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Your Guide to Cow Milk Alternatives

Good-bye cow. Hello rice, potato, goat, sheep, camel, donkey, horse. Expand your dairy-free diet with these surprising alternatives.

[Updated July 12, 2017]

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When Rachael Epstein, owner of Sprout organic hair salon in Baltimore, Maryland, discovered that her 4-month old son, Ezra, was allergic to cow’s milk, she went on a hunt to find a substitute. For a while, she tried a soy-based formula but he reacted to it in the same way, with constant congestion and alarming episodes of breathing difficulties. Ezra’s pediatrician didn’t believe the formula was the problem — he diagnosed the baby with asthma. But after Ezra was rushed to the emergency room one night because he couldn’t breathe, Epstein changed physicians.

Ezra’s new doctor, a naturopath, took Ezra off the soy formula and all dairy products and recommended rice milk. Ezra liked it and, fortunately, it didn’t cause a reaction. The difference was notable. On dairy or soy formula, Ezra suffered constant allergy-induced asthma attacks. After quitting both, the episodes stopped.

The doctor’s advice to quit dairy and soy and start on rice milk “was single-handedly responsible for curing Ezra,” Epstein says, who adds that her son was a skinny baby.

For the next five years, Ezra, now almost seven, continued drinking rice milk. Although generally healthy, he was underweight. He just couldn’t seem to put on the pounds the way his dairy-consuming friends did.

Plant Based Milks

“People will try anything when their child can’t eat,” says Eugene K. Sussman, M.D., a top-rated pediatrician in Washington, D.C. “A lot of parents try rice milk but it’s not a good substitute because there’s no protein in it.”

Maryland-based nutritionist Kelly Dorfman agrees. Milks made from plant sources, like soy, rice, almonds, hemp, oats and potato, “are not nutritious enough to use as formula substitute before one year of age,” she says. They just don’t pack the calcium or protein of cow’s milk nor do they have the calories or fat content. 

Many dairy-intolerant older children and adults enjoy plant milks. These products have favorable attributes but each also has its drawbacks. Soy and almond milks are problematic because both are highly allergenic (soy and tree nuts are two of the top eight food allergens). Rice milk is unlikely to cause an allergic reaction but has little protein and is chock-full of sugar.

The new kid on the non-dairy block, hemp milk, made from hemp seeds, is easier to digest than soy, according to manufacturer Living Harvest. Allergy to hemp is rare and hemp is fortified with calcium. However, like rice milk, the protein and fat content are low and the sugar content is high.

Oat milk is an option for those who don’t react to gluten, the protein in wheat, rye and barley (there’s a risk of cross-contamination during oat processing). However, oat milk isn’t high in nutrients; it’s primarily carbohydrates and sugar.

Potato milk, like DariFree, is non-allergenic for most people but it contains no fat and no protein. For some, potatoes can be hard on the digestive system because they contain a lot of starch.

Nutritionists say the best way to approach plant-based milks is to consider them alternatives or complements to dairy, not substitutes. Even when they’re fortified with calcium, the absorption rate of plant milks is only 75 percent that of cow’s milk. Bottom line: No plant milk alternative provides the nutritional wallop that dairy does.

Raw Milk

Recently, Epstein consulted another doctor, Peter Hinderberger, M.D., Ph.D., a conventionally-trained physician who has also studied alternative medicine. Concerned that Ezra wasn’t getting enough fat and protein in his diet and taking into account the boy’s allergic history, Hinderberger recommended that Epstein give Ezra raw cow’s milk. He indicated that raw milk wouldn’t cause the same symptoms as pasteurized milk.

Raw milk, which is milk that is not pasteurized or homogenized, is potentially dangerous to consume due to the risk of food-borne illness. The pasteurization process kills harmful bacteria responsible for diseases like listeriosis and brucellosis. According to the U.S. Food & Drug Administration ("The Dangers of Raw Milk", October 2006), sensitive populations, such as pregnant women, children, the elderly and people with compromised immune systems, are at particular risk. In addition, it’s illegal to sell raw milk in 28 states.

There is anecdotal evidence that raw milk can be safe if proper precautions are taken, such as ensuring the milk comes from healthy, clean animals and that there is consistently excellent hygiene in all aspects of animal care, as well as milk handling and distribution. Proponents of raw milk contend that pasteurization makes the proteins in cow’s milk more allergenic. According to Middleton’s Allergy Principles & Practices, a mainstream medical reference, “pasteurization may increase the allergenicity of some milk proteins, such as beta-lactoglobulin.”

However, Sussman contends that even if raw milk is obtained from a reliable source, the risk is still too high. “I would not recommend it,” he says. 

