Switching from Cow's Milk to Soy Milk: Pediatric Nutrition Concerns

Soy milk as a substitute for cow's milk?

Dear Dr.
Pei,
My son is currently 1 year and 1 month old.
Before he turned one, he was drinking hydrolyzed protein milk.
He now has four meals a day, drinking milk (240cc) in the morning and before bed, while the other two meals consist of porridge (about 100-200ml).
Recently, I am considering replacing the morning and evening milk with homemade soy milk, but I am concerned about potential nutritional deficiencies or other issues.
I have heard that soy milk is less likely to cause allergies, but I am unsure if this is true or just a marketing tactic.
Additionally, he is very prone to mosquito bites, so I plan to buy mosquito repellent spray or lotion for him.
I would like to ask what ingredients I should be cautious about that could have adverse effects on young children.
Thank you for taking the time to respond.
Sincerely,
Mom of Zhuang

Zhuang Mama, 30~39 year old female. Ask Date: 2011/03/01

Dr. Pei Rensheng reply Pediatrics

Dear Mom Zhuang,
Hello!
1.
After reaching one year of age, formula milk is only a supplementary food, and drinking any specific formula milk has little effect on preventing allergies.

2.
Soy milk has good nutritional value; according to Wikipedia, it is rich in protein, calcium, phosphorus, iron, zinc, and dozens of other minerals, as well as vitamins A and B.
The protein content in soy milk is higher than that in cow's milk.
Additionally, soy milk contains special health factors such as soy saponins, isoflavones, and lecithin, which have cancer-preventive and brain-boosting significance.

3.
Since soy milk is lactose-free, it does not cause side effects for individuals with lactose intolerance and is a cost-effective source of protein.
However, the calcium content in soy milk is relatively low, typically only one-thirtieth that of an equivalent amount of cow's milk.

4.
Soy milk is not more likely to cause allergies than cow's milk.

5.
The main ingredient in commercially available mosquito repellents, diethyltoluamide (DEET), is a synthetic chemical.
The side effects of DEET include dermatitis, allergic reactions, and toxicity to the nervous and cardiovascular systems after absorption through the skin.
There have been reports of fatalities due to accidental ingestion of DEET.
Children are more susceptible to the side effects of DEET than adults, and there have even been reports of children dying from excessive use of DEET.
Most reports of neurological side effects from DEET occur in children, with symptoms such as seizures, coma, and encephalopathy, and there have been cases of death.

6.
However, overall, hundreds of millions of people worldwide use DEET each year, and the occurrence of side effects is relatively low, with severe side effects being rare, making DEET a fairly safe medication.

7.
Commercially available mosquito repellents contain DEET in various concentrations; I have seen concentrations of 4.4%, 12%, 15%, 28.368%, and 50%.
Everyone can purchase an appropriate concentration of mosquito repellent based on their needs or those of their children.

8.
When the concentration of DEET is below 50%, it has minimal side effects on adults, and higher concentrations provide better mosquito protection.
However, once the concentration exceeds 50%, the effectiveness does not significantly improve, and the repellent becomes sticky and uncomfortable.
Therefore, for adults, a concentration of 50% is a good choice.

9.
However, adults do not necessarily need to use high-concentration repellents; if staying outdoors for just a few minutes or a short time, a lower concentration of DEET is sufficient.
Conversely, for activities like hiking, fishing, or camping, a higher concentration is preferable.

10.
A dermatology textbook published in the UK recommends that in tropical areas, children should use mosquito repellents with a DEET concentration below 15%.

11.
Some people mistakenly believe that mosquito repellent should be sprayed on clothing, which is incorrect.
DEET should be applied to the skin, and it is essential to cover all exposed skin; otherwise, insects will still bite the areas that are not treated, such as the ears, which are often missed.
However, applying repellent to hats and clothing can enhance protection against insect bites.
Wishing you health and happiness!
Sincerely,
Dr.
Pei Rensheng
Director of Pediatrics, Taoyuan Hospital, Department of Health

Reply Date: 2011/03/01

More Info

Switching from cow's milk to soy milk for a toddler can raise several nutritional concerns that parents should consider. At 1 year and 1 month old, your child is at a crucial stage of development where proper nutrition is essential for growth and overall health. Here’s a comprehensive look at the implications of this switch, along with some additional considerations regarding mosquito repellent use.

Nutritional Considerations
1. Protein Content: Soy milk is a good source of protein, often containing more protein than cow's milk. However, the quality of protein differs. Cow's milk provides a complete protein source, containing all essential amino acids, while soy milk, although high in protein, may lack certain amino acids in sufficient quantities. It’s important to ensure that your child receives a balanced diet that includes other protein sources such as legumes, eggs, or meat to compensate for any deficiencies.

2. Calcium and Vitamin D: One of the significant concerns when switching to soy milk is calcium intake. Cow's milk is fortified with calcium and vitamin D, which are crucial for bone development in toddlers. While some brands of soy milk are fortified with calcium and vitamin D, not all are. You should check the labels and ensure that the soy milk you choose provides adequate amounts of these nutrients. If it doesn’t, consider incorporating other calcium-rich foods into your child's diet, such as leafy greens, tofu, or fortified cereals.

3. Allergy Considerations: Soy milk is often considered a hypoallergenic alternative to cow's milk, but it can still cause allergic reactions in some children. If your child has a history of allergies or if there is a family history of soy allergies, it’s advisable to introduce soy milk cautiously and monitor for any adverse reactions.

4. Other Nutrients: Cow's milk contains several nutrients that are beneficial for toddlers, including vitamin B12 and riboflavin. Soy milk may not provide these nutrients in the same amounts unless fortified. Ensure that your child’s diet includes a variety of foods to meet their nutritional needs.

5. Digestive Health: Some children may experience digestive issues when switching to soy milk, such as gas or bloating. This can be due to the oligosaccharides present in soy. If you notice any digestive discomfort, it may be worth consulting with a pediatrician or a nutritionist.

Mosquito Repellent Considerations
When it comes to using mosquito repellent on young children, safety is paramount. Many commercial repellents contain DEET (N,N-diethyl-meta-toluamide), which is effective but can have side effects, especially in young children. Here are some points to consider:
1. Concentration: If you choose a repellent containing DEET, opt for one with a lower concentration (10-30% is generally recommended for children). Higher concentrations do not necessarily provide better protection and can increase the risk of side effects.

2. Application: Apply the repellent only to exposed skin and avoid areas where the child might touch their mouth or eyes. Do not apply it to the hands of young children, as they may inadvertently ingest it.

3. Natural Alternatives: Consider using natural repellents that contain ingredients like citronella, eucalyptus, or lavender. While these may not be as effective as DEET, they can provide some level of protection without the potential side effects associated with chemical repellents.

4. Consultation: Always consult with a pediatrician before introducing any new products to your child’s routine, especially if they have sensitive skin or a history of allergies.

Conclusion
Switching from cow's milk to soy milk can be a viable option for your toddler, but it requires careful consideration of nutritional adequacy. Ensure that the soy milk is fortified with essential nutrients and that your child’s overall diet is balanced to meet their developmental needs. Additionally, when using mosquito repellents, prioritize safety by choosing appropriate products and applying them correctly. If you have any concerns about your child's nutrition or health, consulting with a pediatrician or a registered dietitian can provide tailored guidance.

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