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Ask: One of my twins doesn’t like cow’s milk. What else can I do?

Q: I’m weaning my one year old twins off of breast milk and one doesn’t like cow’s milk. What else can I do?

A: Many parents think they need to replace the breast milk their babies have been getting with cow milk but that’s not necessarily the case. In fact, some cultures would never consider it. And for some children with food sensitivities, cow milk is not a viable option.

I took this question to Lindsey Hurd, owner of Angel Food Lactation & Nutrition. Lindsey is a registered dietitian and lactation consultant who specializes in mother-baby nutrition, including counseling moms with food intolerant/food allergic children. Lindsey says whole cow milk has been the first “drink” to follow breast milk in our country primarily because children need less liquid calories as they begin increasing their intake of solid foods. Cow milk contains adequate amounts of fat, calcium, Vitamin D, phosphorus and other key nutrients for toddlers. It is slightly lower in calories than breast milk or formula, as well as a less expensive option than formula.

But, she adds, many families believe it’s required for their little one, and she disagrees.

When toddlers are drinking large amounts of milk daily, eating nutritious food can slip to the wayside. For many, cow’s milk can be more difficult to digest than breast milk, making it pass more slowly through the digestive system and making children feel full longer, she explains. This creates stress around mealtimes when their intake becomes minimal or non-existent. At this point, parents often encourage snack foods or even bribery with their toddler’s favorites to get them to eat something. In time, this can lead to pickiness and a total intake of fewer acceptable foods.

Lindsey says the key to understanding what to give your toddler lies in their overall intake. “Are they eating three or more toddler size 'meals' per day? Are they eating a well balanced diet, including protein sources, fat, carbohydrates, fruits and vegetables? Is their breast milk intake secondary to their food intake?” she asks. “These are great steps to tell you that your toddler may transition well to another form of milk.”

With your child's diet in mind, parents might consider trying alternative milks to cow’s milk, and offer it as a component to their overall diet, much like peas or sweet potato. Lindsey says eating a variety of foods as their primary nutrient source is key to achieving the ideal nutrition toddlers require at this stage of life. Since there are many alternatives to choose from, including almond milk, rice milk, coconut milk and soy milk, Lindsey suggests working with a registered dietician who specializes in pediatrics to help fill in the nutritional blanks and figure out together which dairy alternative may be best for your child.

It’s ideal to wean toddlers off of breast milk and allow their digestive systems time to acclimate to changes by alternating breast milk with the milk of choice. Keep that in mind when making the switch.

Pam Diamond of Cary is a parent coach, postpartum doula, baby sleep consultant and owner of First Daze & Nightzzz.