Alternative Animal Milks

One way to get the nutritional benefits of dairy without the cow is from the milk of other animals, such as goats, sheep and water buffalo. There are people with dairy allergy or sensitivity who don’t react to these. However, the chances aren’t good. Research shows that up to 90 percent of the dairy allergic will also be allergic to goat and sheep milk. There’s no research yet on water buffalo milk.

In addition, it’s possible to be allergic to sheep and goat milks without being allergic to cow’s milk. (Again, no research on water buffalo.)

Goat milk is easy to find in grocery and natural food stores, as are goat-milk cheeses, yogurt and butter. Sheep milk isn’t generally sold as milk since most is processed into cheese and yogurt. The Old Chatham Sheepherding Company produces sheep’s milk products, available at Whole Foods Market and other health food stores.

Water buffalo milk is sold in the form of yogurt and cheese, primarily mozzarella, by the Vermont Spoondance Creamery, formerly The Woodstock Water Buffalo Company. The company is currently collaborating with Children’s Hospital Boston, Harvard Medical School’s teaching hospital, on research into this product’s allergenicity. The milk is available in the United Kingdom but not yet in the United States. You can find water buffalo butter, made by Fattorie Garofalo, an Italian company, in some American gourmet grocery stores, such as Balducci’s in the Washington D.C. area. 

Non-Cow Milks Used Outside the U.S.

Other animal milks, such as donkey, horse and camel, are readily consumed in various parts of the world. Although not widely available in the United States at this time, these milks show promise as potential dairy substitutes.

Donkey milk has a long history. Cleopatra is said to have bathed in it for its skin beauty benefits and reportedly it was fed to infants in 19th century France who had no other source of milk.
More recently, an Italian study, published in Pediatric Allergy and Immunology, revealed that donkey milk was well tolerated by the majority of children in the study, including those who were sensitive to cow’s milk and those allergic to it. Researchers concluded that donkey milk shows great promise as a milk substitute for infants since it tastes good and because its composition and proteins closely resemble human milk. Donkey milk, both powdered and liquid, is currently sold and drunk raw in France, Belgium and Italy. It is not available in the United States but it can be ordered freeze-dried via the Internet.

The same Italian study suggested that mare’s milk may also be a suitable dairy substitute. Like donkey milk, mare’s milk closely resembles human milk. In the early 20th century, this product was so popular in Germany that it was delivered door to door. Mare’s milk went out of fashion for a few decades but now is making a comeback in Europe. It’s available in powdered form and is not pasteurized. Freeze-dried mare’s milk is also available on line. People who are allergic to horse hair may react to mare’s milk.

Camel milk, widely consumed in the Middle East, may be the new hope for dairy lovers. According to Reuven Yagil, DVM, an Israeli veterinarian and professor of human physiology at Ben-Gurion University of the Negev Medical School, people who are allergic to cow’s milk can tolerate camel milk. Yagil, considered the world’s expert on camel milk and allergies, says the allergenic caseins in cow’s milk “do not appear in camel milk.” The camel milk he’s talking about is from dromedaries (the one-hump kind).

Yagil’s research shows that raw camel milk can actually make allergies better, if not disappear. “Allergies are a problem of the immune system. Camel milk contains immunoglobulins that are similar to human immunoglobulins and they help rehabilitate the immune system,” he says.

The only camel dairy in the United States, Oasis Camel Dairy, located in Ramona, California, plans to begin selling raw camel milk this year. Oasis will label its milk as pet food because it’s illegal to transport raw milk for human consumption across state lines. Other companies selling raw milk products, such as Organic Pastures in Fresno, California, do the same when shipping their products interstate.

Yagil warns that drinking raw camel milk is not to be taken lightly. Without proper supervision, raw camel milk is simply not suitable for human consumption. Any milk labeled “pet food” makes him very nervous, he says. Living in Israel, he gets his supply from a source he directly supervises so that he can oversee the milking process and the health of the camels.
“Always check the source of the milk, especially who is marketing it,” he says.

Think Outside the Milk Box 

If you’ve never tasted anything but pasteurized cow’s milk, there’s no doubt that drinking raw cow’s milk or any other animal milk will take some getting used to. And you might have to go through a couple of products before you find one that you or your child likes and tolerates.

The effort was well worth it for Rachael Epstein when Ezra stopped, in her words, “drowning in mucous” from consuming regular cow’s milk. Ezra loved the raw milk so much that the whole Epstein family decided to try it. Now they all drink it, with no ill effects.

Ezra has been gaining weight. And he’s happy because, as Epstein says, “He’s wanted to drink a regular glass of milk forever, like his friends do.”

Epstein admits that she was very nervous at first about trying raw milk, worrying about potential bacterial contamination. She researched products and checked sources to try to ensure the milk would be safe. In the end, she feels that “trying raw milk was a calculated risk worth taking” for Ezra and her family.