Cow's Milk and Milk Alternatives

Source of vitamin D and calcium

Your growing child needs vitamins and minerals such as vitamin D and calcium to build strong bones. Pasteurized, unsweetened whole cow’s milk and fortified dairy alternatives are good sources of vitamin D and calcium for children 12 months and older. Most cow's milk sold in the U.S. is fortified with vitamin D. Look for dairy alternatives fortified with vitamin D and calcium.

When to introduce cow's milk to your child

You can introduce your child to whole cow's milk at 12 months old (but not before). Before your child is 12 months old, whole cow's milk:

• May put them at risk for intestinal bleeding.
• Has too many proteins and minerals for your baby's kidneys.
• Does not have the right amount of nutrients that your baby needs.

How much and how often

Whole cow's milk or fortified dairy alternatives can be included in a child's balanced and diverse diet from 12 months onward but is not a substitute for food.

The Dietary Guidelines for Americans recommend a variety of food groups, including dairy. How much of each food group your child needs depends on their age and activity level. Children aged 12 through 23 months need about 2 servings of dairy daily, including:

• Cow's milk (pasteurized, whole milk fortified with vitamin D, unflavored, and unsweetened).
• Full-fat yogurt.
• Cheese.
• Fortified dairy alternatives (fortified with calcium and vitamin D, unflavored, and unsweetened).

If your child drinks too much cow's milk, they may not be hungry for other foods with important nutrients. Some experts say getting too much cow's milk can make it harder for children's bodies to absorb needed iron from foods.

Follow your child's cues to decide when they are hungry or full. Talk with your child's doctor or nurse for questions about adding whole cow's milk or fortified dairy alternatives to their diet.

Whole cow's milk or lower fat cow's milk

Children can drink unflavored, unsweetened whole cow’s milk. Whole cow’s milk is the same as lower-fat cow’s milk except higher in fat. Young children need fat in their diet for healthy growth and development. If your child has excessive weight gain or a family history of obesity, high cholesterol, or cardiovascular disease, consult their doctor. Discuss with them the type of cow’s milk to give.

Raw or unpasteurized milk

Raw milk and raw milk products from cows, goats, and sheep can carry harmful bacteria and other germs. These harmful bacteria and germs can make your child very sick and can be life-threatening. Raw milk can also be called unpasteurized milk. Do not give your child raw or unpasteurized milk.

Fortified dairy alternatives

Fortified dairy alternatives can include beverages made from plants, such as soy, oat, rice, coconut, cashew, and almond.

If you choose a dairy alternative, remember:

Fortified dairy alternatives are the only milk alternatives that help meet a child's recommended dairy needs. These milk alternatives should not be given before your child is 12 months old.

Choose one that is unflavored and unsweetened. Your child does not need added sugars.

Choose one fortified with vitamin D and calcium. Check labels because nutrient content can vary between brands.

Talk with your child's doctor or nurse about the dairy alternative you are using. The vitamins and minerals in dairy alternatives are different than in cow's milk.