UHT vs fresh milk for toddler: 5 things you should know about milk for your child

What type of milk is best for toddlers? Is ultra heat treated (UHT) milk suitable for toddlers? What to do if the toddler only wants to drink milk?

As your baby grows, their activities increase manifolds - their length increases by 50 per cent at one year and 75 per cent at two years. In addition, their brain continues to develop rapidly.

Research has shown that the brain nearly triples in size in the first two years, reaching approximately 85 per cent of adult weight.

Given the importance of proper nutrition in this phase of a child's life, fulfilling his nutritional requirements is vital. This is linked to choosing between fresh or UHT milk for your toddler.

Around his first birthday, he receives most of his required nutrients from food. However, milk remains an important source of minerals like calcium, and vitamins, particularly B12 for him. And so, choosing the right milk for your baby is still important.

The World Health Organisation (WHO) encourages giving breast milk until the child turns two or longer if required. Breast milk, in addition to providing essential nutrients, can also boost your child's immunity. The immunoglobulins that the baby receives from breast milk act as antibodies and protects him from many illnesses.

That said, after the age of one, other types of milk can be introduced as well to fulfill his growing nutritional needs.

However, when it comes to choosing the most appropriate milk for your child, a mother often has many misconceptions. Here are the five most common myths about milk.

Myth #1: Growing-up formula milk is better than full cream milk

Reality - For children older than one year of age who are on a well-balanced diet, growing-up milk provides no incremental benefit over full cream milk.

Formulas meant for children beyond the ages of one year old (Stage three onwards) are termed as growing-up milk. They are relatively new to the market, so parents may often not be well informed about them.

This myth arises from the way these manufacturers marketed the milk. They claim to be "specially designed to meet the nutritional needs of your toddler", creating the impression that it may be superior to other types of milk.

The trouble is, their nutritional value is often compared solely with cow's milk, instead of cow's milk, plus food which your toddler would, in reality, be eating. Milk and dairy products are the main sources of calcium in their diets.

300ml of cow's milk provides all the calcium that a one- to three-year-old needs (350 mg/d).

However, the recommended daily servings of the mentioned milk do not offer that. For that, your child needs to consume at least 400 ml of marketed milk.

For toddlers, their major source of nutrients needs to come from food, not milk. If they get full from the growing-up formula, they stop getting an appetite for solid food. Because of this, these toddlers become prone to deficiencies later in life.

Debunking the myth of formula milk

Seeing this, in October 2013, the European Food Safety Authority (EFSA) published an opinion about the benefits of growing up milk or toddler milk.

According to the EFSA, "their scientific experts could identify "no unique role" for a young-child formula in the diet of young children". And so, growing up milk is not necessary for toddlers who are eating and growing well.

You can use full cream milk instead, which fulfills the nutritional needs of your toddler along with a balanced diet.

Myth #2: Fresh milk is better than UHT milk for your toddler

Reality - nutritionally speaking, they are more or less, the same.

After your child turns one, you can introduce full cream milk to his diet. Full cream milk can be pasteurised cow's milk, UHT, or powdered for your toddler. There are no significant differences between these three types of milk nutritionally, except for differences in how they are processed, and hence, their shelf lives.

The UHT milk you prepare for your baby, or ultra-pasteurised milk is heated to a very high temperature for a few seconds, and kills all the pathogen as well as bacterial spores, increasing the shelf life of UHT to six to nine months when it is unopened. In contrast, pasteurised milk is heated to a lower temperature for a longer time, and the shelf life is thus shorter, at about two weeks when it is unopened.

After opening, both UHT and pasteurised milk must be kept chilled in the refrigerator for your baby. Powdered milk, on the other hand, is a concentrated form of milk after the water has been evaporated.

Of course, you may still breastfeed your child as well. At this stage, do give your child full-fat milk as he still requires an adequate amount of fats to support his growth.

