Milk for Babies and Toddlers: A Dietitian’s Helpful Guide

Milk is a hot topic with parents and caregivers especially when a baby is transitioning away from breastmilk or formula. In this short guide I share helpful, well-researched information so that you can decide what’s best for babies and toddlers, and when. Included is information on milk alternatives, and at what age to offer almond, soy, rice or goat milks.

This post covers key questions from parents and caregivers, such as:

• What are the health benefits of cow’s milk for a child
• How and when to introduce cow’s milk if you’re breastfeeding
• When and how to offer your baby cow’s milk
• What about alternative milks for babies and toddlers
• What if my baby has a milk allergy or lactose intolerance

Oh milk…

If there was ever a food that caused so much confusion, raised so many questions and was such a source of disagreement, milk would be it! As if feeding toddlers wasn’t confusing enough! All three of my kids drink milk. Not much—around one cup a day (plus some yogurt and cheese). They probably get around two servings of milk or dairy foods per day on average—sometimes less, sometimes more—which helps them meet some of their daily nutrient requirements.

Is cow’s milk essential? No. But some of the nutrients in cow’s milk, such calcium, vitamin D and protein ARE essential.

What are the health benefits of cow’s milk for children?

Cow’s milk is certainly an easy way for your toddler or child to get all of those nutrients in one drink (that most kids enjoy!), but it’s not the only way to get those nutrients. So, if cow’s milk is not your thing, or if you choose not to serve it for whatever reason (maybe your family follows a vegan diet or your child has a milk allergy), that’s A-Okay.

If this is the case however, it’s important to pick complementary foods to replace milk, so that your toddler still gets enough protein, fat, calcium, vitamin D, and other nutrients that they need. Although dairy can be an excellent source of both protein and fat, there are many other non-dairy sources (think meat, fish, eggs, avocado, nuts, seeds, etc.).

When it comes to calcium, dairy foods like milk, yogurt and cheese are likely the easiest way to ensure your child (and you) meet your needs. If dairy isn’t part of your toddler’s diet, it can be a bit trickier to ensure they meet their daily requirements. If you’re concerned or feel that you’re unsure, you likely need individual one-on-one dietitian support to ensure you get it right.

To give you some context into your child’s calcium requirements:

Age	Calcium Requirements (Dietary Reference Intakes)
0-6 mo	200 mg (met through breastmilk and/or formula)
6-12 mo	260 mg (met through breastmilk and/or formula)
1-3 yrs	700 mg (met through food/beverages)
4-8 yrs	1000 mg (met through food/beverages)

And to give you an idea of calcium-rich food sources:

Food source	Serving amount	mg of calcium per serving
milk	250 mL (1 cup)	291-322 mg
yogurt (plain)	175 mL (3/4 cup)	263-275 mg
cheese (hard–like cheddar)	50 mg (1 1/2oz)	252-366 mg
canned salmon	75 g (2 1/2 oz)	179-212 mg
tofu (prepared with calcium sulfate)	150 g (3/4 cup)	302-525 mg
soy beverage	250 mL (1 cup)	321-324 mg
almonds	60 mL (1/4 cup)	93 mg
beans	175 mL (3/4 cup)	93-141 mg
spinach, cooked	125 mL (1/2 cup)	129 mg

For example, a 1-3 year-old who consumes dairy could meet their daily requirements with 1 cup of whole milk + 1 1/2 oz cheese and a small amount of canned salmon throughout the day.

It might take a little more creativity for a child who does not consume dairy — let’s say 1/4 cup almond butter, 1/2 cup tofu, some canned salmon and cooked spinach. And being that ages one to three tend to be “pickier years”, this can be a bit challenging (although, not impossible). If a child continues to be breastfed, they will receive some extra calcium this way. Sometimes health care providers suggest that a formula-fed child continue to consume formula into their second year if their are growth and development concerns (in which case this would top up their calcium too).

How and when to introduce cow’s milk if you’re breastfeeding

Take your time–don’t rush it! You want to give your little one time to adjust to the new proteins and other nutrients in cow’s milk. Some moms like to start with one or two tablespoons a day, served along with formula or expressed breastmilk, then slowly increase the amount of milk over a few weeks until you are serving pure milk.

Some moms like to breastfeed morning and night and serve cow’s milk after lunch. Then eventually they replace the morning feed with cow’s milk too. As mentioned above, I recommend only serving cow’s milk via open cup (not bottle), so if your baby is bottle-fed, this might be the perfect opportunity to wean off of the bottle.

There’s no exact pattern you need to follow. Just take it slow to give baby a chance to adjust. It might take them some time to adjust to the new flavour too, especially if your baby is breastfed. Milk isn’t as sweet as breastmilk, so this may throw them off at first. Give them time to adjust. You can transitioning to cows milk around 11 or 12 months (or a little bit earlier depending on your baby and schedule) and slowly increase this amount until fully transitioned, which typically takes time—anywhere from 2 to 6 weeks.

How much milk should my child be consuming?

According to the American Academy of Pediatrics and Health Canada, your one-year-old should be getting about 16 oz (2 cups) of whole cow’s milk per day (or equivalent to this). If they also eat cheese and yogurt, you can reduce the amount of milk they drink if you’d like (but it’s not necessary).

