The Pros and Cons of Cow’s Milk Alternatives for Milk Allergy

Milk alternatives for milk allergy
Consider the pros and cons of milk alternatives. Jamie Grill/Getty Images

Just about any food, it seems, can be made into milk. Seeds, coconut, nuts and rice are just some of the trending milk alternatives you’ll find in the grocery store. Although it may seem that these milk alternatives would offer the same nutrition as cow’s milk, the truth is, they don’t. There is variability across brands and types.

The most common types of milk alternatives you’ll find in the grocery store are rice milk, soymilk, hemp milk, almond milk, oat milk, and coconut milk.

However, other types are emerging on the market such as cashew milk, buffalo milk, and sheep milk.

When choosing a milk alternative, whether you have a milk allergy or not, there are certain considerations to weigh, such as calorie content, whether important nutrients are present in sufficient amounts, and palatability. For the growing child, the nutrient profile is an important consideration.

Keep these aspects about milk alternatives in mind as you choose the right one for you or your family:


The calorie content of milk alternatives varies considerably. For example, unsweetened coconut milk (40 calories per cup) or unsweetened plain almond milk (30 calories per cup) are low calorie versions, versus the higher calorie ones like hemp milk (140 calories per cup) or flavored rice milk (130 calories per cup). The calorie content of a milk alternative can make a difference, especially if a child is still growing or an adult is watching his waistline.


Cow’s milk offers a good source of protein at 8 grams per cup. The closest milk alternative to this level of protein content is soymilk, at 6 to 8 grams per cup. All other milks offer less protein. For example, hemp milk may offer up to 5-6 grams per cup, and coconut, almond, and rice milks offer no protein to 1 gram per cup.

Again, the protein content matters when considering nutritional needs and dietary patterns of the individual.


Not only does the amount of fat contained in an alternative milk matter, so does the type of fat. Cow’s milk contains both saturated and unsaturated fat, but many milk alternatives are known for their unsaturated fat content, such as oat, hemp, rice, and nut milks.

The amount of fat also matters. Hemp and coconut milks are higher in fat with about 5 to 7 grams of fat per cup, while rice, almond and soymilk are lower in fat at 1 to 3 grams per cup. Again, depending on nutritional goals, such as eating a heart healthy diet or helping an underweight child gain weight, the fat content may be a consideration.

Calcium and vitamin D

Many milk alternatives are fortified with calcium and vitamin D, but that wasn't always the case. Be sure to read the ingredients label and look for a Daily Value (DV) of 20% for calcium, which indicates it’s a good source.

Children drinking alternative milks may not be getting enough vitamin D, an important nutrient in the building of strong bones and supporting general health.

A study in the Canadian Medical Association Journal found that children aged 1 to 6 years who drank cow’s milk alternatives were twice as likely to be vitamin D deficient compared to children drinking cow’s milk. Again, consumers can read the ingredients label and look for vitamin D content (children and adults need 600 International Units (IU) per day). However, finding other sources of vitamin D foods and getting out in the sunshine will help to ensure adequate amounts are consumed.


Some milk alternatives are not palatable. In other words, they don’t taste good. Manufacturers add sugar to make them taste better. While some brands are lightly sweetened, others can contain 2 to 3 teaspoons of sugar.

Other ingredients

Rice products, including rice milk, have been found to have trace amounts of arsenic, a common element found in the water and soil of rice fields. This is a concern for families with children who consume rice milk, and may be a concern for adults as well.

The American Academy of Pediatrics advises that parents offer their children a wide variety of foods, including other grains such as oats, wheat and barley, which will decrease their child’s exposure to arsenic from rice. This is good advice for milk alternatives as well. Rotate different types when possible.

Other additives such as guar gum, carrageenan, xanthan gum, and more are included in milk alternatives to improve the texture and thickness of the milk or to keep the ingredients in milk uniformly distributed. Some individuals are concerned with the health effects of these additives.


Consumer Reports:

Today's Dietitian:

Canadian Medical Association Journal:

American Academy of Pediatrics:

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