When can babies drink milk?

The day you start giving your child cow's milk is an exciting one – no more formula or pumping. Cow's milk is often easier and less expensive, and serving it can feel like a big step for you and your child.

(If you breastfeed, you can keep going for as long as you and your baby want – even if they're also drinking cow's milk.)

Most kids love milk, so you likely won't have any issues with the transition. And that's great, because milk is a rich source of calcium, which builds strong bones and teeth and helps regulate blood clotting and muscle control. It's also one of the few sources of vitamin D, which helps the body absorb calcium and is crucial for bone growth. Almost all milk in the United States is fortified with vitamin D.

Milk also provides protein for growth, and carbohydrates to give your child the energy they need all day. And if your child gets enough calcium from the get-go, there's evidence that they'll have a lower risk of high blood pressure, stroke, colon cancer, and hip fractures later in life.

When babies can have milk

Don't give your baby cow's milk until they're a year old. Babies can't digest milk very easily – it can tax their immature kidneys, which can lead to illness, fever, and diarrhea.

Cow's milk also doesn't have the right amounts of iron, vitamin C, and other nutrients young babies need, nor does it provide the healthiest types of fat for growing babies. It may even cause iron-deficiency anemia in some babies, since cow's milk protein can irritate the lining of the digestive system, leading to blood in the stools.

That's why it's best to stick with breast milk or formula until your baby turns 1. It's okay for your baby to have other dairy foods, though, like cheese or yogurt, when they start eating solids around 6 months since they aren't eating a lot of those foods.

Note: Due to the baby formula shortage, the American Academy of Pediatrics (AAP) said in May 2022 that babies older than 6 months can have whole cow's milk for a brief amount of time in a pinch. This "is not ideal and should not become routine," the AAP said, noting that this is a better option than diluting formula or making homemade baby formula. Babies under age 1 shouldn't have more than 24 ounces of whole cow's milk every day, and should eat solid foods that contain iron or take an iron supplement to prevent anemia, the AAP advised. 

How much milk should toddlers drink?

Experts recommend giving toddlers from 1 to 2 years old 16 to 24 ounces, or 2 to 3 cups, of whole milk daily so they get all the calcium and vitamin D they need to grow.

From 2 to 5 years old, experts recommend giving children a little less milk – 16 to 20 ounces, or 2 to 2½ cups, daily. Once your child turns 2, experts recommend switching from whole milk to skim or low-fat milk.

If your toddler drinks too much milk, they might not be hungry enough to eat other snacks and meals. And since toddlers don't eat very much, you want to be sure you're giving yours a variety of foods packed with as many nutrients as possible. If they want more milk than you're giving them, offer them water instead to quench their thirst – it's not as filling as milk.

Don't let your child sip drinks like milk or juice from a sippy cup throughout the day. Prolonged and frequent exposure to drinks with sugar in them (even natural sugars, which milk has) can cause problems for their teeth. For the same reason, don't put your toddler to bed with a bottle or sippy cup of milk. Remember to also brush your child's teeth after they have their last drink of milk for the day.

The best milk for toddlers

Experts recommend giving whole milk to toddlers, since they need the higher fat content to maintain weight gain, help the body absorb vitamins, and help their developing brain.

If your child has a family history of obesity or heart disease, though, their healthcare provider may recommend low-fat or nonfat milk. Talk to your child's pediatrician if you have any concerns.

Some parents prefer to give kids organic milk, but there's no nutritional difference between them – both organic and nonorganic milk have the same amount of protein, vitamins, lipids, and minerals. The main difference is that organic milk must come from cows that weren't given bovine growth hormone (and it's more expensive).

Don't give your child "raw" or unpasteurized milk. Without pasteurization, milk may contain harmful bacteria or parasites that can cause serious health problems.

Milk alternatives for toddlers

If your family follows a vegan diet or has a milk allergy, you may choose to give them an alternative to cow's milk. Just like cow's milk, your baby shouldn't drink an alternative milk before they're a year old.

Many plant-based milks have less protein, vitamin D, and calcium than cow's milk, so look for a milk that's fortified with vitamin D and calcium. The nutritional value of non-dairy milk varies between brands, so check the label before buying. Choose one that's unflavored and doesn't have added sugars, since toddlers don't need added sugars in their diet.

Talk with your child's pediatrician about the milk alternatives you use so they can recommend ways to supplement your child's diet if they're lacking in the nutrients commonly found in cow's milk – calcium and vitamin D especially.

Soy milk

Soy milk is nutritionally equivalent to cow's milk, so it's a great alternative. It has a comparable amount of protein, calcium, and vitamin D (though cow's milk does have more vitamin D). Soy milk also has more iron than cow's milk.

Just as with cow's milk, choose whole-fat soy milk for children under 2 years old.

