P3B342: Milk Mania: Analyzing Online Information and Perception Regarding Milk Alternatives for Toddlers

Background: Alternatives to traditional dairy milk (i.e., oat, almond, soy) have become increasingly popular in recent years. The quality and content of information regarding the nutritional value of milk alternatives (MA) for toddlers is currently unknown, and it is unclear which factors influence caregivers’ decisions to switch toddlers to MA. This study seeks to highlight trends in potential benefits and drawbacks of MA discussed on online blogs to help pediatricians effectively counsel caregivers regarding proper nutrition in early childhood.

Methods: The top 200 MA blogs related to children under 5 years old were identified by a Google search of phrases (i.e., "milk substitutes for kids"). The following data were collected: a) blog name, b) writer credentials, c) concerns about MA, d) mentioned allergies/intolerances, e) MA types/nutrient composition, f) MA pros/cons, g) best MA claimed. Descriptive analysis was conducted in R.

Results: A total of 145 blogs were analyzed. Across blogs, 32% were written by nutritionists/dieticians, 12% physicians/nurses, 5% holistic providers, 4% PhDs/scientists, and 47% laypeople. Specific types of MA mentioned included soy (84%), almond (79%), rice (65%), coconut (60%), oat (54%), hemp (43%), goat (37%), pea (35%), general plant-based milk (11%), and other milks (i.e., homemade, potato) (28%) (Figure 1). Concerns for switching to MA included: growth/development issues (27%), nutritional value (75%), and taste (21%). 83% of blogs mentioned allergies/intolerances (i.e., dairy, nut, soy, gluten); 54% described MA nutrient compositions. Common positive comments regarding MA included: proper calcium content (n=164), proper vitamins/minerals (n=157); negative comments included: lower protein content (n=297), lower fat content (n=207). Across blogs, the most commonly claimed “best” MA were soy (37%) and pea (17%) (Table 1). Of blogs discussing soy milk, 29% mentioned risk of isoflavones/phytoestrogens; 23% of blogs discussing rice milk mentioned risk of arsenic. 14 blogs recommended making homemade milks, and 2 blogs claimed homemade milks as the best MA (i.e., “homemade [is] always better than store bought”; “make a more nutritious, fuller bodied and flavored milk”).

Conclusion: Online blogs provide a large source of information for caregivers seeking to switch their toddlers from dairy milk to MA. While a portion of blogs were authored by medical professionals, nearly half were written by laypeople lacking the proper training necessary to counsel others regarding MA or pediatric nutrition. The lack of consistency in information across blogs was concerning, revealing the need for greater dissemination of accurate information and pediatric recommendations regarding MA from medical professionals. Additionally, unsupported recommendations such as making unfortified homemade milks presents significant concern for growing toddlers. It is imperative that pediatricians and nutritionists have a greater online presence in order to guide MA-related recommendations and ensure the healthy development and nutrition of toddlers in early childhood.