemingly endless options. Let’s dive into what you need to know about introducing milk, the pros and cons of different types of milk, and my recommendations.

When to introduce milk

At 12 months old, the recommendation from the American Academy of Pediatrics is to begin introducing cow’s milk^[1]. If your child is on formula, you would begin the transition from formula to cow’s milk at this time. I recommend transitioning gradually so your child can get used to the taste of cow’s milk. If you are choosing an alternative milk (more on that below), the transition would also begin at 12 months old. To clarify, your child can eat dairy foods (yogurt, cheese, etc) and also cow’s milk (and alternative milks) cooked in foods after they start solids. However, it’s recommended not to drink cow’s milk or alternative milks as a beverage until 12 months old as these can crowd out formula or breastmilk, which are appropriate nutrition sources. 

According to the US Dietary Guidelines, for toddlers over 12 months who have transitioned off formula, the recommended amount of dairy per day is 1⅔ to 2 cups^[2]. This includes cow’s milk, yogurt, cheese, fortified soy beverages, and soy-based yogurt. For children between 2-3 years old, the recommended amount of dairy per day is 2 cups, and for 4–8-year-olds, it is 2.5 cups.

The reason for this limit is that if your child drinks too much milk, they may not be hungry for other food, which will crowd out those foods and their nutrients. Also, too large a volume of milk can hinder iron absorption from other foods.

The way I like to approach milk is that it is a drink and not a meal replacement. At this age, the majority of your child’s calories and nutrition should be coming from solid foods^[3].

Opt for full-fat cow’s milk

For all children under 2, the recommendation from the Dietary Guidelines is to use full-fat dairy, meaning whole milk. Whole milk is higher in fat than 1% or 2% milk. This fat helps young children grow and develop. If overweight or obesity is a concern, speak to your pediatrician about whole milk vs. other types of milk^[4].

What to know about alternative milks

How various alternative milks compare to cow’s milk is a very popular question. When I think about cow’s milk versus alternative milks, there are a few nutrient categories that are important to consider:

• For growth, high calories, fat, and protein are helpful.
• Always aim to have the least amount of added sugar possible in your milk selection (ideally no added sugar).
• Calcium is needed daily for healthy teeth and bones.
• Vitamin D is also needed for healthy bones, as well as inflammation reduction, immune function, and cell processes.

This chart about milk nutrition comparisons is a helpful visual breaking down the nutrients found in cow’s milk and alternative milks:

• Cow’s milk is high in calories (160 kcal per cup), high in protein (8g per cup), has no added sugar, is high in fat (9g per cup), high in calcium, and usually fortified with Vitamin D.
• Almond milk is low in calories (35 kcal per cup), low in protein (1g per cup), has no added sugar, is low in fat (3g per cup), high in calcium, and has no vitamin D. So for children who generally need calories, protein and fat, almond milk is not an ideal choice. The only benefit is it is fortified with calcium.
• Oat milk is high in calories (120 kcal per cup), low in protein (3g per cup), high in added sugar (7g per cup–it’s from processing the oats, but it still counts as added sugar), moderate in fat (5g per cup), high in calcium and high in vitamin D. I would not recommend giving an oat milk like Oatly to children regularly due to the added sugar content.
• Soy milk has a moderate amount of calories (80 kcal per cup), is high in protein (7g per cup), has no added sugar, is low-moderate in fat (4g per cup), high in calcium, and high in vitamin D.
• Pea milk has a moderate amount of calories (80 kcal per cup), is high in protein (8g per cup), has no added sugar, is low-moderate in fat (4.5g per cup), very high in calcium, and very high in vitamin D.
• Hemp milk has a low-moderate amount of calories (60 kcal per cup), is low in protein (3g per cup), has no added sugar, is low-moderate in fat (4.5g per cup), high in calcium, and moderate in vitamin D.
• Coconut milk beverage (this is different than canned coconut milk) has a low amount of calories (45 kcal per cup), has no protein (0g per cup), has no added sugar, is low-moderate in fat (4g per cup), very low in calcium, and low in vitamin D.

As you can see, there are pros and cons to all the different types of milk. For alternative milks, I often recommend pea milk or soy milk, depending on the family’s preferences. The CDC recommends soy milk for their top choice of alternative milks^[5]. When choosing a milk make sure that it has good calorie, protein, and fat content, is unflavored, has no added sugar, and is fortified with calcium and vitamin D.

What’s the deal with calcium?

If your child is eating a wide variety and volume of solid foods, then it would not be too difficult to obtain calories, fat, and protein from their diet. However, calcium and vitamin D are nutrients to think more closely about. If your child is not drinking any cow’s milk or alternative milks, then calcium and vitamin D must come from the diet.

Children 1-3 years old need 700 mg of calcium per day while children 4-8 years old need 1,000 mg of calcium per day^[6]. For reference, 1 cup of cow’s milk has about 300 mg of calcium, 1 cup of yogurt has about 415 mg of calcium, and 1 cup of raw spinach has about 245 mg of calcium. This chart has a list of foods that are high in calcium. You’ll see that while it is possible to reach your child’s calcium needs from diet alone, without also getting calcium from cow’s milk or an alternative milk, it becomes more difficult. That’s one major reason why cow’s milk (or alternative milks) are recommended.

Originally appeared here on April 21, 2022

[1] https://www.healthychildren.org/English/ages-stages/baby/formula-feeding/Pages/Why-Formula-Instead-of-Cows-Milk.aspx

[2] https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf

[3] https://www.chop.edu/news/making-switch-cow-s-milk-1-year-olds

[4] https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/cows-milk-and-milk-alternatives.html

[5] https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/cows-milk-and-milk-alternatives.html

[6] https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/