Is All “Milk” Created Equal for Kids?

Milk alternatives, sometimes called non-dairy or plant-based milks, are on store shelves and in fridges everywhere. Oat, soy, almond, coconut, cashew, and macadamia are among the most popular. But are they healthy? And are they milk? Or are they juice?

“The word and name “milk” is important because the implication is all of the products called “milk” are equal substitutes for one another,” says pediatric gastroenterologist Sarah Lusman, MD. Dr. Lusman works with kids and families on a variety of stomach and nutritional issues, including celiac disease, food allergies, and inflammatory bowel disease.

It’s confusing. It’s also a potential health problem. “The nutritional value of dairy milk is unmatched by these other beverages,” says Lusman.

If you—and especially your children—are drinking milk for the nutritional benefits, non-dairy alternatives may not be providing what you need.

We spoke to Lusman to learn everything about milk and “milk.”

Why is dairy milk important for kids?

Dairy milk is a source of nutrition for young children. It contains high-quality protein and is an excellent source of calcium and vitamin D. It also contains helpful nutrients, including:

• Potassium
• Phosphorus
• Vitamin B2 (riboflavin)
• Vitamin B12
• Vitamin A (added during processing or fortified)
• Protein

While it's full of nutrients, parents should be mindful of the amount of carbohydrates and fat in whole milk. If you want to cut down on saturated fat and cholesterol, you can try a reduced-fat version like 2% milkfat, low-fat (1% milk fat), and nonfat (skim). These varieties have been processed to reduce or eliminate milkfat. 

Children under two years of age should drink whole milk: milk fat is important for brain development.

If you eat a vegan diet, have a dairy allergy or lactose intolerance, speak to a healthcare professional about the best ways to get the nutrition you’re missing.

Is non-dairy “milk” healthy? 

Non-dairy “milks” are not necessarily unhealthy, but they do not contain as much protein as dairy milk. 

Non-dairy “milk” products contain additives like oils and are not always fortified with necessary micronutrients. They also have higher-than-usually-consumed concentrations of things, like nuts, which may trigger reactions like stomach aches.

So, although the ingredients in milk alternative products are not necessarily harmful for most children, it can be dangerous to rely on them. Replacing milk with something else can lead to nutritional deficiencies and overconsumption. 

Should non-dairy milk be called “milk”? 

No. It is misleading to label non-dairy milk as “milk” because it leads people to believe that plant-based alternatives are nutritionally equivalent to dairy milk. We should find another way to refer to them that is less confusing for parents.

Is nut milk, or other non-dairy milk, better than cow milk? 

No. Nutritionally, there is nothing better than dairy milk.

However, for some young children who have food allergies or other dietary intolerances, non-dairy can be a suitable or even a necessary alternative. Consult a pediatrician, pediatric gastroenterologist, or registered dietician to ensure children are getting adequate nutrition and a balanced diet. 

What do patients (or their parents) ask about milk?

Does my child need to drink milk?

Ideally, yes. Dairy milk is an important source of fluid, protein, calcium, and vitamins. Let’s also talk about what else your child is eating and see if they are getting these nutrients from other foods. This is especially important for children who cannot drink milk due to allergies or intolerances. 

What do patients ask about non-dairy milk?

Which non-dairy milk is best to give children?

It depends on the child and the beverage. Milk alternatives are not all equal.

Some children who are allergic to dairy milk will also react to soy milk. But soy milk can be a good source of protein for children who are lactose intolerant.

Nut milks are not quite as high in calories and protein as dairy milk. Coconut milk has more calories than nut milks, but most of those calories come from fat.

If weight is a concern, almond, oat, and rice milks are very low in calories, but we need to find a way to supplement certain nutrients. Again, talk to a pediatrician, pediatric gastroenterologist, or registered dietician to ensure children are getting what they need to be healthy.

What do you wish everyone knew about non-dairy “milk”? 

Alternative “milks” are not a straightforward substitute for dairy milk. Using milk alternatives interchangeably with dairy milk products should be done with caution in young children and extreme caution in infants. For infants who can’t tolerate dairy, there are nutritionally complete formulas available that might make sense as an alternative.

In short, milk alternative beverages can be used to supplement a balanced diet but should only be done with guidance from a knowledgeable pediatrician, pediatric gastroenterologist, registered dietician, or internist for adults.