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The Informed Parent

Got Milk?

by Shanna R. Cox, M.D., F.A.A.P.
Published on Oct. 22, 2007

In the last several years, the “Got Milk?” commercials have made many of us laugh, and also have strongly advertised a product that many consider a centerpiece of childhood. Usually we begin talking about the transition to cow’s milk after a child’s first birthday. However, in some cases alternatives to cow’s milk must be considered.

Children who have a milk protein sensitivity may need to be changed to soy milk. More rarely, a child may have both a milk and soy protein allergy, therefore may need another alternative to obtain some of the vital nutrients offered by these beverages. The problem is that an eight ounce glass of milk, soy or rice milk are not equivalent in the nutrition they offer. The major benefits of cow’s milk are the high protein, Vitamin D and calcium content that is offered in a relatively small package. Additionally there is a fair amount of fat that supports the growth of a child’s brain.

The chart below illustrates the differences between equal servings of whole, reduced fat, soy and rice milk. Note that the soy and rice milk varieties must be enriched to meet the quantities of calcium noted.


Serving Size--8 oz.





Whole Cow’s Milk


9 gm

291 mg

8 gm

2% Cow’s Milk


4.7 gm

297 mg

8 gm

Soy Milk (fortified)


5 gm

300 mg

6 gm

Rice Milk (fortified)


2.5 gm

300 mg

1 gm

Several things are important to note about the above products. First, these are “milks” that should be used only for children greater than one year of age. They are not appropriate alternatives to breast milk or formula for children less than a year.

In addition, there are significant differences between a fortified and non-fortified product. There are many non-fortified soy and rice products available in the grocery store. These are not nutritionally adequate for young children. There have been multiple cases of malnutrition, rickets and vitamin deficiency from either early introduction of these products or using the non-enriched varieties.

It is recommended that the cow milk products be utilized unless there is a clear cut contraindication to doing so, such as documented allergy to milk protein. Families should directly ask their pediatrician if there are questions about using an alternative milk product. Nut milk products, such as almond milk have similar characteristics to rice milk and again must be fortified to handle toddler’s nutritional needs. Hopefully this chart provides some clear cut practical data to help understand why “milk does a body good!”

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