It’s More Than Just Calcium
Yesterday, I witnessed once again children refusing to drink dairy milk because there was rice milk on offer. I have seen this before, in many other occasions. The rice milk was there for a child who is allergic to cow’s milk, but the other children developed a preference for it - it’s sweeter than cow’s milk. And I know that many adults allow this behaviour without particular concern and some even welcome children’s acceptance of milk plant-based alternatives for the convenience when there’s an allergy or intolerance situation.
That made me want to briefly talk about this study published earlier this year which showed the potential problems that replacing cow’s milk with plant-based-milk-like drinks (i.e. milk alternatives) can cause to children’s health.
Important to note that it is obvious that, when a child is sensitive to dairy milk (allergic or intolerant), there’s a need to avoid it and then to find ways to assure that the child is provided with adequate amounts of those nutrients from other foods and even supplements. Problem is that not all milk alternatives provide it, not all consumers know that, and that’s what I want to highlight here.
The reason I find it important to bring attention to this is because most children are dairy lovers and get a substantial chunk of their nutrition from it (or its plant-based alternatives). Current guidelines make it easy to assume that calcium content is what counts, only.
It’s not just the calcium
The study I mention here compared 11 milk alternatives available in Australia against dairy milk in terms of protein, vitamin B2, vitamin B12 and iodine content (1).
Protein is important for growth and maintenance of several parts of our body and physiological processes (e.g. hormonal balance and body cells repair). Foods rich in protein are meats, fish, eggs and dairy. These are considered high-quality protein sources because they contain all essential amino acids (protein building blocks) that our body requires. Complementary sources of protein (lower-quality protein, with ‘missing’ essential amino acids) are legumes (i.e. beans, peas and lentils) and whole-grains (e.g. rice, wheat, oats).
Vitamin B2 is important in the process of energy release from nutrients into our body cells. Foods rich in vit B2 are liver and dairy, and fortified foods (e.g. cereal, plant-based-milk-like drinks).
Vitamin B12 is important for body cells synthesis and for keeping our nerve cells healthy. Foods rich in vit B12 are all animal foods (e.g. meats, eggs, dairy) and fortified foods.
Iodine is important for thyroid hormones health which are important for growth. Foods rich in iodine are iodised salt, seafood, seaweed and dairy, also plant-foods that grow in iodine-rich soil and animals fed with these plants (2).
The researchers analysed the quantity of each of the above mentioned nutrients in plant-based-milk-like drinks (i.e. milk alternatives) and compared them against dairy milk. In the table below you can see the quantities showed as percentage compared to dairy milk’s.
Table of milk alternatives nutritional content compared to full-fat dairy milk (in %).
Note: all products were fortified with calcium, except coconut product.
This doesn’t mean that these products are bad and should not be consumed. This means that, nutritionally speaking, they are not a replacement for dairy. So, children that consume them, must be regularly checked for these important nutrients to make sure they aren’t deficient.
The results of this study show that children (2-13yo) who replace dairy milk with soy milk would keep adequate amounts of vitamin B2, but substantially reduce their vitamin B12 intake. And children who rely only on oat or rice milks would have a substantial decline in their protein and iodine intake. This is just an indication that by just taking dairy milk away and replacing it with a plant-based alternative can affect significantly a child’s critical nutrients’ intake.
The authors call for a revision of the Australian Dietary Guidelines because the guidelines call these plant-based-milk-like drinks as “dairy alternatives” as long as they contain at least 100mg of calcium per 100ml which is comparable to dairy milk. But the argument that the authors mean to make clear is that dairy milk provides many more critical nutrients than only calcium and that, given our dietary pattern, the absence of dairy may be significant to lead to nutrient deficiency.
This study isn’t isolated as the only one to show these problems. Other studies show similar results and call for similar caution in replacing dairy milk with plant-based alternatives (3). I mentioned this particular study because it analysed 11 products available in Australia. So, it’s highly relevant to us.
And my argument with this article is that removing dairy milk and dairy products from a child’s diet, for whatever reason – health, preference or life-style – is only nutritionally safe if additional care is taken to assure all nutritional needs are met otherwise the child’s healthy development can suffer.
For professionals who cook or feed children, have a look at the upcoming webinar on how to handle allergies and intolerances in the ECEC setting (<— click on this link). Let me show you the importance of certain allergens commonly removed from menus - dairy is one - and how you can go around that to make sure your children aren’t missing out on critical nutrients.
References
(1) Time to consider more than just calcium? The impact on protein, riboflavin, vitamin B12 and iodine intake of replacing cows’ milk with plant-based milk-like drinks—an Australian usual intake dietary modelling study. (Study, 2025, Australia) https://doi.org/10.1007/s00394-025-03697-8
(2) Understanding Nutrition. (Textbook, 2011, Australia)
(3) A Systematic Review on the Impact of Plant-Based Milk Consumption on Growth and Nutrition in Children and Adolescents. (Study, 2024, Canada) https://doi.org/10.1016/j.tjnut.2024.09.010
