As we are in the process of saying good-bye to Neocate, one must ask the next logical question: “Now what?”
My son is a creature of habit. I have always worked hard to provide him with a predictable routine that I think he really appreciates. Even before he could walk, when Dinosaur Train ended he would crawl over the stairs and start making his way to bed. Although even E eventually got tired of rewatching the same episodes of Dinosaur Train over and over and over and over, he is still very much enamored of his three “cups” a day. So, what should we put in those cups?
A couple of months ago E’s dietician told me that when children have to avoid dairy she typically recommends soy, followed by oat or hemp milk. She said those are the “milks” that are most like dairy milk. She was specifically referring to amount of fat and protein, which support growth and brain development and are the most important components of milk for one to two-year-olds. Unfortunately we didn’t get around to trying hemp milk until last month, which wasn’t a big deal because E was still getting everything that he needed from the Neocate. But I was curious about whether hemp milk would still be best now that E is over two years old, an age when pediatricians recommend switching to 1% or nonfat milk anyway.
I found surprisingly very little about which type of “milk” is the best substitute for dairy milk in toddlers. I actually couldn’t find anything in the medical literature! (Admittedly I am not a nutritionist or dietician and may have been looking in the wrong places, so if you know of any published papers, please share!). There are several websites and blogs that discuss the merits of various “alterna-milks,” but most are written with the assumption that an adult will be using them. There were two sites that seemed to give good information about milk alternatives for children (KC Kids Doc and Amazing and Atopic ) and I encourage you to read what they have to say.
For my own edification I wanted to compare all of E’s “milk” options side by side (have I mentioned that I tend to over-research?). And because this question comes up all the time among parents of children with milk allergies, I even included the “milks” that aren’t safe for E right now. I’ll admit that this is a quick survey of some of the most common “milks” on the market. I just chose one brand for each type, so it is possible that the nutrition information can change from brand to brand. It is also important to always check the ingredients. For example, the Tempt Unsweetened Original Hemp Milk is the only rice-free version of hemp milk that can find!
The chart below includes the basic nutrition information for each of the major types of non-dairy milk, as well as whole and 1% cow’s milk, to give you some perspective. All of the information is based on a serving size of 8 fluid ounces. The daily recommended values (DVR) are the ones provided by the manufacturers, so remember that they are based on the recommendations for adults.
Non-Dairy “Milk” ComparisonsClick on the picture to open a more readable .pdf
Most people think of calcium as milk’s most critical component. The companies that make “alterna-milks” are well-aware of this and are happy meet that requirement. It seems that all types of “milk” are fortified to ensure that they have at least as much calcium as cow’s milk, often more. So, I don’t think it makes sense to base my decision on calcium content alone and looked closer at the rest of the nutrition information, like ingredients, calories, sugar, sodium, fat, and protein, as well as the nutritional “perks” provided by some of the “milks.”
The plant-based “milks,” tend to have fewer calories than whole cow’s milk. However, the alterna-milks require more ingredients to achieve a cow’s milk-like taste. This often includes sugar or another sweetener (like brown rice syrup). So, watch out for sugar (rice milk and oat milk have way more sugar than others). The plant-based milks also require some sort of thickener, like carrageenan or xantham gum. I’ve heard of these additives causing reactions in some FPIES kids so make sure you keep that in mind if you fail a milk trial (i.e., it might be the carrageenan not the almonds that are the allergen). Carrageenan is pretty controversial but that is beyond the scope of this post. As far as I’m concerned, there isn’t enough evidence that food-grade carrageenan is harmful and it’s so pervasive in alterna-milks that trying to avoid it isn’t worth the aggravation. We already avoid so many things that we know will hurt E, I’m not interested in adding poorly supported “maybes” to the list. We’ll just hope that future research doesn’t come back to point out that I’m an awful mother for poisoning my child with carrageenan. Obviously, this is a personal decision so please do your research.
If you are looking for a beverage that has a nutrient makeup similar to milk, soy is the way to go. It has the same amount of protein as cow’s milk. The calories are similar to 1% milk and it has approximately the same amount of fat as 2% milk (not shown on the table). All this with less sugar, cholesterol, and sodium. But soy is controversial too. I’m not well-versed in the GMO and phytoestrogen issues related to soy. E is clearly allergic and so we generally keep it out of the house. Again, do your research, talk to your doctor and/or dietician, and decide for yourself whether the benefits are enough to outweigh any possible risks.
While we are on the topic of “milks” that aren’t an option for E right now, let’s look at rice and oat milk. These two have almost as many calories as whole milk with the about the amount of fat as 1% milk. They have more sugar and significantly less protein (though oat milk’s 4g of protein is pretty high compared to the other options). They do not boast any additional nutrients, either. Another no-no for us, coconut milk, has far fewer calories but more fat and less protein. I’ve gotta say, the stats here do not make me sad that they aren’t options for E right now.
