Toddlers need cow's milk to grow strong bones

What the research found

Australian health guidance says dairy foods are rich in calcium and help build strong bones. It suggests 1 to 1½ serves a day for toddlers aged 1 to 2. It also lists non-dairy calcium sources, such as calcium-enriched soy drinks, tofu, and tinned fish with bones. For children who avoid dairy, it advises seeing a dietitian.

A 2024 cluster-randomised trial of 315 Chinese children aged 4 to 6 found that 390 ml of milk a day for 12 months increased forearm bone density and content compared with bread. A meta-analysis in the same paper supported a benefit. These children were older than toddlers, and the trial measured bone markers, not fractures.

Other research is less clear. A 2006 trial of children aged 5 to 11 who already ate about 800 mg of calcium a day found calcium supplements gave little meaningful skeletal benefit. A 2017 study of children under 6 found cow's milk intake wasn't linked to fewer fractures, although vitamin D supplements were. A 2020 commentary argued that milk of any kind isn't required after weaning if the diet is balanced.

What it doesn’t mean

• This doesn't mean milk is bad for bones. It means calcium and vitamin D matter most, and cow's milk is one convenient way to get calcium.
• Children with a cow's milk allergy had lower bone density and calcium intake in a 2016 study, and fewer than half used calcium and vitamin D supplements. If your child avoids dairy, talk to a GP or dietitian about calcium.
• Cow's milk shouldn't be the main drink before 12 months because of the iron deficiency risk. From 12 months, water should be the main drink, and solid foods should make up most of the diet.