Alternative Milks: Best Options for Milk Allergy

Consider These Things Before Buying

Get the best milk alternative for your growing child. David Goehring/Flickr

Little Kevin was allergic to cow’s milk and soy and wasn’t growing very well. He drank about two cups of rice milk each day and was picky about other sources of protein, like meat. He needed a calorie-dense and fortified milk to help better meet his calorie and mineral needs for growth. Some kids with multiple food allergies, like Kevin, get behind or slow in their growth.

Milk is generally nutrient-rich, packed with calcium, vitamin D, phosphorus and protein, but if you’re allergic to cow’s milk, soy or other food allergens, your milk alternative options may be few.

Generally, people with food allergies to milk use soy milk, rice, oat, hemp, coconut, almond or other nut milks as their milk staple.

It’s important to find a milk substitute that can meet your nutritional needs for calcium, vitamin D and protein. While many milk substitutes exist, not every one offers the important nutrients in the right quantities like milk. As a full-grown adult, this may not matter as much as it will to a young, growing child.

The Myth Behind Milk Substitutes

You might believe that all it takes to accommodate your cow’s milk allergy is to simply find another milk. But, milk substitutes are not created equal. Since the term ‘milk’ is attached to most of the milk substitute products available, it’s easy to lump them together, and assume they contain the same nutrients and calories as cow’s milk. Not true. The fact is only milk produced from a mammary gland, such as cow’s milk, is really milk.

Other “milks” produced from plants (like nuts, oats, or hemp) do not contain lactose, the natural milk sugar found in cow’s milk. Nor do they contain natural sources of calcium or phosphorus, requiring these nutrients to be added during production.

The Growing Situation in Children

Children and teens with a milk allergy need reliable sources of protein, fat and calories just as do their non-milk allergic growing peers.

Yet, often, the options for a milk substitute with ample calories and protein may be limited, particularly when children have a soy allergy too, or multiple food allergies. Take almond and rice milks, for example. Almond milk has very little protein or fat, and some versions may not be fortified with adequate vitamin D (in amounts mimicking cow’s milk). The same goes for rice milk: it is a low source of protein, fat and calories. This may not be a big deal for adults, but it can contribute to poor weight gain and slowed growth in food allergic children.

Protein Content May be Low

Protein is critical to the normal growth and development of children. Alternative milks may be a poor source of protein, with some containing only one or two grams of protein per cup (7 grams less than cow’s milk). Fat may vary too, and in the slow growing child this nutrient becomes an important consideration. While a child can get protein and fat from other food sources, parents and caregivers should keep an eye on adequate eating and growth.

A general rule of thumb is to look for the highest protein content in a milk alternative. Be sure to read the label to track this information down. As a point of reference: cow’s milk and soy milk contain about 8 grams of protein per cup.

Mineral Content Varies

Alternative milks vary in their calcium and vitamin D content, as well as other nutrients like phosphorus and potassium. Because most alternative milks are non-dairy substitutes, they don’t contain a natural source of calcium. According to the 2010 Dietary Guidelines for Americans (DGA), children, teens, and women, and some men, don’t meet the recommended intakes for calcium and vitamin D. Not only that, individuals consuming alternative milks may not absorb these nutrients as well as they would from cow’s milk. In particular, soy milk contains phytates and may inhibit the absorption of calcium. Therefore, it is important to look for milk substitutes that contain adequate fortification of nutrients, particularly of calcium and vitamin D. Calcium, vitamin D are important for bone development in the childhood and early adult years, and help preserve bone during the adult years.

Multiple Food Allergies

The child who is allergic to milk, soy and nuts won’t be able to drink cow’s milk, soy milk or nut milks. A milk substitute that will meet his needs for growth and development, or a diet of other foods that are rich in the missing nutrients will have to be planned accordingly. So, even if oat or coconut milk becomes the best option, the onus will be on the other foods in the diet to meet the growing child’s nutrient requirements. It’s best to seek out extra help in meal planning from a qualified healthcare professional in this instance.


2010 Dietary Guidelines for Americans

Various alternative milk websites.

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