The subject of cow’s milk consumption is confusing due to some conflicting information. Is dairy good for your heart or bad? Do I need dairy to support my bone health or will veggies or a supplement do? Does my dairy need to be grass fed? Low fat? Fermented? How about my growing child? Do they need dairy and how much and which type? Confounding the picture further is the fact that schools and daycares and other health programs have certain requirements based on outdated data or other cost considerations. Outside of health, when you introduce environmental factors and issues such as animal welfare, things get downright paralyzing.

Here is my attempt at a simple breakdown by age:

Infants

Fed is best. If you can breast feed your baby, great. Fantastic. But guess what - for many women it is really, really hard. Sometimes it is impossible. So do your best. If latching fails, pumped milk is great too but you lose some bonding and the feedback loop where baby’s illness can actually stimulate mom to produce proteins and antibodies to help baby fight it off. If even pumping fails or just doesn’t fit for you, take comfort in the fact that commercial formulas are pretty darned good and there are plenty of smart docs and other folks who grew up on formula. Newborn feeding is a small part of of the massive job that is raising a child.

Toddlers

AAP currently recommends whole milk starting at age 12 months then transitioning to skim, 1% or 2% milk at age 2-5 years old. See full beverage recommendations here. What is this recommendation based on? Concern that too much saturated fat can contribute to obesity and heart disease. In reality it probably does not matter that much if you feed your toddler skim, 1%, 2% or whole (3.25%) milk. I personally find skim milk pretty off-putting, so we have 3.25% milk at our house. I also want my kids to stay full at breakfast when we tend to consume our dairy. Importantly though, we don’t rely on milk as a primary calorie source. The only clear harm with cow’s milk is when you feed your kiddo (or yourself) too much. Limit pediatric milk consumption to 16 ounces per day to avoid anemia and potential constipation. So feed your toddler and child whatever milk or milk substitute that suits your family best. Here is the other fact about milk at this age. Humans do not need cow’s milk at all. But if you do choose to omit cow’s milk please realize that you may need to supplement your kiddo with vitamin D, B12 and folic acid if they are also avoiding animal products. Consider too that fermented dairy has demonstrated health benefts so consider stocking your fridge w/low fat yogurt and keifer. Two studies discussing health effects of dairy nd dairy type can be found here.

Older Kids

The VeChi study is the best study we have to help us understand health benefits of adolescents consuming vegetarian, vegan or omnivore diets. The study included 6y-18yo German children.

The bottom line is that there were no major differences in nutrient deficiencies across the groups. Lipid profiles tended to be better in the plant based diets. Kids do not require cow’s milk.

This post is primarily about kids, but adults are not really any different. Dairy can be a part of a healthy diet but it is not essential (see studies above). If you can get your calcium and D from plant and sun sources that is clearly the most “healthy” way to do that. If you can’t - go ahead and eat dairy but look for more health promoting forms of dairy such as fermented products. Better yet get your calcium from plant based sources such as leafy greens and sweet potatoes. Plant sources are clearly associated with better heart and bone health whereas dairy sources are not. For D the only clearly beneficial source is the sun. What if you are doing your best and you still do not get enough Calcium and D? Go ahead and take a supplement.