After the child is two years old, you can switch to low-fat milk supplemented by a balanced age-appropriate diet, if your child is eating and growing well.

Myth #3: It is better for my baby to take hypoallergenic formula or specialised formula

Reality - Specialised formulas are not going to provide extra nutrition or benefit to your child who is growing well. They are prescribed by doctors for children with medical needs.

While most healthy babies can take normal infant formula, babies with specific allergies or medical conditions may require specialised formulas. Before you think about using them, we suggest you consult with a medical professional first. With this, they may recommend better alternatives.

If you survey the formula section of a supermarket, you will find many brands and the jargon is confusing. However, read the fine script and you will notice that they fall into these five broad categories.

1. Soy-based formula

Derived from a plant source, these formulas are particularly useful for children who are allergic to bovine proteins.

2. Lactose-free formula

A few babies cannot digest lactose - a sugar commonly found in milk. For them, this formula is a boon.

3. Extensively hydrolysed formula (EHF) or partially hydrolysed formula

These formulas contain proteins that are broken down into easily digestible components. They also serve as alternatives for kids with allergies to the proteins in cow's milk.

EHF contains proteins that are broken down into small units.

This makes it easy for babies with severe inflammatory bowel diseases or cow milk allergies to digest the formula.

Partially hydrolysed formula is generally used in babies suffering from colic, though it is not recommended in babies who have milk protein allergies.

4. Hypoallergenic formula

This is meant for infants with allergies or who have a family history of allergies to milk proteins. Even though soy-based formulas are not completely hypoallergenic, they are sometimes used in infants who tolerate them well.

5. Anti-regurgitation formula

This is meant for infants who may suffer from gastroesophageal reflux disease (GERD) and have a tendency to throw up.

This formula is a bit thicker than usual and sits better in the stomach.

Most of these specialised formulas are used right from birth. In the case of a rare allergy developing late, they are used in toddlers. Clearly, these are not premium formulas but are meant for babies who cannot have regular formula.

Myth #4: My baby is allergic to formula or cow's milk

Reality - most babies take a bit of time to adjust to new milk, whether it's fresh or UHT milk for your toddler.

Allergies to cow's milk protein are not uncommon. However, many babies take a while to adjust to the new milk. The symptoms of allergy are apparent in the bowel movements of the baby. If you see blood or mucous in the stools, it is a sign of an allergy.

Cow's milk allergy can cause a wide range of symptoms, including skin reactions (red itchy rash or swelling of lips/face); digestive problems (eg stomach ache, vomiting, diarrhoea) or hay fever-like symptoms (ie runny or blocked nose).

In such cases, meet your doctor. He will rule out if there is any other cause of allergy. Once established, your baby might have to switch to soy-based milk/formulas. Just don't self-diagnose the allergy and switch on your own. Regular formula up until age one and cow's milk, later on, are both beneficial for your child if they can tolerate it well.

Myth #5: There are so many different kinds of milk in the market, and I should just continue to feed my toddler formula milk

Reality - Unless contraindicated, full-cream milk is better than anything else commercially available for your toddler, a good option for your toddler once he turns one.

When it comes to the formulas, they are quite tightly regulated in Singapore. Because of this, even common products provide the necessary nutrients that your child needs. A costlier formula does not necessarily mean a better one.

That said, after the age of one, you can opt for cow's milk to supplement a balanced diet. However, you also need to avoid the milk that experts do not recommend.

1. Filled milk

Filled milk is fortified with fats from other sources, especially vegetable fats. Many commercially available evaporated milk and condensed milk, the ones used in your favourite kopi, are filled milk.

Even though they are not nutritionally deficient, they are best avoided in children due to the inordinate amount of sugar in them. That said, you can safely use them in baking, but they should not form a part of the recommended daily allowances.

2. Plant-based milk meant for adults

You often see soy milk, almond milk, rice milk, and coconut milk in the supermarkets. The target audience of these products revolves around lactose-intolerant adults. Their ingredients boast the exclusion of lactose. Moreover, manufacturers fortify them with calcium and vitamins to serve as milk alternatives for vegans.

