What’s the Best Milk for my Baby?

Written by Trishell Simon, M.D., pediatric resident
along with Gillian Belnavis, M.D. and Lisa Gwynn, D.O., M.B.A., MSPH, FAAP

When I go to the grocery store these days, I’m in awe of all the choices, particularly milk and infant formula.

Choices within choices within choices.

It’s no longer just whole milk, 2% or low fat. Now it’s soy, almond, cashew, and coconut. And should I get organic, fortified, or milk from humanely treated cows? Infant formulas aren’t any less burdened by the buffet of brands. In this age of hyper healthiness and doubt that anyone would have our best interests in mind, the bombardment of ads beaming from our phones has caused an information overload, making it nearly impossible to know what’s best. Apparently, the latest type of milk to join the grocery store shelves and add to the confusion is goat’s milk.

As a pediatric resident, I recently advised a new mother about what to give her newborn.

Working at one of the largest public health systems in the U.S., I’ve become an ardent breast milk advocate. I’ve repeated “breast is best” to many first-time mothers and gone through countless 3 a.m. “proper nipple latch technique” sessions with frustrated, tired, but loving moms. It never occurred to me to be prepared to answer questions of parents who want a different option.

Parent: Can I start my infant on whole goat’s milk?

I say no. The research is clear that infants should not be given infant formulas until one year of age. But what about goat milk infant formulas? It wasn’t so clear to me, so I had to do some reading.

Goat milk infant formulas are relatively new to the U.S. baby food industry, gaining commercial popularity within the last few years. In Europe, New Zealand, and Australia, goat milk brands such as Kabrita, Holle, and Little Oak have been used extensively and researched more. Some products boast of their ability to avoid digestion issues, constipation, and gas. Others promote the added prebiotics and no synthetic ingredients like taurine, L-Carnitine, or maltodextrin, a food additive that adds powdery texture. After learning more, I still questioned if these formulas are safe. Are they better than the traditional cow-derived infant formulas, and what response should I give moms?

Are goat milk formulas safe?

Generally, yes. Like cow-based formulas, goat formulas usually require modifications to mimic that of human milk. They undergo dilution, the addition of vitamins and minerals, primarily B9, B12, and Vitamin E, and even protein modification.

However, avoid giving infants whole goat milk for the following reasons. Studies have compared the blood levels of methionine and phenylalanine (amino acids – building blocks for protein synthesis). They found these levels were higher in infants fed whole goat milk than breast and cow milk formulations.

Why is this important? Newborn screening.

Elevated blood levels of these substances in a newborn infant render this test positive. Therefore, it requires further evaluation for metabolic diseases by a pediatrician and geneticist, much to parents’ dismay. Pasteurized goat milk contains virtually no folic acid (Vitamin B9) or Cobalamin (Vitamin B12) and can therefore cause megaloblastic anemia. Like cow milk, it also contains very little iron, leading to microcytic anemia. Therefore, most babies with “goat milk anemia” may have a combined B9/B12 and iron deficiency.

So, what is best? When compared with cow milk-based formulas, factoring cost, lack of scientific evidence for reduced allergy symptoms, and no difference in growth or nutritional status, the answer is pretty clear. However, scientific research continues. There may be benefits discovered later on.

But in this age of choices, the safest, most trusted, and the organic option is mom’s milk.

Breast is best!

Talk with your pediatrician about infant formula choices.

Ask questions like:

• What types of formulas are available?
• How can I tell if my infant has a milk allergy?
• When should I consider switching infant formulas?
• How should I prepare different formulations?

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Tags: baby nutrition in Miami, Dr. Gillian Belnavis, Dr. Trishell Simon, Lisa Gwynn, milk for babies, newborn nutrition