MS, RD, LDN, CSSD, CBS
Rachel holds a Master’s in Nutrition Communication from Tufts University and is also a Board Certified Specialist in Sports Dietetics. She works as a nutrition and wellness coach with focuses on infant and maternal nutrition, mindful eating, and weight loss.
The transition to milk can be an exciting milestone. By 12 months, your little one is increasing the amount of table foods he consumes on a daily basis which means that he’s relying less on formula and breastmilk for nutrition. Toddlers between the ages of 1 and 2 have a greater need for fat, protein and vitamins to support their rapid growth and development, and liquid milk makes up the greatest daily source of nutrition (up to 60-70% of total caloric intake!) for this age group.
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Formula fed babies are encouraged to transition to milk at the 1 year mark, while breastfed babies can continue drinking breastmilk for as long as it’s available. Introduce milk in a cup as opposed to a bottle. Once your child is 1 year old, offer all liquids in a cup and not in a bottle. Begin presenting a cup with water at around 6 months of age to give your baby ample time to practice this new skill before his first birthday.
So which milk or milk alternative is best? Many options exist, and you should weigh the pros and cons of each with your child’s healthcare provider depending on your toddler’s age, weight and any potential food sensitivities. Here are the most common milks and milk alternatives available to families today:
Whole Cow’s Milk – Whole cow’s milk, when included with a variety of foods, can support the growth and development of children over 1 year of age and is recommended as a replacement to formula at this age by the American Academy of Pediatrics. It contains about 150 calories per 8 ounces and is a good source of calcium, protein, fat and Vitamins A and D. Unless your child’s healthcare provider has a specific concern about obesity, choose whole cow’s milk rather than reduced fat cow’s milk (like 1% or 2% milk) until your child is 2 years old.
Breastmilk – The AAP recommends babies continue to breastfeed through their first birthday, while the World Health Organization (WHO) recommends breastfeeding until at least age 2. So if your toddler is still nursing 3-4 times a day, you do not need to add cow’s milk to his diet right at 12 months. After all, breastmilk has a higher fat content than whole cow’s milk (to support brain development), and the nutrients in human milk are significantly more bioavailable than those in cow’s milk (meaning our bodies can better absorb and use those nutrients) because it is species specific. So if you’re still breastfeeding, don’t stress about milk! Your toddler is doing just fine. However, if you are offering breastmilk in a bottle, try offering it in a cup.). If your child is only nursing once or twice per day, then some cow’s milk or other beverage (see below) may be needed. Feel free to discuss this with your toddler’s doctor or a Happy Family Coach!
Toddler Formulas –Toddler or transitional milks are fortified with vitamin D, iron, DHA and other healthy fats, and fiber (in some cases, beneficial prebiotic fibers) and are lower in sugar than cow’s milk. These extra nutrients can be important even for toddlers already eating a balanced diet, and can be a good option in place of cow’s milk for those who are not breastfeeding.
Soy Milk – For those with a sensitivity or intolerance to dairy, soy milk provides adequate calories and protein for the growing toddler. Look for soy milk that is unsweetened and fortified with calcium and Vitamin D.
It is important to note, that approximately 40% of children who are allergic to cow’s milk are also allergic to soy milk so soy milk and soy infant formulas are recommended for children only under specific circumstances.
Rice Milk – Children with allergies to both cow and soy milk or who follow vegetarian or vegan diets often turn to rice milk, but this might not the best choice for your growing toddler as it’s low protein, fat, calorie, vitamin and minerals than other dairy alternatives. . If you choose to use rice milk, opt for unsweetened versions fortified with calcium and Vitamin D and make sure your toddler’s diet includes other sources of protein, healthy fats and vitamin and minerals
Almond Milk – Almond milk, like rice milk, is low in protein and fat when compared to the unique nutrient needs of the younger toddler and therefore might not be the best choice as a milk alternative. If you choose to use almond milk, opt for unsweetened versions fortified with calcium and Vitamin D and make sure your toddler’s diet contains other sources of protein and healthy fats.
Hemp Milk – Unsweetened hemp milk can be a nutritious part of your toddler’s diet only when coupled with a variety of whole, nutrient-rich foods because hemp milk contains many of the same nutrients found in cow’s milk but at lower levels.
