Does my toddler need milk? ...and answers to other common questions about milk for babies and toddlers.
Let's talk about milk.
The most common questions I hear regarding feeding babies and toddlers are about introducing cow's milk. For years, we were told about the health benefits of dairy and the importance of it in our diets. Now that it has taken a more backseat role on Canada's Food Guide, and many people are opting for plant-based diets, parents are undoubtedly questioning whether it is the right choice for their kids. I will break down the answers to the most common milk questions and how to make the most appropriate choice geared to your family.
Breastfeeding is a big area of advocacy for me. I fully support the "fed is best" message, I also believe that every mother who chooses to breastfeed should have access to the support, healthcare, and encouragement needed to breastfeed her baby for as long as she and her child(ren) choose. There is a lot of promotion of breastfeeding these days which is amazing, even more amazing are all the support services available to women, such as La Leche League and lactation consultants in hospitals and community settings. However, I do feel that there is a major gap in the promotion of the continuation of breastfeeding into toddlerhood. The nutritional benefits of breastmilk are still very essential at this age as well as many other benefits of breastfeeding at this time.
There seems to be a stigma around breastfeeding a toddler which can make for uncomfortable experiences and conversations for a breastfeeding mother. Many people are unaware of the WHO recommendation to breastfeed to 2 years and beyond. A lot of the health recommendations we are given for toddlers assume that they have weaned off of breastmilk and onto cows milk. At my son's 12-month doctor's visit, I was asked if the milk he was drinking was homogenized. I simply stated: "he is breastfed".
Does my breastfed child need cows milk?
Human breastmilk is more nutritionally suited to a human child than cows milk. As long as you are breastfeeding approximately 3-4 times per day (or night), you likely do not have to substitute with cows milk. If your child is in daycare and you are unable to send them with expressed breastmilk, they will likely make up for the lost nursing time when they are with you.
What about vitamin D?
Breast milk does not contain enough vitamin D to meet a baby or toddler's requirements unless mom is taking a vitamin D supplement containing around 6400IU of vitamin D per day. Continue to provide your breastfed toddler with 400IU per day of vitamin D drops. Cows milk and formula are fortified with vitamin D.
Should I introduce cow's milk to my baby (or toddler)?
This is very much a personal decision for your family. As stated above, if you are breastfeeding you likely do not need to replace human breastmilk with cow's milk. You may, however, choose to introduce your child to cow's milk products such as cheese (choose high-fat, low sodium), yogurt (choose high-fat, unsweetened), or kefir to provide a source of fat and calcium and improve their tolerance to dairy products. You can begin introducing these dairy foods occasionally (not fluid cows milk) around 6 months of age. Try to focus on iron-rich foods first for babies 6-12 months.
Fluid cow's milk can be introduced at around 12 months. If your baby is not breastfeeding and you would like to give them cows milk, offer about 2 cups (500mL) of homogenized (3.5%) milk per day in open cups with or after meals and snacks. Not between meals and snacks. Avoid giving milk in a "sippy" cup or bottle. If your toddler also eats a lot of dairy foods, you can reduce this amount. Try to avoid giving more than 750mL of milk per day. Continue offering water with and between meals in an open cup.
What if my toddler doesn't like milk?
Some toddlers just don't like to drink cows milk. This is especially common if they are still occasionally breastfeeding. You can offer smoothies made with fluid cow's milk, other dairy foods (cheese, yogurt), along with other non-dairy calcium, protein, and fat sources such as almond butter.
What if my child is a "picky eater"?
The nutrition from solid foods is important. For toddlers, selective ("picky") eating is common but sometimes milk can fill a child up and interfere with meals. If your toddler is breastfed, try offering nursing sessions after mealtimes rather than before. It is common for toddlers who love dairy products and drink cows milk frequently to not consume enough iron-rich foods. This is concerning because iron deficiency can affect a child's brain development. If your toddler loves dairy products, try offering only 2-3 servings per day and serve water, rather than milk, as a beverage most often.
What if my family is vegan, avoids dairy, or my child has an allergy?
If you are not breastfeeding until 2 years of age or including dairy foods in your toddler's diet, Health Canada recommends offering soy formula to toddlers until 24 months of age to meet their nutritional requirements. You can offer the formula in an open cup.
Fortified soy or pea milk can be offered but are lower in fat. Try to ensure you are adding extra fat and calories to your child's diet such as with oils, avocado, fatty fish, nuts/seeds. Other plant-based milk alternatives such as almond, rice, hemp, coconut are not recommended as a milk substitute for children under 2 years of age but you can still use them for recipes and baking.
Can I give food instead of cows milk?
Cow and goat milk cheeses and yogurts do contain calcium and some of the same nutrients as fluid cow milk. If you choose to offer dairy foods instead of fluid milk, try to offer 2-3 servings per day and limit overly salty or processed cheeses and sweetened yogurts.
If you prefer not to offer dairy products or soy products, speak with a Registered Dietitian who can help you with planning to meet your child's nutritional needs in other ways.
Milk has gotten a lot of attention and has really turned into a rather controversial topic! The foods (and drinks) you offer your child are ultimately a decision that should be made based on your family's lifestyle and dietary preferences. If you are able to provide your child with breast milk as long as you and your child desire, great! If not, there are other ways to meet the nutritional needs of a toddler.
Always consult a Registered Dietitian if you are looking for help with meeting your child's nutritional needs.
The nutrition information contained in this resource is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician, registered dietitian, or other qualified healthcare providers with respect to any questions you may have regarding the nutritional requirements based upon a medical condition. Reliance upon any content provided in this resource is solely at your own risk. Speak with your health provider if you suspect your child may have a condition or delay that would prevent them from eating safely.