Milk and Milk Alternatives

By Jennifer Yoon, RDN/LDN, Pediatric Alliance — St. Clair



Many moms are choosing plant-based milk alternatives for various reasons. They may have been told cow’s milk formula is an inadequate or inappropriate diet for their infant. (In fact, cow’s milk formulas are completely adequate and appropriate for infants.) They may be concerned about hormones, antibiotics, or other additives, or a desire to pursue a plant-based diet for their child.

As a child weans from formula or breast milk, whole cow’s milk provides important nutrients for growth, including 8 grams of protein, 8 grams of fat, and 300 mg of calcium per 8-ounce serving. The protein and nutritional content of milk alternatives from plant sources varies widely. Plant-based milk alternatives should be researched and used with awareness and caution. Here is a breakdown of the milk alternatives and their nutritional values from Eating Well (click on chart to enlarge):













A study published in the American Journal of Clinical Nutrition looked at dietary habits and growth parameters of 5,000 children ages 1-3. Children who drank 3 servings a day of cow’s milk were 1.5 centimeters taller than children who drank milk alternatives.

“Many parents are choosing non-cow’s milk beverages like soy and almond milk because of perceived health benefits,” the authors write in the report. “However, non-cow’s milk contains less protein and fat than cow’s milk and may not have the same effect on height.”

Important things to consider are whether the child has a varied diet that includes other sources of protein, fats, and a variety of grains. The child’s growth and weight gain should be monitored. A nutrition consult may be necessary to ensure nutritional adequacy.

Other considerations:

> All milk substitutes must be fortified with calcium and vitamin D, with the exception of almond milk which is naturally high in calcium.

> Fortified products have a lower bioavailability than naturally occurring minerals.

> All plant proteins contain incomplete chains of amino acids, which is why a variety of grains are needed in a vegan diet.

> Hemp has the most beneficial mix of amino acids, and contains alpha linolenic acid, but the taste is dirty and grainy, and so it’s least acceptable.

> Soy milk is the most nutritionally adequate substitute. Animal studies, blood level data, and some uncontrolled population-based studies suggest phytoestrogens contained in soy may effect sexual development of females and males including pubertal timing, ovarian function, and endocrine dysfunction. Soy formulas have been widely used for many years resulting in circulating phytoestrogen levels thousands of times higher than normal, yet detrimental effects have not been evident in humans. There are few studies investigating estrogenic effects on male development and they are inconclusive.


*** Jennifer Yoon sees patients at the Pediatric Alliance — St. Clair office. For an appointment, please call (412) 221-2121. Read more from Jennifer on The PediaBlog here.