Goat’s Milk – While goat milk does contain more calcium, B6, vitamin A and potassium than cow milk, it lacks folate and B12. So if goat milk is your primary choice, it’s important to supplement with folate and B12 or choose fortified goat milk to serve as an adequate cow’s milk alternative.
If offering cow’s milk, stick to whole milk from 1 to 2 years of age
Whole milk provides the full milk fat needed for your toddler’s developing brain. Skim milk or nonfat milk provides too high a concentration of protein and minerals and should not be given to infants or toddlers under age 2 unless directed by your child’s healthcare provider.
Introduce milk in a cup, not in a bottle
Once your child is 1 year old, offer all liquids in a cup and not in a bottle. Begin presenting a cup with water at around 6 months of age to give your baby ample time to practice this new skill before his first birthday.
For more information on introducing cups, see The pros and cons of cups, sippy cups, and straws for babies and toddlers.
Experiment with milk temperature
If your baby is used to drinking warmed formula or room temperature breastmilk, then the switch to ice cold milk might be a tough transition. Begin with warmed milk and slowly transition to cooler milk until your little one is happy drinking it right out of the fridge.
Try mixing milk with formula or breastmilk
If the flavor change to milk is too drastic for your toddler, try adding a few ounces of breastmilk or formula to an ounce or two of whole cow’s milk or the milk alternative of your choosing. As your toddler becomes more comfortable, slowly decrease the percentage of formula or breastmilk until you are offering only milk (or milk alternative).
Ease the transition as necessary by working milk into foods your child likes
If your little one isn’t taking to milk, try incorporating it into fresh fruit smoothies, hot whole grain cereals (use milk instead of water for cooking), beat into scrambled eggs and omelets and mash with sweet or regular potatoes.
Continue offering other foods rich in calcium and vitamin D
Offer plenty of cheese, plain yogurt, cottage cheese, beans, seafood and enriched breads and cereals. While calcium and vitamin D fortified orange juice is available in stores, limit your toddler’s juice intake to no more than 4-6 ounces per day, if at all.
Limit your toddler to no more than 24 ounces of whole milk a day
Research shows that toddlers who drink more than 24 ounces of cow’s milk a day have higher rates of iron deficiency because cow’s milk can interfere with the absorption of iron. Plus with too much milk, your toddler’s little belly will be too full to eat all the other healthy foods you’re now providing during the day.
While the milk fat is essential to brain development, toddlers gain a lot of calories from foods, like proteins, grains, vegetables and fruits that also provide all kinds of other vitamins and minerals. So 2-3 small glasses of milk a day is all he needs, as opposed to the 3-4 bottles of breastmilk or formula he used to drink.
Consult with your toddler’s healthcare provider
Speak with your child’s healthcare provider if your child is overweight or you have a family history of obesity, high blood pressure or heart disease. If your child’s growth is above the 95 percentile, switching to 2% milk at his first birthday may be the best choice.
If your baby has a dairy or soy sensitivity, speak to your healthcare provider about which type of milk to introduce first. And don’t worry – many infants outgrow a milk or soy protein intolerance by their first birthday. You and your child’s pediatrician can form a plan of which soy and dairy products to re-introduce and the pros and cons of each type of milk.
If your family doesn’t eat dairy or your child won’t or can’t adapt to cow’s milk
Cow’s milk is an easy delivery system for calcium, protein, fat, and, when fortified, vitamin D but it may not be for your child (or you). If it’s not, it will be especially important for your child to eat nutritious foods that are high in these nutrients, notably fish (sardines with the bones and salmon, in particular), lean meats, eggs, legumes (beans), dark green leafy vegetables, and, if tolerated and acceptable, yogurt, cottage cheese, and cheese.
When choosing milk alternatives, opt for unsweetened varieties
Sugar is often added to soy, rice, hemp and almond milks. While it increases the caloric intake (for better or for worse), it provides no nutritional benefit and increased exposure to sugar can affect your child’s affinity for sweetness. As flavor preferences are developing at this time (and no child needs help liking sweets!), it’s best to limit added sugar whenever possible. Beware of “Original” flavors as these often have sugar added; look specifically for “Unsweetened” claims instead.