Dear Dairy, Today we talk about cow’s milk

One of the more talked-about topics amongst my group of friends when our children were nearing their first birthday was the topic of cow’s milk — and specifically, what the babies should start drinking as some of them began weaning from formula or breast milk. The decision to consume dairy is influenced by a lot of factors: Cultural, lifestyle, health, allergies or sensitivities, preferences and even religious reasons. But, the one factor that each parent was concerned about was nutrition — and what role dairy plays in that.

Is cow’s milk necessary?

It is necessary for baby cows! However, for humans, cow’s milk is not essential. The nutritional benefits of cow’s milk (like protein, calcium and vitamins) can be achieved through a thoughtful, well-balanced approach to cooking. However, it is certainly convenient and many people enjoy the taste. Cow’s milk is neither good nor bad — but a choice based on many factors unique to your child and family. Here, I outline some useful information surrounding the topic of cow’s milk as you navigate this decision for your own family as well as provide insight to dairy alternatives.

Cow’s milk is one of the most common allergens — though is still statistically a low risk.

An approximated 2.5 percent of children younger than three years old are allergic to milk (with most allergies developed in the first year of life). Most children eventually outgrow a milk allergy.

It is more common (though still relatively rare) for a child to be diagnosed with lactose intolerance — usually evidenced by runny stools and bloated stomachs.

Sometimes strategies like eliminating then later re-introducing cow’s milk, reducing the quantity of cow’s milk being consumed, or opting for naturally lactose free options (like aged, hard cheeses) to avoid exposure to lactose can be helpful if your child is experiencing any possible reactions to milk. However, always work with your pediatrician to find a solution that is best for your child if lactose intolerance is diagnosed.

Not all cow’s milk is created equal.

If you choose to use cow’s milk as a part of your child’s daily diet, it pays to be picky about what kind you serve. I recommend looking for non-homogenized, low-temp pasteurized, 100% grass fed whole milk. First of, fat content is important for tots, so the AAP recommends Whole Milk until age 2. There’s been research to show that 100% grass fed milk contains more nutrients including higher levels of the coveted Omega-3s that are so important to developing brains. I am personally an advocate for choosing the minimally processed foods, so the labels “non-homogenized” and “low-temp pasteurized” personally appeal to me. Homogenized milk is processed so that the fats are evenly distributed (think no need to shake it up to mix) and low-temp pasteurization makes the milk safe, but may help preserve some of the proteins and nutrients that can be damaged in high-temperature pasteurization. I have a friend or two that uses raw milk and swear by it — but for me, I do not have access to a purveyor I trust in my urban lifestyle… so I feel safer knowing the science of low-temp pasteurization is in my fridge.

Drinking cow’s milk before 1 years old is not recommended, but cheese, yogurt & cooking with milk is OK.

Assuming no allergies or intolerances, many pediatricians are fine with the introduction of cheese, yogurt and fluid milk as an ingredient (i.e., in baked goods or a sauce) at 6 months when starting the introduction of solid foods. The rationale is that drinking milk runs the risk of replacing formula or breastmilk, which is not recommended before one unless your child has already weaned significantly and is on a well-balanced solid diet. Each child has their own timeline for food, and your pediatrician will guide you on when the timing is right for the introduction of fluid milk (if you choose to incorporate it into your child’s diet).

There are both plant-based and animal-based milk alternatives — but you should be aware of their nutritional purpose.

Cow’s milk (especially 100% grass fed milk) is a decent source of folic acid, fat (and Omega 3s from grass fed milk), vitamins D, K, calcium & protein. You may notice some milk (typically high-temp pasteurized milk) is “fortified” with vitamins or other nutritional benefits. This is because it is not naturally occurring or is damaged/reduced during the processing.

Goat’s Milk

Like cow’s milk, goat’s milk is an excellent, natural source of Vitamins D, K, Calcium & Protein. It does not have as much folic acid, however, as cow’s milk so do opt for fortified products. The taste is different, but the consistency and texture is the same as a cow’s milk. Also, goat’s milk has naturally less lactose, meaning it may be an option if your little one has a lactose intolerance. If your child has a cow’s milk allergy, talk to your doctor first about goat’s milk as an option.

Almond Milk

The basic recipe for almond milk calls for almonds and water. However, many of the almond milks you will find in your grocery store have lots of other things added into it (some for health reasons, some more dubious). Avoid varieties that have added sugar, artificial or natural flavors, carrageenan or preservatives. Almond milk is typically a good source of Vitamins A & D and sometimes Calcium due to fortification. Although almonds are a good source of protein, Almond milk is not because the ratio of almonds to water is so small so you will need to make sure protein is being included in other ways. And while it is naturally lactose free, it is a obviously off limits for those that have nut or almond allergies. Always shake well to ensure distribution of the added nutrients.

Fortified Soy Milk

Soy milk is made from crushed soybeans and is a naturally excellent source of protein, potassium (and if fortified, vitamins A & D). Do opt for organic, unflavored (i.e., less processed) versions of soy milk made from whole soybeans so that the valuable proteins are not damaged. Avoid flavored soy milk or those made with sweeteners. Also, if you are concerned about genetically engineered products, know that most soy crops are genetically engineered — so opt for products that are certified Non-GMO. There have been some disputed findings about the role of hormones in soy products — but in moderation, is generally approved by the medical community. Always shake well to ensure distribution of the added nutrients.

Fortified Rice Milk

The least allergenic of the milk options, rice milk is chiefly made from rice and water. As such, it is not a good source of protein, and is significantly lacking in calcium and Vitamins B & D. It can offer vitamins and calcium, but only when fortified to include those ingredients after processing.  It also has twice as many carbohydrates than cow’s milk (24 grams vs. 12 grams), so it is not the best choice to pair with cereals or oatmeal. When choosing rice milk, opt for variations that are organic, unflavored and do not have additional sweeteners added to reduce the carbohydrates.

What foods are good sources of nutrition if we avoid drinking cow’s milk after 1?

The core nutritional value of drinking milk is protein, calcium and Vitamins B & D. It is entirely possible to eat foods to meet these nutritional requirements.

Protein – Outside of the obvious meat choices, Greek yogurt, quinoa, fish and eggs are all great sources of protein. So are legumes or beans — although they are missing essential amino acids, so serve lentils, black beans and hummus with things like brown rice or whole wheat flatbread to round them out.

Calcium – Dried figs, dark leafy greens (kale! turnip greens! spinach!), canned salmon with bones, black eyed peas, white beans, sesame seeds, broccoli, okra & oranges are all excellent sources of calcium.

Vitamin D – Vitamin D is critical in helping the body absorb calcium and other nutrients, so including some natural Vitamin D food sources in your family’s diet is important. Where to get it? Fatty fishes like salmon and trout, canned tuna (please opt for pole caught!) are an option, egg yolks, certain mushrooms are grown with ultraviolet light and are enriched with Vitamin D,  and cheese contains a very small amount of naturally occurring Vitamin D.

B Vitamins – These include B6, B12 & folate (i.e., folic acid) are found in fruits, vegetables, grains and some protein sources. Folate is especially difficult to acquire through diet alone, so many breads, grains and cereals are required to be fortified with it. However, natural sources of B6 include: beans, poultry, fish, dark leafy greens, papayas, oranges, and cantaloupe. B12 is naturally found in animal products like eggs, dairy, meat and poultry. It is often also fortified in non-dairy alternatives like Rice or Soy milk. Folate is found in many fruits, vegetables, grains and animal products; with spinach, asparagus and brussel sprouts having some of the highest levels of folic acid.