MS, RD, LDN, CBS
Janel holds a Master’s in Nutrition Communication from Tufts University. As the recipient of the 2010 Massachusetts Young Dietitian of the Year award, she believes in making healthy eating simple, sustainable, and delicious.
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While water should make up the majority of the fluids we drink, having cow’s milk or a milk alternative in moderation can be a healthful source of some of the nutrients you need to support your health and pregnancy.1
In addition to needing extra calories, fluids, and protein during pregnancy, moms-to-be also need more calcium, iron, folic acid, and vitamin D than they did before.2,3
Regardless of whether you drink cow’s milk while pregnant, eat dairy, or choose milk alternatives instead, pregnancy is an especially important time to eat nutritious, whole foods in order to reach your daily nutrition needs.3
Read more: Key Nutrients to Support a Healthy Pregnancy
Read on for the pros and cons of cow’s milk and milk alternatives to see if they will help you meet your needs.
Read more: Meal Plan: Key Nutrients of Pregnancy
For some, the naturally occurring sugar in cow’s milk (lactose) can cause digestive trouble in the form of bloating, diarrhea, and gas. This is called lactose intolerance.12 If you are lactose intolerant, there are lactose-free dairy options you can purchase.
If you’re allergic to cow’s milk protein, vegan, or just don’t like the taste of cow’s milk, a variety of milk alternatives are on the market. Some are plant-based like soy, rice, almond, hemp, or cashew “milk,” while others are animal-based, like goat milk.
Goat’s milk is a popular animal-based milk alternative. While it contains more calcium, B6, vitamin A, and potassium than cow’s milk; it also has more calories and saturated fat than whole cow’s milk, and contains less B12.13
If goat’s milk is your drink of choice, you may need to include foods or a supplement (with your doctor’s approval) with B12 to make up the difference. Finding goat’s milk that is fortified with B12 will also make it an adequate cow’s milk alternative.
Note that there is a strong chance that people who are allergic to cow’s milk protein will also be allergic to goat’s milk protein.14 Check with your doctor before making this switch if you have an allergy.
Read more: Major Allergens While Pregnant and Breastfeeding
Milk-alternatives, such as those made from soy, rice, almond, hemp, oat, coconut, and cashew are rising in popularity. These milk alternatives are naturally lactose-free, their fat content is primarily the good-for-you unsaturated type, and they can usually fit into a vegetarian or vegan diet.15
Many plant-based milk alternatives are fortified with calcium, vitamin A, and vitamin D to provide amounts similar to or greater than cow’s milk.15
But note that without fortification, such as plant-based milks made at home, these milk alternatives will contain only very small amounts of these important nutrients.15 You can determine whether a product has been fortified by checking the ingredient list and nutrition facts panel.
Be aware that healthy nutrients aren’t always the only things added to milk alternatives during processing. Sugars and sweeteners can also sneak in, adding empty calories. You can tell if a product has been sweetened if you see a type of sugar in the ingredient list.
Learn more: Minimizing Added Sugars
Keep in mind that ingredients and nutrition facts vary between brands.
While cow’s milk and milk alternatives can be part of a healthy diet, aim to drink milk in moderation and focus on eating a varied, well-balanced diet. 17 If you are not a milk drinker, you can incorporate milks or their alternatives with your favorite foods, for example cold cereal, oatmeal, frittatas, and whole grain baked goods.
Read more: How Much Should You Eat While Pregnant?
If you have questions about your diet while pregnant, reach out to our team of registered dietitians and lactation counselors for free! They’re here to help on our live chat from Monday – Friday 8am-8pm (EST), and Saturday – Sunday 8am-4pm (EST). Chat now!
Unless otherwise directed by your doctor, the Dietary Guidelines for Americans recommends skim or low-fat milk to help reduce intake of saturated fats.8
Beware of “original” and flavored types of plant-based milk, as these products often have sugar added. Instead, look for “unsweetened” in the name. Check that the ingredient list does not have any type of sugar and that the nutrition facts panel includes no added sugar.
Remember that cow’s milk and goat’s milk contain naturally occurring sugar (in the form of lactose) which will appear as grams of sugar on the nutrition facts panel. But these milks, if plain and not flavored, will have zero grams added sugar.
Supplemental calcium will appear on ingredient lists as tricalcium phosphate or calcium carbonate; vitamin A as vitamin A palmitate; and vitamin D as D2/ergocalciferol (plant-based) or D3/calciferol (animal-based).
Without fortification, plant-based milk alternatives will contain very little of these nutrients. With fortification, they could contain up to 40% of the recommended daily value.15
Eating foods rich in these nutrients is especially important if your milk or milk alternative has not been fortified, or if you choose not to drink a milk or milk alternative. Eat 8 to 12 ounces of low mercury fish per week19 (sardines with the bones and salmon, in particular), lean meats, eggs, legumes, and dark green leafy vegetables.