Oat milk

Oat milk has less protein than cow's milk, but after soy milk it's the best alternative milk option. It has more carbohydrates and protein than other alternative milks, and has iron, vitamin B, and other vitamins and minerals.

If you opt to give your child oat milk, it's better to go with store-bought than homemade, since store-bought oat milk is also fortified with calcium and vitamin D. Even fortified oat milk won't have as much vitamin D as cow's milk, though, so you may need to get them more vitamin D another way.

Almond milk

Almond milk has less protein and is overall less nutrient-dense than cow's milk, so pediatricians don't recommend giving it to children. It does, however, have vitamin A, iron, and calcium. If you choose almond milk, look for one that's fortified with vitamin D and consider other ways to get more protein into your toddler's diet.

Rice milk

Experts suggest not giving rice milk to toddlers because rice products can contain inorganic arsenic. Rice milk is high in carbohydrates, has calcium, and is often fortified with vitamin D, but has less protein than cow's milk.

What is toddler milk?

Toddler milk is a formula marketed to parents as "transitional milk" to help wean off of breast milk or formula. Toddler milk isn't necessary, since it has added sugars and other non-nutritious ingredients compared to normal milk.

Opt for regular milk or a nondairy milk alternative instead – it's both more nutritious for your child and less expensive.

Is ultra-pasteurized milk good for toddlers?

Ultra-pasteurized milk is cow's milk that goes through a more intense pasteurization process than regular milk. It's heated to a higher temperature to kill more bacteria, then packaged according to strict guidelines to keep it sterile.

Because of this process, ultra-pasteurized milk has a longer shelf life than regular milk – sealed, ultra-pasteurized milk can last up to 30 to 90 days. Once it's opened, it's good for 7 to 10 days. It's more commonly found outside the United States, but you may see it at some stores.

There aren't any official recommendations about whether it's better to give children ultra-pasteurized milk. There's no difference in nutritional value, but some say it has a more "cooked" taste than regular milk, so your kids may not like it if they've been drinking regular milk.

If the longer shelf life of ultra-pasteurized milk is appealing and you want to give it a try, talk to your child's healthcare provider.

What to do if your toddler won't drink milk

Some toddlers take to cow's milk right away, but others might be hesitant to make the switch because it has a different texture, taste, and even temperature than breast milk and formula.

If that's the case for your toddler, try mixing cow's milk with some breast milk or formula at first. (Try one part milk to three parts of breast milk or formula.) Then slowly shift the ratio until they're drinking 100 percent milk. It may also help to serve cow's milk at room temperature or warm, rather than cold.

It can be a challenge to meet the nutritional recommendations for dairy if your child won't drink milk. But there are other ways to get more dairy in your little one's diet. Try these ideas:

• Add milk to their cereal, oatmeal, and soups.
• Give them yogurt, cottage cheese, or other cheese products like string cheese and Babybel cheese as snacks.
• Make them a smoothie with plain yogurt, milk, and fruit (like bananas or berries).

Milk allergy vs. lactose intolerance

If your child drank cow's-milk-based formula as a baby without any problems, they most likely won't have any issues with cow's milk once they're old enough to drink it. Even babies who were exclusively breastfed for the first year can usually handle regular cow's milk because they've been exposed to cow's milk protein through breast milk.

If your child drank soy formula because your doctor recommended it, though, check with your child's healthcare provider before introducing cow's milk. They may recommend that you start with a soy milk that's fortified with vitamin D and calcium.

Lactose intolerance is different from a milk allergy. Lactose intolerance is when your body has a difficult time digesting milk and dairy products. It's uncommon in babies, but may develop later in life.

Symptoms of lactose intolerance include loose stools, gas, and abdominal pain, cramping, and bloating.  Your child may become temporarily lactose intolerant after a stomach bug with diarrhea.

There are different levels of lactose in various dairy products, so your baby may be able to tolerate yogurt and some kinds of cheese, even if they can't drink milk.

True allergies to cow's milk are uncommon. Unless you exclusively breastfed your baby, you'd likely know if your baby had a milk allergy since cow's milk is in most formulas. Symptoms of a milk allergy include:

• Hives
• Upset stomach
• Diarrhea
• Vomiting
• Swelling
• Itchy, watery, or swollen eyes

If your child's mouth or throat swells, if they have difficulty breathing, or if they have symptoms in more than one part of their body (for example, if they're vomiting and they have hives), call 911 or go to an emergency room right away. These are signs of a severe allergic reaction, or anaphylaxis.

If your child has a milk allergy, keep two epinephrine auto-injectors on hand in case they have a severe reaction. The severity of allergic reactions can vary, so even if your child usually has mild reactions, they could one day have a severe reaction, so it's best to be prepared.

Your child will need to avoid all dairy foods, including cheese, condensed or evaporated milk, ice cream, yogurt, margarine that contains milk, butter, milk chocolate, and others. Check the nutrition label on any food products you buy – the label will say if there's milk in it.