We’ve been drinking almond milk for about a year. It’s been really helpful as a milk substitute in recipes (I’ve used it in everything from cupcakes to mashed potatoes) and I like it in my cereal. It has a mild and slightly nutty flavor and I never notice a difference in recipes but would rather skip a latte than use almond milk (yuck!). We tried it as a way to test a tree nut and get a milk substitute. I never cared much about the nutrition stats because E was still getting everything he needed from Neocate and almond milk was never meant to provide him with everything he missed out on in cow’s milk. But now I wondered how it stacked up. It’s really low in calories and fat. It has no sugar but only 1g of protein and is higher in sodium than the other options. It does include bunch of vitamins and minerals including 50% of the (adult) daily recommended value of vitamin E. I feel pretty good about using it daily (for E and me) but I don’t think we can rely on it solely and, because of the low protein, I definitely wouldn’t have been comfortable using it in his cups before his second birthday.
We’ve recently added hemp milk to our repertoire. I think it’s creamier than almond milk but also has a stronger flavor. Even the unsweetened original flavor has added vanilla. Vanilla is one of E’s favorite flavors, making hemp milk an automatic winner in his book. As I mentioned before, it was recommended by E’s dietician so I expected it to compare well to the other milks. And it does. It has more calories than almond milk but not as many as cow’s milk. It is the alterna-milk with the most fat, actually the same amount as whole milk! This is good for the brain development of one-year-olds but I’m not sure that my 95th percentile-for-weight two-year-old needs all that fat. The good news is that it’s supposedly “good fat” and has a lot of omega 3 and omega 6 fatty acids. It has no sugar and a respectable amount of sodium but just an ok amount of protein (2g). My favorite thing about the hemp milk is that it’s safe for E and he loves it. The other stats make me comfortable serving it to him on a daily basis but I’m still happy that he had the protein of the Neocate until age 2. It’s vanilla flavor makes me hesitant to try it recipes. I assume it will be ok in sweet recipes but I don’t know how it will hold up in savory ones. Oh, and it also failed the latte test 😦
Out of curiosity I added cashew milk and flax milk to the list. E passed a cashew trial this summer so I know the milk would be safe for him. However, that seems to be one of its few positives. Another one is that it is low in calories, but it is on the high side for fat and has no protein. Flax milk, on the hand looks like a winner! It’s low in calories and fat (which might make it a poor choice for the under-two crowd) as well as sugar and sodium. BUT it has 5g of protein! That’s higher than any of our other options. It also contains omega 3 and omega 6 fatty acids. I haven’t tasted it so I can’t report on that. However, flax milk really does seem like the best option.
So, what will be in E’s cups? We decided to let him decide – between almond milk and hemp milk.
These are the two that are safe for him and I feel comfortable with the stats. They each have their pros and cons and I don’t feel like one really wins in the nutrition field. As far as taste, hemp seems to have E’s favor but almond will be better to have around for recipes. The hemp milk is sold in smaller containers that are about half the size of the almond milk and the same price, so the almond is easier on the wallet. They are both available in shelf-stable versions, which is nice for stocking up. I’m also really excited that the shelf-stable almond milk is sold in 11oz containers. This will be great when we are on the go! I like the idea that E gets to choose, I try to allow him autonomy as much as possible and this is one more way that he can feel in control of his diet. We’ve only been doing this for a couple of days but so far he doesn’t seem to favor one or the other. I think it really depends on his mood, just like what you drink depends on how you are feeling at the time.
I’m kind of bummed that we tried hemp milk instead of flax milk. I really think that would be the best version and if E passed it (and the taste was ok) I might consider that as our primary milk. However, as my husband so eloquently said, “we don’t really need him to have another weird milk right now.” He’s right. We have two good “milk” options and other foods to try. I don’t really see a compelling reason to push another version of milk. Also, we are just over a month away from E’s cow’s milk challenge (eek!). If he passes milk and likes it we’d likely just switch over to cow’s milk anyway. If he doesn’t pass maybe we’ll give the flax a try, but I’m really trying to be optimistic about a pass.I love seeing this little boy with a (hemp) milk mustache!!
So, what are your thoughts? What “alterna-milks” do you use? Have you tried flax milk?Remember, this is just my analysis. I’m not qualified to make recommendations but I hope that sharing this information will help to give you an idea of what’s out there and how we made our decision. Please talk to your child’s pediatrician, allergist, gastroenterologist, and/or dietician so that you can make the best choice for your child. Good Luck! And (as always) please share any additional information in the comments section.