WHAT IS THE BEST MILK FOR YOUR CHILD?

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

Parents are rightfully concerned about choosing the right milk for their young children, as what your child drinks plays a key role in their health. Children require different amounts of breast milk, formula, and solid food depending on their age, size, nutritional needs, and individual circumstances. Some children have allergies or milk intolerances. This makes expert guidance from healthcare professionals for the specific needs of your child crucial.

Here’s a general guide:

Infants (0-12 months): Breast milk or formula milk (consult pediatrician for recommendations)
Toddlers (1-2 years): Whole cow’s milk or fortified non-dairy milk (e.g.soy milk)
Children (2-5 years): Reduced-fat cow’s milk (2% or 1%) or fortified non-dairy milk

Considerations:

Allergy or intolerance: If your child has a milk protein allergy or lactose intolerance, consider non-dairy milk

Nutritional needs: Choose milk with essential nutrients like calcium, vitamin D, and protein.

Always check the nutrition label and choose unsweetened, unflavored options to promote healthy habits.

MILK AVAILABLE IN SOUTH AFRICA

South Africa has a wide range of infant and toddler milks and formulas available, suitable for different ages, and including specialised formulas (such as comfort, lactose-free, soy) as well as goat-milk options and dairy blends. These are widely available from pharmacies, supermarkets and specialist baby stores. Before you buy any of these, make sure to consult your paediatrician to choose the right formula for your child‘s specific needs.

Key issues with available milks and formulas include:

Misleading marketing
Harmful flavourings
Unsuitable alternatives
Soy milk: Not recommended for infants/toddlers without specific needs, and even then, it has risks like phytoestrogens and potential cross-allergies.

Goat’s milk: Deficient in folic acid and not a safe alternative for cow’s milk allergy; with similar issues as cow’s milk.

Plant-based milks (almond, coconut, etc.): These are not nutritionally adequate as a primary source for babies and toddlers.

In South Africa stage 1–3 formula products (from birth to 36 months) are covered by Regulations relating to foodstuff for infants and young children. But stage 4 products (from 36 months plus) are not. Stage 4 formula products are commonly packaged, branded and labelled to closely resemble stage 1–3 formula products, leading to parents mistakenly assuming these products are also controlled by the same Regulations.

PRODUCT RECALLS

Product recalls occur when a company removes a product from the market, or fixes it, because it’s unsafe, defective, or doesn’t meet standards. A company that announces a product recall is not inherently untrustworthy; in fact, it can demonstrate a commitment to safety, transparency, and high quality standards.

URGENT RECALL

In January 2026, the recall of following product was listed as urgent in South Africa:

Product: Nestlé NAN Special Pro HA Infant Formula (0-12 months), 800g tin

Batch Number: 51660742F3, Best Before 15 Dec 2026

Danger: Potential contamination with a toxin (cereulide) from a German plant; parents must stop using this specific batch immediately and check for symptoms like severe vomiting or lethargy. Contact a doctor should your child experience these symptoms.

What to do if you have the product:

Stop using immediately: Do not feed this formula to your infant.

Check the batch number: Verify the batch number on your 800g tin is 51660742F3.

Return for Refund: Take the product back to where you bought it for a full refund.

Monitor Your Baby: Watch for severe vomiting, persistent diarrhoea, or unusual sleepiness, and seek medical help if these occur.

For more information: South African Government News Agency and Nestlé Global. 

COWS MILK

Dairy milk has essential nutrients that support a child’s growing body, including:

High-quality protein

Calcium (supports bone health)

Potassium (helps maintain healthy blood pressure)

Vitamin D (supports bone health and heart health)

Vitamin B12 (builds red blood cells)

Vitamin A (improves the immune system)

Phosphorus (supports bone health)

Vitamin B2 (riboflavin, which converts food into energy)

Vitamin B3 (niacin, which converts food into energy)

Cow’s milk is one of the best ways to replenish these vitamins and plays an important role in keeping your child healthy. But cow’s milk should not be introduced before one year of age.

MILK FORMULAS

Often called baby formula or infant formula, milk formula is usually made from cows’ milk that has been treated to make it more suitable for babies. There’s a wide range of brands and types of formula available, so make sure to check labels carefully to make sure you’re buying suitable milk for your baby.

Formula provides babies with the nutrients they need to grow and develop. However, it does not have the same health benefits as breastfeeding for you and your baby. For example, it cannot protect your baby from infections.

