Cow's Milk, Oat Milk or Soy Milk: What Should My Toddler Drink?

The basics

• From 12 months, plain pasteurized whole cow's milk can replace formula. See the cups and milk guide for moving from bottle to cup.
• About 16-24 oz (475-710 mL) a day is plenty. More can crowd out food, and lead to low iron and constipation.
• From age 2, most children can switch to low-fat (1%) or skim milk. Your pediatrician may suggest this earlier or later based on growth and family history.
• Toddler or "transition" formulas aren't needed and cost more.
• Breastfeeding can continue. A toddler who nurses several times a day doesn't need cow's milk, but still needs calcium and vitamin D from foods like yogurt, cheese, tofu and fortified foods.

Making the switch

• Go straight to cow's milk, or mix it with formula or breast milk for a week or two if your child resists.
• Cold, room-temperature or warm are all fine.
• Serve milk with meals and water between meals.

Plant milks compared

• Fortified soy milk (unsweetened): the only plant milk the US consensus treats as a near-match for cow's milk in protein and nutrients.
• Pea-protein milks: some are made with protein close to cow's milk and fortified; there's less research on them, so check labels and ask your pediatrician.
• Oat, almond, coconut, cashew and hemp: low in protein and often in fat and calories. Fine in cooking or cereal, but not as the main milk without a plan.
• Rice milk: low in protein and can contain arsenic. Not recommended as a toddler's main drink.

Whichever you choose, pick unsweetened and fortified with calcium and vitamin D, and offer other protein and fat sources.

Families who skip dairy

For milk allergy, veganism, religious or cultural practice, or simple preference, a toddler can thrive without cow's milk with some planning. Focus on protein (beans, lentils, tofu, eggs or meat if you eat them), calcium, vitamin D, vitamin B12, iron and healthy fats. A pediatric dietitian can help. See the vitamins and supplements guide.

Lactose intolerance and allergy

• Lactose intolerance is uncommon in toddlers. Lactose-free cow's milk has the same nutrients.
• Milk allergy can cause hives, vomiting, eczema flares or blood in stool. Talk to your pediatrician before switching milks.

Milks to avoid

• Raw (unpasteurized) milk from any animal. It can carry dangerous germs.
• Unmodified goat or sheep milk as the main drink, unless pasteurized, fortified and agreed with your pediatrician.
• Flavored or sweetened milks, and condensed or evaporated milk as a drink.

When to check in

• Mention it at the next checkup if your toddler drinks much more than 24 oz (710 mL) a day, eats little, or seems pale and tired.
• Ask before using a plant milk as the main drink, or if constipation follows the switch.
• If your child has swelling of the face or lips or trouble breathing after milk, call 911.