Ask Dr. Lloyd: The Low-down on Alternative Milks

July 23, 2012

 “Alternative milks” are a hot topic recently. Between all of the new “health” drinks, like rice milk and even hemp milk, how can you choose what is best for your child?

We’ll start with some basic nutrition information:

Starting at age 12 months, your child is ready to wean off formula or breast milk, his or her main source of nutrition for the first year of life.  Your child is growing and developing rapidly and needs many building blocks from their diet to meet the needs of their body. Toddlers need 1000-1400 calories a day, split between 3 meals and 2-3 snacks. Your toddler only needs 16-24 ounces of milk each day, so they have room for a wide variety of other foods, which provide key nutrients for their active bodies.


  • Protein is what your body is made of!  It is the scaffolding of your bones, muscles, cartilage, skin and blood. It is also full of B vitamins, vitamin E, iron, zinc and magnesium. These help your body’s nervous system and metabolism. The nutrients also help your body release energy, protect from anemia, and build up a strong immune system.
  • Examples include meat, poultry, seafood, beans and peas (but not green peas, green lima beans or green string beans), eggs, soy (including tofu), and nuts and seeds.


  • Grains are full of fiber, B vitamins, and lots of essential minerals (like iron) that your body needs to grow. Just like in the protein food group, these minerals help your body’s nervous system and metabolism and also help your body release energy, protect from anemia, and build up a strong immune system.
  • Try to provide at least half of the grains as whole grains in your toddler’s meals.
  • Examples include wheat, rice, oats, cornmeal and barley.


  • Fruits are low-calorie, low in fat and low in sodium. They are also cholesterol-free! They help provide potassium, fiber, vitamin C and folic acid.  Benefits include helping produce red blood cells, helping with overall body healing, keeping your teeth and gums healthy, and helping with heart health. (And the fiber helps with bowel health, too!)
  • Vegetables are also low in calories and fat and are cholesterol-free. They, too, provide fiber, folic acid, potassium, vitamin A and vitamin C. They help with many of the same things that fruits do–and also keep eyes and skin healthy!
  • Try to fill at least half your toddler’s plate with fruits and vegetables.
  • Examples include seasonal fruits and vegetables, frozen fruits and vegetables and 100% juices. Beans and peas are also vegetables, along with potatoes (but French fries don’t really count as a serving of vegetables!).


  • Full of calcium, potassium, vitamin D and protein!  Dairy, especially the calcium, helps with bone health and bone and teeth growth. In adults, if reduces the risk of osteoporosis, heart disease, and type 2 diabetes and lowers blood pressure.
  • Examples: milk, pudding, ice cream, cheese, yogurt and calcium-fortified soy drinks.

(**For more info on dietary guidelines, check out this downloadable “my plate” diagram at

So what makes milk special?

  • True milk is only made by mammals and is easy to digest and nutrient rich.
  • It contains calcium to build strong teeth and bones.
  • It is fortified with vitamin D, to help your child absorb and use the calcium.
  • There’s lots of protein for building muscle and bone, and for providing energy.
  • There’s also lots of carbohydrates for energy from the lactose, a type of sugar.
  • Whole cow’s milk also has good fat–necessary for your toddler’s growing brain.
    • Continue to use whole milk until your child is 2-3 years old.
    •  Low-fat milk can be started after that, but no skim milk until age 5 years.

One more fact about milk: It does not make mucous. It does, however, leave a coating in the mouth and throat after drinking, but it only lasts a short time after drinking it. So, it’s perfectly safe for your child to drink if he or she has a cold or respiratory illness.


Let’s go through the different sources of milk, and the benefits and potential drawbacks of each type.

Animal sources:

  • Cow’s milk
    • Benefits: High in calcium, vitamins D and A and B-12, protein, carbohydrates and fats.
    • Cons: Low in iron. Difficult to handle in large amounts if lactose-intolerant.
  • Goat’s milk
    • Benefits: Similar to breast milk, easy to digest, high in protein and calcium.
    • Cons: Lower folic acid. No iron or B-12. Must be pasteurized to be safe to drink. Can have allergy if allergic to cow’s milk. Strong odor and flavor.

Nut/bean/seed “milks”–made by soaking the nut or bean in water

  • Soy milk
    • Benefits: Lots of protein, calcium and vitamin D, if fortified. Also cholesterol-free. Look for full-fat (regular) preparation for your toddler.
    • Cons: Children with cow’s milk allergy/sensitivity can have an allergy to soy products too. No B-12. Contains isoflavones, which “mimic” estrogen in the body, so avoid consuming large amounts of soy.
  • Almond milk
    • Benefits: High in calcium, and vitamin D if fortified. Lots of vitamin E.
    • Cons: Low in protein.  Low in fat (good for adults but not for your youngster’s growing brain!). Low in vitamin B-12. Made with a thickener which may contain wheat–unsafe for those with gluten or nut allergies.
  • Coconut milk
    • Benefits: High in saturated fat, low carbohydrates and sugars.
    • Cons: Low protein. High calorie. Low B-12. Unsafe for those with nut allergies.  Not a good substitute for other more nutritious types of milk.
  • Hemp milk
    • Benefits: High in omega-3 and 6 fatty acids, low carbohydrates and sugars. Some protein.
    • Cons: Expensive. Made with thickener. Not for children with nut and seed allergies.

Grain sources

  • Rice milk
    • Benefits: Contains no lactose, the sugar implicated in most cow’s milk sensitivities or allergies. High in calcium and vitamin D, if fortified. Also has vitamins A and B and iron. Good source of calcium for adults with soy or nut allergies.
    • Cons: Low in protein and fat- both needed for growth. High in carbohydrates and sugar. No B-12. Ok for the occasional drink, but not a good substitute for more nutritious milks.
  • Oat milk
    • Benefits: Moderate amount of protein and some fiber. Ok for those with soy/nut/seed sensitivity.
    • Cons: Very high in carbohydrates. Also uses a thickener. Unsafe for those with gluten sensitivity.

Now that we’ve walked through the 3 main types, here’s a handy table with all the nutritional information for a sample of each type of “milk”: (click to enlarge)

The Low-Down

In summary, cow’s milk is not a necessity of your toddler’s diet, but it is a great source of protein, fat, vitamin D and calcium.

Cow’s milk is a major source of calcium for your child’s growing body. If there’s a milk allergy or lactose-intolerance, soy milk (if calcium-fortified), tofu, calcium-fortified orange juice and cereals are other options for calcium. Calcium supplements can also be considered.

If you continue to breastfeed your toddler after the ages of 12 months, make sure he or she gets plenty of iron and vitamin D from other foods.

For protein, beans, eggs, and peanut butter are other examples of foods which provide that vital building block.

To obtain the same nutrients and vitamins and minerals from other sources, it takes a bit more meal planning but it can be done for situations like allergies, lactose intolerance or a vegan diet. The alternative “milks” can provide some of the nutrients, but not all. Use care in reading labels if you decide to try other beverages and make sure the missing parts are provided from other foods in your toddler’s diet.

Do you have other questions you’d like Dr. Lloyd to tackle? Let us know by emailing


Image credit: Flick user mowiekay

Dr. Lloyd is moving!

On May 21st, 2018, she joined Portland Pediatrics! Her new office is located at:
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Webster, NY 14580
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