First infant formula (first milk)

First infant formula is suitable from birth and should always be the first formula you give to your baby. The cows’ milk in formula contains two types of proteins – whey and casein. First infant formula is based on whey protein which is thought to be easier to digest than other types of formula.

Unless your healthcare provider suggests otherwise, first infant formula is the only formula your baby needs. Your baby can stay on it when you start to introduce your baby’s first solid foods at around 6 months and they can drink it throughout their first year.
Goats' milk formula

This is suitable from birth as they are produced to the same nutritional standards as cow’s milk-based formula.

It is important to note that goats’ milk formulas are not suitable for infants with cows’ milk allergy as the proteins they contain are very similar.
Hungrier baby formula (hungry milk)

Hungrier baby formula (hungry milk) is suitable from birth, but ask your healthcare provider for advice first. This type of formula contains more casein than whey, and casein is harder for babies to digest.

Although often described as suitable for “hungrier babies”, there’s no evidence that babies settle better or sleep longer when fed this type of formula.
Anti-reflux (staydown) formula
Comfort formula (hydrolysed formula)

Comfort formula is suitable from birth; but ask your healthcare provider for advice first.

This type of formula contains cows’ milk proteins that have already been partly broken down (partially hydrolysed). This is supposed to make it easier to digest and help prevent digestive problems such as colic and constipation. However, there’s no evidence for this.

Partially hydrolysed formula (comfort formula) is not suitable for babies who have cows’ milk allergy.
Lactose-free formula
Hypoallergenic formula
Follow-on formula

Follow-on formula is suitable from 6 months, but ask your healthcare provider for advice first.

Follow-on formula should never be fed to babies under 6 months old.

Research shows that switching to follow-on formula at 6 months has no benefits for your baby. Your baby can continue to have first infant formula as their main drink until they are one year old.

The labels on follow-on formula can look very similar to those on first infant formula. Read the label carefully to avoid making a mistake.
Soya formula

Soya formula is suitable from 6 months but only under medical supervision.

Soya formula is made from soya beans, not cows’ milk. It’s occasionally used as an alternative to cows’ milk formula for babies who have cows’ milk allergy.

There are some concerns about the fact that soya contains phytoestrogens. These are found naturally in some plants. The chemical structure of phytoestrogens is similar to the female hormone oestrogen. Because of this, there are concerns that they could affect a baby’s reproductive development, especially in babies who drink only soya-based infant formula. Babies’ low body weight means they take in much higher amounts of phytoestrogens than older children or adults who eat soya products as part of a varied and balanced diet.

Also, soya formula is more likely than cows’ milk to harm a baby’s teeth.

Only use soya formula if it has been recommended or prescribed by your healthcare provider.
Growing-up milk (toddler milk)

Growing-up milk (toddler milk) is suitable from one year, but ask a healthcare professional for advice first.

Growing-up and toddler milks are marketed as an alternative to cows’ milk for toddlers and children over one year old. But children aged 1 to 5 years do not need formula milks including infant formula, follow-on formula, growing up or other toddler milks.

Pasteurised whole and semi-skimmed cows’ milk can be given as a main drink from age one, as can goats’ and sheep’s milks. Pasteurised skimmed and 1% cows’ milk should not be given as a main drink until after two years of age (and preferably only after five years of age).
Types of milk to avoid
Not all milk is suitable for feeding babies. You should never give the following types of milk to a baby under one year:

condensed milk

evaporated milk

dried milk

goats’ or sheep’s milk (but it’s fine to use them when cooking for your baby, as long as they are pasteurised)

other types of drinks known as “milks”, such as soya, rice, oat or almond drinks

cows’ milk as a drink (but it’s fine to use it in cooking)

unpasteurised (raw) milk

DAIRY ALLERGIES AND MILK ALTERNATIVES

Milk allergy
A food allergy happens when your immune system overreacts to a specific food protein. When you eat or drink that protein, it can trigger an allergic reaction. A food allergy can be potentially life-threatening.

Allergy to cow’s milk is the most common food allergy in infants and young children. About 2.5 percent of children under three years old are allergic to milk. Nearly all infants who develop an allergy to milk do so in their first year of life. If your child has a milk allergy, they must avoid all milk products.

Symptoms (can be severe/life-threatening):

Skin: Hives, eczema, swelling (lips, tongue, throat).

Respiratory: Wheezing, coughing, shortness of breath, hoarse voice, throat tightness.

Digestive: Vomiting, diarrhoea, stomach cramps.

Other: Tingling mouth, paleness, loss of consciousness, anaphylaxis (emergency).

