I’m in a few Facebook groups focused on feeding kids, and I see this question daily. There are so many options available. There are even dozens of versions of cows’ milk, even without considering specific brands. You can choose your milk based on fat content (skim, 2%, whole, etc) or farming technique (conventional, organic, grass-fed), or even different processing techniques (ultrafiltered, lactose free, UHT pasteurized). For those with food allergies or different dietary preferences there are also countless alternative products. They make “milk” from everything these days it seems: almonds, cashews, coconuts, hemp, oats, peas, and of course, soybeans. There are different brands, recipes and blends for all of these and probably others I’ve either forgotten or never heard of.

I had no idea before having kids that this was such a big topic, and even once I knew it was a question, I didn’t plan to ask it. Then my oldest son was diagnosed with food allergies, including milk. Since then I’ve done more research on available milks than I could’ve ever dreamed. Here’s what I’ve learned:

The cream of the crop is still cow’s milk.

This isn’t just my bias as a dairy farmer. Once it was clear that Dominic was not going to be able to drink cows’ milk, his doctor was unwilling to recommend anything beyond some variation of cow’s milk and referred us to an allergist, who referred us to a dietitian. There we learned that a few of the alternatives come close (I’ll get to that in a minute), but nothing quite matches the nutritional profile of whole cows’ milk for young kids.

Milk is simple and natural (it’s just milk + vitamins), and it’s clean and safe. Many people don’t realize that every load of milk gets tested for basically everything every time it’s picked up from the farm (milk testing is not a spot check). Because we’re confident in the basic product, we don’t buy anything special. James (and David and I) drink generic-brand whole milk. If you’ve got a different preference in farming or processing, there’s almost certainly an option out there for you, but know that from the standpoint of safety and nutrition, all milk is essentially equal.

What if cows’ milk doesn’t sit well?

For many people, milk causes digestive problems. If lactose is the issue, there are lactose free milks like Lactaid or ultrafiltered milks like Fairlife (which are also lactose free). In hopes that this was the type of issue Dominic was having, we did try Fairlife, but unfortunately he still had an allergic reaction, so we stopped there.

Another option for those with trouble digesting milk is A2 milk. This is milk from cows with matching recessive A2 genes that enable them to make a more digestible form of casein. This milk is not as widely available, but the science is really cool. There’s quite a bit of interest in the industry, and it’s becoming more prevalent. I haven’t had the chance to try A2 milk yet, but we are watching for this trait in our breeding program.

The big advantage of these options is that you don’t sacrifice the nutritional profile and short ingredients list of cow’s milk. In the case of lactose-free, all you give up is lactose (naturally occurring sugar in milk), and with ultrafiltered you also gain some additional protein and a really creamy consistency. Unfortunately, these are not a good option for our family.

What if there’s a cows’ milk allergy?

This is where we find ourselves with Dominic. He has an IgE mediated allergy, specifically to whey proteins, which means his immune system responds to anything containing whey (A2 and lactose free milks, definitely still contain whey). He’s never had a severe reaction, thankfully, but we do carry an epipen. He also has IgE mediated allergies to all tree nuts, so almond milk and cashew milk are not on the table for our family. Fortunately, there are a lot of options for those faced with this predicament.

In December 2017, we met with a dietitian who (given Dominic’s specific allergies) recommended soymilk as a first choice or Ripple pea-based milk as an alternate. We elected to use soymilk based on the fact that it’s more widely available and about half the price of Ripple. One way in which alternatives differ from cows’ milk is that brand does matter. There’s no set recipe for these alternatives, so both nutrition and flavor can vary between brands. Dominic drinks Silk Original soymilk.

We chose Silk simply because it has more fat than the store brand version where we usually shop. It’s a little more expensive, but for most alternatives, the biggest thing they lack compared with whole milk is fat. I assume this is because they’re designed to compete with 2% milk for adult consumers, but kids need fat. Dominic especially struggled with the fat missing from his beverage as he transitioned from formula to food, so we gave him as much fat as we could in every way possible. Side note: Silk Protein is an amazing option if you are allergic to milk but not to nuts. It’s the closest thing I’ve seen to milk’s nutritional profile, but again is unfortunately not an option for our household.

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There are even more alternatives available today than there were in 2017, but I think our dietitian’s advice still stands: When evaluating alternatives, you must read labels closely. For a milk alternative, the best options are fortified with calcium and vitamin D and contain high quantities of protein and fat. Milk is a good source of some other essential nutrients, but these things are the hardest to replace.

Whatever your situation, you should always consult your healthcare provider with any serious questions or concerns, but sometimes we all like to hear from other parents. If you have any questions about how your milk is produced or our experiences with milk alternatives, please ask.