If you are a vegan or a vegetarian who doesn’t eat eggs or dairy, supplementation may be important. Chat with your doctor if you feel you may need a supplement.
Read more: Why Calcium Matters for Babies, Tots, and Mama
Read more: Why Vitamin D Matters for Babies, Tots, and Mama
Read more: What’s the Deal with Seafood?
Pregnant women are advised to avoid unpasteurized raw milk and milk products.18 Plus, the safety of store-bought, fresh-pressed milk alternatives is unclear so it’s best to choose pasteurized versions.
Read more: Food Safety During Pregnancy
We know parenting often means sleepless nights, stressful days, and countless questions and confusion, and we want to support you in your feeding journey and beyond. Our Happy Baby Experts are a team of lactation consultants and registered dietitians certified in infant and maternal nutrition – and they’re all moms, too, which means they’ve been there and seen that. They’re here to help on our free, live chat platform Monday – Friday 8am-8pm (EST), and Saturday – Sunday 8am-4pm (EST). Chat Now!
Read more about the experts that help write our content!
Meal Plan: Key Nutrients during pregnancy
How Much should you eat when pregnant?
Meeting Your Needs and Baby’s on a Vegan Diet
Why Folate Matters for Babies, Tots, and Mama
How to Manage Iron-Deficiency Anemia
Staying Hydrated Even if You’re Peeing Plenty
Meal Plan to Help Manage Morning Sickness
What Can I Do To Prepare to Breastfeed?
1. Mayo Clinic. Pregnancy Nutrition: healthy eating basics. Accessed 13 August 2021. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition.
2. Nation Institute of Health, US National Library of Medicine. Pregnancy and Nutrition. Accessed 19 August 2021. Mayo Clinic. Pregnancy Nutrition: healthy eating basics. Accessed 13 August 2021. https://medlineplus.gov/pregnancyandnutrition.html
3. The American College of Obstetricians and Gynecologists. Nutrition During Pregnancy. Accessed 13 August 2021. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy.
4. FoodData Central: non-fat milk. Accessed 13 August 2021. https://fdc.nal.usda.gov/fdc-app.html#/food-details/171269/nutrients
5. FoodData Central: 1% milk. Accessed 13 August 2021. https://fdc.nal.usda.gov/fdc-app.html#/food-details/489011/nutrients
6. FoodData Central: 2% milk. Accessed 13 August 2021. https://fdc.nal.usda.gov/fdc-app.html#/food-details/684918/nutrients
7. FoodData Central: whole milk. Accessed 13 August 2021. https://fdc.nal.usda.gov/fdc-app.html#/food-details/1097512/nutrients
8. United Stated Department of Agriculture. Dietary Guidelines for Americans 2020-2025, 9th December 2020. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf
9. Cow’s Milk and Children. Accessed 16 August 2021. https://medlineplus.gov/ency/article/001973.htm
10. Yeh, E.B., Barbano, D.M. and Drake, M. (2017), Vitamin Fortification of Fluid Milk. Journal of Food Science, 82: 856-864. https://onlinelibrary.wiley.com/doi/full/10.1111/1750-3841.13648#
11. Patterson, K.K., Exler, J., Byrdwell, W.C., Phillips, K.M., Horst, R., Lemar, L.E., Holden, J.M. 2010. Vitamin D content and variability in fluid milk from a USDA nationwide sampling to update values in the National Nutrient Database for Standard Reference. Journal of Dairy Science. 93(11):5082-5090. https://www.ars.usda.gov/research/publications/publication/?seqNo115=250089
12. Academy of Nutrition and Dietetics. Lactose Intolerance. Accessed 16 August 2021. https://www.eatright.org/health/allergies-and-intolerances/food-intolerances-and-sensitivities/lactose-intolerance
13. FoodData Central: Goat’s milk. Accessed 16 August 2021. https://fdc.nal.usda.gov/fdc-app.html#/food-details/171278/nutrients
14. Food Allergy Research and Education. Milk Allergy. Accessed 19 August 2021. https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/common-allergens/milk
15. Vanga SK, Raghavan V. How well do plant based alternatives fare nutritionally compared to cow’s milk?. J Food Sci Technol. 2018;55(1):10-20 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756203/
16. FoodData Central: Soy Milk. Accessed 16 August 2021. https://fdc.nal.usda.gov/fdc-app.html#/food-details/1097542/nutrients
17. Harvard Health. The Nutrition Source: Milk. Accessed 18 August 2021. https://www.hsph.harvard.edu/nutritionsource/milk/
18. FoodSafety.gov. People at Risk: Pregnant Women. Accessed 18 August 2021. https://www.foodsafety.gov/people-at-risk/pregnant-women
19. Food and Drug Administration. Advice about eating fish. Accessed 20 August 2021. https://www.fda.gov/food/consumers/advice-about-eating-fish
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