Milk and Milk Alternatives During Pregnancy

JanelMS, RD, LDN, CBS

Read time: 7 minutes

What should you know about which milk to choose during pregnancy?

Know what milk options are available
Learn the pros and cons of different types of milk

While water should make up the majority of the fluids we drink, having cow’s milk or a milk alternative in moderation can be a healthful source of some of the nutrients you need to support your health and pregnancy.¹

In addition to needing extra calories, fluids, and protein during pregnancy, moms-to-be also need more calcium, iron, folic acid, and vitamin D than they did before.²^,³

Regardless of whether you drink cow’s milk while pregnant, eat dairy, or choose milk alternatives instead, pregnancy is an especially important time to eat nutritious, whole foods in order to reach your daily nutrition needs.³

Read on for the pros and cons of cow’s milk and milk alternatives to see if they will help you meet your needs.

Cow’s Milk Nutritional Facts

Cow’s milk is available in:
- fat-free or skim (80 calories, 0 grams of fat per 8 ounce serving)⁴
- low-fat or 1% (110 calories, 2.5 grams of fat per 8 ounce serving)⁵
- reduced fat or 2% (120 calories, 5 grams of fat per 8 ounce serving)⁶ and
- whole or full-fat milk (150 calories, 8 grams of fat per 8 ounce serving)⁷
One 8 ounce serving of cow’s milk provides roughly 8 grams of protein, 25% of calcium requirements, 10% of vitamin A, and when fortified, 25% of vitamin D.⁴
It’s usually best to choose skim or low-fat varieties for yourself and anyone in your family over 2 years of age to limit your saturated fat intake (It’s recommended for children between the ages of 1 and 2 to drink whole milk in order to meet their unique nutrient needs).⁸^,⁹
All cow’s milk is naturally rich in protein, fat, and calcium. Full-fat whole milk is also naturally rich in vitamin A,⁴ while lower fat milks are fortified with vitamin A.¹⁰ Most commercial milk is fortified with vitamin D.¹¹

When do you need a cow’s milk alternative?

For some, the naturally occurring sugar in cow’s milk (lactose) can cause digestive trouble in the form of bloating, diarrhea, and gas. This is called lactose intolerance.¹² If you are lactose intolerant, there are lactose-free dairy options you can purchase.

If you’re allergic to cow’s milk protein, vegan, or just don’t like the taste of cow’s milk, a variety of milk alternatives are on the market. Some are plant-based like soy, rice, almond, hemp, or cashew “milk,” while others are animal-based, like goat milk.

Animal-based milk alternative: Goat’s milk

Goat’s milk is a popular animal-based milk alternative. While it contains more calcium, B6, vitamin A, and potassium than cow’s milk; it also has more calories and saturated fat than whole cow’s milk, and contains less B12.¹³

If goat’s milk is your drink of choice, you may need to include foods or a supplement (with your doctor’s approval) with B12 to make up the difference. Finding goat’s milk that is fortified with B12 will also make it an adequate cow’s milk alternative.

Note that there is a strong chance that people who are allergic to cow’s milk protein will also be allergic to goat’s milk protein.¹⁴ Check with your doctor before making this switch if you have an allergy.

Plant-based milk alternatives

Milk-alternatives, such as those made from soy, rice, almond, hemp, oat, coconut, and cashew are rising in popularity. These milk alternatives are naturally lactose-free, their fat content is primarily the good-for-you unsaturated type, and they can usually fit into a vegetarian or vegan diet.¹⁵

Nutrients added to plant-based milks

Many plant-based milk alternatives are fortified with calcium, vitamin A, and vitamin D to provide amounts similar to or greater than cow’s milk.¹⁵

But note that without fortification, such as plant-based milks made at home, these milk alternatives will contain only very small amounts of these important nutrients.¹⁵ You can determine whether a product has been fortified by checking the ingredient list and nutrition facts panel.

Be aware that healthy nutrients aren’t always the only things added to milk alternatives during processing. Sugars and sweeteners can also sneak in, adding empty calories. You can tell if a product has been sweetened if you see a type of sugar in the ingredient list.