However, the safety and nutritional efficacy of this non-dairy milk has not been established in children. So, it is best to avoid these till they can make an informed decision about their own dietary choices.

Toddler and milk: Frequently asked questions

Toddlers are like little whirlwinds of energy, and their nutritional needs can sometimes leave parents scratching their heads. One common question is whether it's time to pull the plug on milk consumption. Fear not, we've got the scoop on this and more! Here's your handy guide to toddler milk habits:

Should my toddler stop drinking milk?

Not necessarily! Milk is a fantastic source of calcium and vitamin D, which are crucial for bone development. Most experts agree that toddlers can continue drinking milk as part of a balanced diet. However, it's essential to introduce a variety of foods to prevent them from becoming too reliant on milk.

You may have wondered, 'When do toddlers stop drinking milk?' The answer is, they don't stop. Milk is still VERY important for their development, it's just no longer the star of the show," said Alicia Grogan, a licensed pediatric occupational therapist and editor of the Your Kids Table website.

How much milk should a toddler drink?

The general rule of thumb is around 16 to 24 ounces of milk per day for toddlers aged one to two years or around two cups for children aged one and up.

Because unlike when they were babies they can have an unlimited fill of their milk, toddlers need to get most of their nutritional intake in food, and not milk.

According to Jennifer Anderson, a registered dietitian who has a Masters of science in public health from Johns Hopkins School of Public Health, when it comes to dairy, toddlers do not need more than one to three servings per day total.

"That includes cheese, yoghurt, milk, and all forms of dairy. A cup of milk is one serving for a toddler. So, two cups of milk is basically all the dairy that they need in a day."

Moreover, it's also okay for your toddler to drink up to 18 to 20 ounces in a day, as long as they are eating well, said Alicia. Some toddlers can handle, and may even need, those extra couple of ounces.

However, "The problem with going over 16 ounces, after you've been through the weaning process, is that they may fill up on too many of their calories with milk and they won't look to food to fill them up, which they now need to be doing," she reminded.

Excessive milk consumption can fill up their tummies, leaving less room for other essential nutrients. Keep in mind that milk intake can vary based on individual needs, so don't stress if your toddler's intake fluctuates a bit.

When is the best time to give milk to my toddler?

There's no one-size-fits-all answer, but many parents find that offering milk during meals and snacks can help balance their toddler's diet. This approach prevents milk from replacing more nutrient-dense foods.

"Drinking milk during a meal is so important because if they are drinking milk in between, they never really have a chance to get hungry, and if they don't have a chance to get hungry, they aren't going to eat well," shared Alicia.

"This can lead to picky eater toddlers very quickly. This is why it is even more important to know when to give your toddler milk if they are a picky eater," she reminded.

Plus, milk can be a soothing bedtime ritual, promoting relaxation before sleep.

What to do if my toddler only wants to drink milk?

If your little one is showing a strong preference for milk, do not panic. Gradually encourage them to try a wider range of foods by offering small portions of different fruits, veggies, and whole grains. Be patient; it might take several tries before they warm up to new flavours. Remember, toddlers can be picky eaters, but their tastes will likely expand over time.

"If your child does reach the point where they have reached 16 ounces for the day, you can say, 'There's no more milk available now, we'll have more tomorrow.' Empathise with them and understand how frustrating this is for them. This is a really big deal to them! Their favourite food is now gone for the rest of the day. Stay close, even if they are having a tantrum and remind them that more milk will be available tomorrow," advises Jennifer. 

Mums and dads, make an informed choice about the milk you choose. Whether you choose fresh or UHT milk for your toddler, it's important to know what you're giving them.

If you are unsure, always ask your doctor about the best thing suited for your child.

ALSO READ: Soy milk for babies: A nutritional alternative

This article was first published in theAsianparent.