Always see a healthcare professional for suspected milk allergy, especially if symptoms are severe or include breathing difficulties, as it requires immediate treatment with epinephrine.
Lactose intolerance
Food intolerances do not involve the immune system. People who are lactose intolerant are missing the enzyme lactase. Lactase breaks down lactose; a sugar found in milk and dairy products. As a result, people with lactose intolerance are unable to digest these foods. While lactose intolerance can cause great discomfort, it is not life-threatening.

Symptoms (only digestive):

Bloating, gas, cramps, abdominal pain.

Diarrhoea, nausea.

Symptoms usually appear shortly after consuming dairy.

If your child is lactose intolerant, they can often tolerate small amounts of milk or use lactose-free products.
Dairy alternatives: plant-based milk
It is generally recommended that children under the age of five should avoid plant-based milks. Unless a child has dietary restrictions, cow’s milk is recommended for children aged 12 months and older to help supply protein, calcium, vitamin D and other nutrients.

The exception is for children with dairy intolerance or allergy, or for families with a dietary preference such as eating vegan due to religious or lifestyle beliefs. For children who need an alternative to cow’s milk, soy milk is the best plant-based milk choice.

Plant-based milk refers to non-dairy milk options, which can be made from a variety of plants, nuts or seeds. It is important for parents to note that most non-dairy milks are not nutritionally equivalent to cow’s milk and require fortification.

Common plant-based milks include:

Soy milk

Almond milk

Oat milk

Coconut milk

Pea milk

Rice milk

For young children, dairy alternatives need to match cow’s milk’s critical nutrients (calcium, vitamin D, protein, fat), making fortified soy or pea milk the best choices, especially after age one; while oat, almond, or coconut milks are fine in recipes, they lack nutrition as a primary drink unless heavily fortified and paired with other foods. Some plant-based milks are sweetened with added sugars, so it’s important to check labels to understand each product’s nutritional value. Always consult a paediatrician before switching.

KEY TAKE-AWAYS

INFANTS (0-12 MONTHS)

For babies under one year, breast milk is best. If breastfeeding isn’t possible, iron-fortified infant formula can be used. Cow’s milk and alternatives aren’t suitable as a main drink until after 12 months, when whole cow’s milk can be introduced (up to two cups daily), along with a varied diet, with low-fat options for toddlers over two years old.

Before 12 months, a baby’s digestive system isn’t mature enough for cow’s milk, and it lacks the specific proteins, fats, iron, and other nutrients for optimal growth. Not only is cow’s milk low in iron, it can also interfere with iron absorption, potentially causing iron deficiency anaemia in infants.

Top choices
Breast Milk: The ideal food, offering tailored nutrition, hydration, and antibodies to fight infections, with a Vitamin D supplement recommended for exclusively breastfed babies. Breastfeeding your infant from birth to 6 months old may lower their risk of obesity later in life.

First Infant Formula(whey-based): The only safe substitute for breast milk, meeting all nutritional needs for babies under 12 months; look for iron-fortified options.
What to avoid
Cow’s Milk: Not suitable as a main drink before 12 months due to difficulty in digestion and potential intestinal bleeding.

Plant-Based Milks: Soy, almond, oat, or rice drinks aren’t nutritionally complete for this age and should be avoided as a primary drink.

Sweetened Drinks: Juice, squash, or sugary drinks offer no nutritional benefit and risk tooth decay.

Cereal/Powdered Milks: Avoid regular, low-fat, skim, evaporated, or condensed milk, as well as homemade concoctions.

TRANSITIONING (12 months and up)

After the age of one, babies can transition to pasteurised whole cow’s milk as their main drink, alongside solids. Toddlers need the fat in whole milk for brain development and growth. They should have no more than 2-3 cups a day to ensure they still eat other iron-rich foods.

Plant-based milks (soy, almond, oat) are not recommended before the age of five as they lack essential nutrients, although soy can be an alternative if medically indicated.

Children can switch to low-fat or skim milk after the age of two if your healthcare provider recommends it. Reduced fat milks lack the crucial fat children need for brain development and growth.

Avoid unpasteurised milk as it can make children very sick.

It is essential you consult your healthcare provider for personalised advice on formula brands or any feeding concerns.

WHAT IS THE BEST MILK FOR YOUR CHILD?

WHAT IS THE BEST MILK FOR YOUR CHILD?

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

MILK AVAILABLE IN SOUTH AFRICA

COWS MILK

MILK FORMULAS

DAIRY ALLERGIES AND MILK ALTERNATIVES

KEY TAKE-AWAYS

FURTHER READING