Best Milk for Babies Starting Solids?

Like so many aspects of starting solids the question of the best milk for babies when starting solids is a confusing one! 

The use of milk, as in cows milk (dairy-based) or an alternative non-dairy milk (including soy, almond, coconut or oat milks) have a number of considerations and guidelines that need to be weighed up. There is no one singular answer to this for all babies. 

I have previously written a blog on alternative milks but this one specifically covers this question in more details for babies when starting solids. It is a valid question and because there is no on fixed answer I more than understand why you are confused.

I have also just recently launched my brand new game changing 'baby porridge' - my Baby Porridge with Pumpkin mix - which is grain-free, allergen-free and yes contains pumpkin! I have said in the instructions it can be made with a "milk of choice" so this will also help you make that choice!

Guidelines

Here in New Zealand our Ministry of Health guidelines are for no cows milk as a drink before the age of one. This guideline is to ensure cows milk is not used as a breastmilk substitute, as it is not nutritionally sufficient to be so.

It does not mean no cows milk at all.

Cow milk falls under the dairy classification which does need to be introduced as a top eight allergen in the first year, ideally with repeated exposure based on tolerance. This does not necessarily mean in milk form but unlike other allergens which often have a number of food sources, dairy based options are mainly cows milk, yoghurt and cheese.  

Provided that there is no allergic response cows milk is still fine to be included as part of a meal or in baking. Examples include a cheese sauce, a grain-free porridge (I got you here!), or in some grain-free baking. 

Allergen Introduction and Allergic Responses

An allergic reaction is defined as a response of the autoimmune system to the protein in a food. This means the immune system creates IgE antibodies to protein (IgE-mediated). 

The current Australasian Society of Clinical Immunology and Allergy (ASCIA) feeding guidelines are for all infants to be given allergenic solid foods in the first year of life, ideally as soon as possible, (including those at high risk of allergy).

I have a previous blog on this which goes into more detail as well as in The Nourished Baby. The key point here is that as mentioned above dairy does need to be introduced and 'tested' with two isolated oral intros before cows milk is used regularly. The is also the same for many plant based milk alternatives which fall into the top eight allergens including almond milk (treenuts) and soy milk (soy).

Nutrition Considerations

Without getting too lost into the complex topic of dairy intolerance, which is very different from an allergic response, we want to watch for overall intake of dairy and dairy alternatives from a nutritional perspective. While dairy and these plant based milk alternatives do contain a number of helpful nutrients including fat and protein they are low in overall iron and can displace an opportunity for an iron rich source. Moreover, when used in more traditional cereals these are not only highly processed, low in nutritional value but are also a grain (see my blog on why I don't recommend baby rice here). 

Go back to those three core foods for a baby, a source of iron and a source of healthy fats. You will notice I have been very careful to ensure that my new Baby Pumpkin Porridge contains all of three core foods. I have another helpful blog here too on baby food portions. 

Your 'Milk of Choice' Options Summary

 - Cows Milk = if your baby has had a dairy-based formula before starting solids you can use this milk and do not need to do a specific allergen introduction. Just keep in mind volume. What you use in the pumpkin porridge is fine.

- Lactose Free Milk = this milk is still dairy-based so the same guidelines around this as an allergen applies. 

- A2 Milk = this is also a dairy-based milk so as above, but as a side note this is a hugely controversial milk and its benefits are heavily over-exaggerated in  marketing which is referenced in peer-reviewed research (I will do another blog on this!)

- Almond Milk = you need to have orally introduced treenuts first, then almond milk in meals/baking can be an easy way to keep up exposure to this allergen for babies.

- Soy Milk = similar to almond, you need to have orally introduced soy as an allergen (soy milk can be a good way to do this) before using regularly. If you have used a soy formula and your baby has not had an allergic response you do not need to do an 'allergy intro'.

- Coconut Milk = Coconut milk is a good milk for a baby to start with if you have not previously introduced any other milks or allergens. Coconut is very nutritious and is not an allergen! You can read my blog here on this - Is Coconut a Nut?. If you are using the pumpkin porridge at the start of solids this is one I would recommend using. 

- Oat Milk = This is one milk that I would not recommend as it is grain-based and there are a lot of other options. It does not contain wheat (possibly traces) so you do not need to do a wheat allergy intro but nutritional the other plant based milks are a lot more nutrient dense. 

Hope this gives some points to help you make the best choice for your baby! Be sure to check out upcoming events for extra support and question time!

x Dr Julie