The milk dilemma ...

The milk dilemma ...

I grew up next door to a small dairy farm. Every morning one of us kids had the job of heading round to the farmer with a bucket to collect some milk from that mornings collection. The fresh milk was raw (unpasteurised) and unhomogenised. That meant that the cream naturally separated and rose to the top. We would skim this off for those in the family who liked extra creamy milk (it was also sold in Scotland as “Top of the Milk”) and then we had our homemade version of low-fat milk underneath. Alternatively you just gave it a good stir before using.

Fast-forward to today and parents face an enormous array of choice in the supermarket milk department. You have to choose between regular milk, organic milk, low fat or skim milk, A2, lactose-free, omega-3 boosted, calcium and vit D boosted, or do you go dairy free and opt for soy milk, rice milk, oat milk, almond milk or even quinoa milk.

If you are feeling confused I don’t blame you!

To try to help, let me talk you through each of these types of milk. For further advice speak with an Accredited Practising Dietitian (APD) who can give you specific advice for your child.

1. Dairy milk options

Regular full cream milk 

This is milk that has only been pasteurised (to kill most of the bacteria present. There are a few microbes that can survive the pasteurisation process) and homogenised (to disperse the fat globules throughout the milk for smooth consistency and to stop the milk from separating as I described above). 

Full cream milk is recommended for children from 12 months until at least 2 years, but you can happily keep using for longer if you wish. Young children need the extra kilojoules found in whole milk and the fat carries nutrients including vitamins A and D. If your child eats cheese regularly s/he is getting these nutrients in a more concentrated form there. So for most kids from age 2 you can use a lower fat milk if that’s what the rest of the family are using. It certainly makes the shopping easier. 

Light/lite/low fat milk

These are milks with about half of the cream removed before homogenisation. From the table you can see that this fairly dramatically reduces the kilojoules but you still get all of the protein and calcium. Actually, a little more calcium as once the cream is removed more of the other milk components are present. You do, however, lose the fat-soluble nutrients, so you need to ensure your child is getting them elsewhere if you choose this milk.

Skim milk

From the table you can see that skim milk has the lowest energy (about half that of full cream milk) but still delivers all of the protein and calcium. It also has a very different taste to full cream which some kids might prefer, and vice versa. If your child is overweight or is a great eater and has many other sources of healthy fat and fat-soluble nutrients, then skim milk is an option to consider from age 5. 

I am not a fan of food products manipulated to be low fat – they usually have a whole bunch of fat replacers and undesirable additives. But skim milk is different. To me it’s just the same as us skimming the cream off the top as kids. It’s just one way of reducing your energy intake if you do have a cup or more of milk in your daily diet. 

A2 milk

Now we start to get a little more complicated. The A2 refers to the type of beta-casein – one of the milk proteins – present. Most milk has a combination of both A1 and A2 beta-casein, while A2 milk only has A2 beta-casein. Why does this matter? 

It all lies with a little peptide called BCM7 that we get when we digest A1 but not A2 beta-casein. While the research is still in relative infancy, the theory is that BCM7 can cause problems within the gut leading to IBS type symptoms, and if it gets across the gut wall and up into the bloodstream can have all sorts of detrimental affects throughout the body, including the brain. 

Now with a normal healthy gut peptides should not get across – they are broken down further into amino acids for uptake – but in young children the gut is more permeable (and in adults with gut problems) and this may well be happening. 

A1 has been associated with type 1-diabetes and so if you have a family history you may want to play safe and switch your family to A2. I also think it’s worthwhile for those with intolerances to milk. A2 does still contain lactose, so is not suitable for those with lactose intolerance. But be sure to have a proper diagnosis as often the intolerance is not to lactose but some other aspect of the milk. In this case anecdotally many people report they are OK with A2. If it means your child can then have milk then fabulous. 

For more information go to www.a2milk.com.au

Lactose-free milk

Lactose is the type of sugar (a carbohydrate) found in milk. As young children we produce an enzyme called lactase that breaks down lactose into the component sugars glucose and galactose ready for absorption. However many of us stop producing this enzyme as we get older. Lactose then passes undigested into the colon, where the resident bacteria have a field day fermenting it. The result? Gas, bloating and usually diarrhoea. If you suspect lactose intolerance in one of your kids, see your GP who can organize a hydrogen breath test to confirm. If this is positive you don't need to cut out dairy foods. Simply choose a lactose-free milk such as Zymil.

Nutrient-enriched milks

These are milks which have had additional nutrients added. Some directed at better bone health boost the calcium levels and have added vitamin D. Others such as Heart Active have plant sterols added to assist in lowering blood cholesterol levels. I would not use this type of milk for your children as the plant sterols can reduce the absorption of fat-soluble antioxidants such as beta-carotene. 

Others have omega-3 fats added and this can be useful for your children if you cannot get them to take a supplement and/or they don’t eat fish several times a week. 

2. Soy milk

Soy milk is a good dairy alternative for those that have a diagnosed allergy or intolerance to dairy milk. However don't assume it is healthier. I would always opt for dairy milk over soy in the absence of allergies or intolerances. Soy is a common allergen and can cause just as many problems for kids as dairy in those who are susceptible. On the plus side soy is one of the few plants to provide the full array of essential amino acids we need, therefore soy is an excellent source of plant protein. The jury is still out on whether the phytoestrogens found in soy are beneficial or detrimental. I suggest using soy in the way traditional Asian diets do and not as the refined ‘soy protein isolate’ used in many Western foods. If you do choose soy milk for your kids, choose one made from whole beans, has nothing nasty added and is fortified with calcium. 

3. Almond milk

Perhaps as a result of the negative press regarding soy, almond and other nut and grain ‘milks’ have gained in popularity. They offer a good alternative to dairy milk for those who can’t or don’t want to have dairy, however as with soy don’t make the assumption they are any healthier. In fact they don’t contain many almonds at all – often only about 2% although some have up to 11% - and they add sugar, emulsifiers, gums and salt to create the right taste, texture and nutritional profile as close to dairy milk as possible. 

4. Grain milks including rice, oat and quinoa

Similar to almond milk these products are made with the grain and then have other ingredients added to create the end product, usually an oil, sometimes sugar (rice syrup, agave or cane sugar all common), salt and may also have emulsifiers and gums although usually nothing artificial. I recommend them for those who cannot or don’t want to have dairy and read the ingredients list to be sure of the simplest natural product. Oat milk has more protein than the other alternatives, although still less than dairy. 

milk facts table

*calcium is not naturally present but is usually added. The amount therefore depends on the brand.