Learn more: Minimizing Added Sugars

Here is a snapshot of the calories, fat, and protein content for a few types of plant-based milk alternatives:

Soy milk contains more protein (9 grams per 8 ounces) than most plant-based milk alternatives and comes in a variety of non-fat, low-fat and flavored options. Fat may range from 2 to 6 grams per 8 ounces depending on the brand. It also contains more calories than many other plant-based milk alternatives, ranging from 90-130 per 8 ounce glass depending on the fat and sugar content.¹⁶^,¹⁵
Hemp milk:Unsweetened hemp milk has more fat than most other plant-based milks – about 6 to 7 grams per 8 ounces, and between 2 and 5 grams protein depending on the brand. There are about 80 calories per 8 ounces, depending on whether the product is sweetened or not.
Oat milk and coconut milk: These are generally low in protein with about 0 grams (coconut) to 2 grams (oat) per 8 ounces. They may contain between 2 and 4 grams of fat (sometimes oils are added to help make a plant-based milk taste creamier). Oat and coconut milks may have between 45 and 120 calories depending on if they are sweetened or have added fats.
Rice, almond and cashew milk tend to be the lowest in protein and naturally-occurring vitamins and minerals; have between 0 and 2 grams fat, and are generally low in calories (45, 40 and 25 calories per 8-ounce glass, respectively). ¹⁵ Added sugars and fats will increase the amount of calories in these plant-based milks.

Keep in mind that ingredients and nutrition facts vary between brands.

How to choose the right milk for you during pregnancy

Focus on eating your calories, not drinking them

While cow’s milk and milk alternatives can be part of a healthy diet, aim to drink milk in moderation and focus on eating a varied, well-balanced diet. ¹⁷ If you are not a milk drinker, you can incorporate milks or their alternatives with your favorite foods, for example cold cereal, oatmeal, frittatas, and whole grain baked goods.

If you have questions about your diet while pregnant, reach out to our team of registered dietitians and lactation counselors for free! They’re here to help on our live chat from Monday through Friday, from 8am–6pm ET, and Saturday and Sunday, from 8am–2pm ET. Chat now!

When drinking cow’s milk, choose skim or other low-fat varieties

Unless otherwise directed by your doctor, the Dietary Guidelines for Americans recommends skim or low-fat milk to help reduce intake of saturated fats.⁸

When choosing plant-based milk alternatives, opt for unsweetened varieties

Beware of “original” and flavored types of plant-based milk, as these products often have sugar added. Instead, look for “unsweetened” in the name. Check that the ingredient list does not have any type of sugar and that the nutrition facts panel includes no added sugar.

Remember that cow’s milk and goat’s milk contain naturally occurring sugar (in the form of lactose) which will appear as grams of sugar on the nutrition facts panel. But these milks, if plain and not flavored, will have zero grams added sugar.

Make sure it’s fortified

Supplemental calcium will appear on ingredient lists as tricalcium phosphate or calcium carbonate; vitamin A as vitamin A palmitate; and vitamin D as D2/ergocalciferol (plant-based) or D3/calciferol (animal-based).

Without fortification, plant-based milk alternatives will contain very little of these nutrients. With fortification, they could contain up to 40% of the recommended daily value.¹⁵

Choose foods rich in calcium and vitamin D

Eating foods rich in these nutrients is especially important if your milk or milk alternative has not been fortified, or if you choose not to drink a milk or milk alternative. Eat 8 to 12 ounces of low mercury fish per week¹⁹ (sardines with the bones and salmon, in particular), lean meats, eggs, legumes, and dark green leafy vegetables.

If you are a vegan or a vegetarian who doesn’t eat eggs or dairy, supplementation may be important. Chat with your doctor if you feel you may need a supplement.

Make sure your milks are pasteurized

Pregnant women are advised to avoid unpasteurized raw milk and milk products.¹⁸ Plus, the safety of store-bought, fresh-pressed milk alternatives is unclear so it’s best to choose pasteurized versions.

Let’s Chat!

We know parenting often means sleepless nights, stressful days, and countless questions and confusion, and we want to support you in your feeding journey and beyond. Our Happy Baby Experts are a team of lactation consultants and registered dietitians certified in infant and maternal nutrition – and they’re all moms, too, which means they’ve been there and seen that. They’re here to help on our free, live chat platform Monday through Friday, from 8am–6pm ET, and Saturday and Sunday, from 8am–2pm ET. Chat Now!

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