Q: Doctor, there are several types of plant-based milks available. Which one should I be giving my 3-year-old daughter?
A: Keep in mind that dairy milk remains the gold standard. Within the dairy milk varieties, we have different fat concentrations, and the recommendation is to use low fat or skim milk in otherwise well children above the age of 2.
Obesity is becoming a big issue and children for the most part are getting adequate calories and fats from other sources. Lactose intolerance usually is not apparent (except briefly after an infection) below the age of 5, and these children can get lactose free milk. What should be avoided is sugar-sweetened milk, including chocolate or strawberry milk, as these are high in calories and have high glycemic index.
Dairy milk is rich in protein, calcium, vitamins, including A and fortified with vitamin D.
The first milk alternative available for a long time now has been soy milk. Soy milk formulations for infants is also available and is used for cow milk protein intolerance, galactosemia (a rare condition where the body cannot metabolize galactose – a part of lactose the sugar found in milk, other part being glucose), or if the family is vegan.
Soy milk is often fortified with calcium and vitamins, and its nutrients can match those of cow milk.
Soy milk remains a good alternative to cow milk unless of course the individual is allergic to soy.
There have been reports of excessive estrogens in soy milk in the past, but this has been mostly unfounded.
The more recent additions to the lineup include:
There are others – sesame seed milk, hemp milk, cashew, hazelnut, macadamia nut – these we will discuss later.
The key points to keep in mind when trying an alternative to low fat unsweetened dairy milk would be things like – why are you moving away from dairy milk, is the alternative supplying adequate proteins, is it artificially sweetened, are you a vegan, do you have nut allergies, are you going to be following a balanced diet in addition to the special milk you want to consume, are you concerned about climate change and the contribution of cattle to global warming?
In general, plant-based milks are an attractive alternative if you are consuming a cup or two a day. These are not recommended as a primary source of nutrients. Consuming the primary source of the milk is better than the milk obtained from them, just like consuming the fruit is better than the juice.
No matter what, maintain a balanced diet, avoid sugar-sweetened beverages and don’t give up on low fat dairy (lactose free if needed) milk.
Pankaj Vohra is a pediatric gastroenterologist at UNM. Please send your questions to email@example.com.