Refer back to the tables above for daily requirements of calcium and some dairy and non-dairy sources (and amounts). Because milk is so nutritious and is an easy way to keep little one’s full and satisfied, sometimes it can be relied on too much. This can easily create or perpetuate picky eating issues and displace other important nutrients (like iron), so I suggest to stick to a maximum of two cups of milk per day and serve alongside meals (rather than in between). And hey, if you don’t want to feed your child any dairy foods, again, that’s ok!

Dairy foods are not “must-haves,” (as you can see in the chart, there are many calcium-rich choices) but the nutrients in dairy foods—like calcium and vitamin D—are vital. Regardless of whether your child drinks milk or not, they should still be given a Vitamin D supplement of 400 IU’s per day (you can continue giving Vitamin D drops). It’s too challenging to ensure that your toddler meet their requirements through food alone.

Ok. So, when and how do I introduce cow’s milk to my child?

If you choose to feed your toddler whole cow’s milk, it can be safely introduced to replace breastmilk or formula at around 12 months of age (and no sooner than nine months).

Before this age, your baby’s digestive tract isn’t quite mature enough to handle large quantities of the nutrients in cow’s milk. A bit of milk in a recipe is fine, but you do not want to offer a cup of milk until about 12 months of age. I recommend serving milk in open cups (not sippies or bottles).

Be sure to stick with whole milk to start; you don’t want to feed your baby reduced-fat or fat-free milk until after the age of two because they need dietary fat found in milk for proper growth and development. Depending on where you live, this milk may be called whole, homo, homogenized, full-fat, or 3.25% milk fat.

What about plant-based milk alternatives (like almond milk) for babies and toddlers?

This is important: Milk alternatives such as rice, hemp, coconut, oat, cashew, or almond beverages don’t contain enough calories, protein, or fat to directly replace breastmilk, formula, or cow’s milk. Using these milk alternatives alone won’t provide proper nutrition for growth and development, especially before 12 months of age. In saying this, it’s totally fine to blend up a smoothie and add a bit of almond milk, or to stir some coconut milk in your toddler’s oatmeal. But these milk alternatives should not be used as a replacement for cow’s milk, breastmilk, or formula, because they are simply not nutritious enough.

Here’s what you need to know:

Beginning at 12 months, if you are no longer breast- or formula-feeding, your best options are:

• Whole cow’s milk: This milk contains the essential protein, dietary fat, vitamins, and minerals your baby needs. And don’t use skim or 2% milk—whole cow’s milk contains extra fat, which is important for growth and development.
• Goat’s milk: Goat’s milk is comparable to cow’s milk in its nutritional qualities. It has similar amounts of protein, calcium, and vitamin A. Choose one that’s whole-fat, pasteurized, and fortified with folic acid and vitamin D. 

Soy milk may be appropriate under these circumstances:

Unsweetened soy milk has about the same amount of protein as cow’s milk, but not as much dietary fat, so it’s not the best option—although some dietitians recommend it as the best option for vegan babies and suggest adding more dietary fat to the toddler’s diet in other ways (with healthy oils, nuts, seeds, salmon, etc.).

Read labels of milk alternatives: almond, coconut, hemp, or rice beverages are often fortified with similar vitamins and minerals as cow’s milk, but they don’t contain nearly enough protein or dietary fat to be considered a safe or healthy alternative to whole cow’s milk for this age group.

Your child will not get enough of the nutrients they need if you simply swap any of these plant-based milks 1:1 with cow’s milk and make no additional changes to their diet. These plant-based milks are NOT the same as cow’s milk, as you can see in the chart below.

What if my baby has a milk allergy or lactose intolerance?

Surprise, surprise—there is some controversy in the nutrition world about certain milk alternatives for toddlers, and soy milk is at the top of the list. Some nutrition experts believe that since it’s lower in calories, fat, and protein when compared to cow’s milk, it’s not a suitable alternative. Others believe it’s okay because it’s the closest plant-based option (nutritionally speaking) to cow’s milk.

In cases where cow’s milk is not an option (maybe your child has a milk allergy or is vegan), you can offer full-fat, fortified, “original” (not unsweetened) soy beverage instead of milk as long as there are no growth or development concerns. If there are concerns, your child will need to consume a high-fat/high-calorie diet, and soy milk will not suffice.

Some conventional soy products come from genetically modified soybeans and may contain traces of synthetic pesticides or fertilizers. If this is a concern to you, choose an organic soy beverage. Check your package carefully to ensure that the soy beverage is fortified with vitamins and minerals (such as calcium and vitamin D), which are added to mimic the nutrients found in cow’s milk.

Beyond the nutrient content, there’s another soy controversy you should know about. Soy contains antioxidants known as isoflavones, which may protect against certain diseases. That’s good news.

Isoflavones have a mild estrogen-like effect, and that’s where some people kinda freak out a little. Estrogen is a sex hormone that plays an important role in reproduction, so some people wonder if soy will make their daughter go through puberty too early or make their son grow man-boobs. These are legitimate questions!

The answer is mostly that we don’t know. Very few studies have been conducted that involve children and soy intake, and the few that do exist are very small or are funded by the soy industry (so you can guess the findings might be swayed).

At the end of the day, it’s your choice as a parent whether you want to offer soy milk as an alternative to cow’s milk, because there isn’t enough science to make a truly non-biased, evidence-based decision.

Bottom line

That’s a lot of information, but I hope that it helped to answer some of your questions about milk and dairy for your toddler. If you’re concerned or overwhelmed, my team and I are here to help!

You might also be interested in reading about what and how much your toddler should be eating, and how to deal with common toddler picky eating issues!