Ask the Nutritionist

Types of Milk: Which One Is Right For You?

How to make sense of all the different options in the dairy aisle.

Q: I think milk is causing my digestive upset and sinus congestion. But I’m not sure if all milk products cause me trouble, or if I’m just choosing the wrong type of milk. There are so many options out there: rBGH-free, grass-fed, non-GMO, organic, and many more. What’s the difference? —Annabelle T., Portland, Ore.

A: First, let me say up front that our bodies have similar trouble handling certain proteins in milk as they do with the gluten in wheat. Cow’s milk is one of the most common food allergies in the country, and milk allergy as well as lactose intolerance contribute to digestive distress of all types, including diarrhea, cramps, bloating, gas, and gastrointestinal bleeding, as well as many cases of asthma, sinus congestion, ear infections, and skin rashes.

If you think that you have a problem with milk, I recommend that you stop consuming all dairy products to see if that alleviates or lessens your symptoms. If you respond positively to dairy elimination, you can try different types of dairy to find out if there’s one you can tolerate. Or you may discover that life is just better without dairy altogether.

Keep in mind that most of today’s cows aren’t the same as the cows from our great-grandparents’ time. Modern cows have been bred to increase milk production, and sometimes are injected with genetically modified recombinant bovine growth hormone (rBGH), also known as recombinant bovine somatotropin (rBST). They’re also typically raised on feed that contains genetically modified organisms (GMOs). All of these factors can produce problematic milk.

Some people who can’t tolerate conventional milk do better with natural alternatives. And it’s important for anyone who drinks or cooks with milk to understand all the options and how they differ. Here’s a handy guide:

Did You Know?

Cow’s milk is one of the most common food allergies in the United States.


There are two main types of the beta-casein protein found in milk: A1 and A2. Conventional cows’ milk contains both, while A2 milk comes from cows that naturally produce only A2.

Research has shown that the A2 protein does not cause digestive discomfort for some people, so A2 milk may be an option for those who aren’t allergic to cows’ milk, or who haven’t been medically diagnosed with lactose intolerance.

While it is free of added hormones, rBGH, and antibiotics, A2 milk is not organic, meaning it comes from cows fed conventional feed. A2 milk has been available in Australia for a decade, but is still relatively new to the U.S.


Lactose-free milk is enriched with lactase, an enzyme that helps break down lactose, the naturally occurring sugar in milk. When your body is deficient in lactase, you might experience lactose intolerance symptoms such as gas, bloating, or diarrhea after you eat milk products. Some people notice an improvement when they consume lactose-free milk. They also notice that the milk tastes sweeter. To avoid GMOs and pesticides, look for lactose-free milk that is also organic, such as Organic Valley.

Goat Milk

While the fat content of cow’s milk and goat milk is similar, the fat globules in goat milk are smaller, making it easier for the body to digest. It is also lower in lactose than cow’s milk, and it contains mostly A2 casein, with only trace amounts of the major protein to which many people are allergic, A1 casein.

The taste and smell of goat milk differ from those of cow’s milk, and may take some getting used to. You can use it as a substitute for milk in recipes, but bear in mind that when heated, it often has a distinct “goat” flavor, so it often works better in cold dessert recipes. Brands of goat milk include Meyenberg and Summerhill Goat Dairy.


Recombinant bovine growth hormone, which was developed from genetically engineered E. coli bacteria, is injected into some cows to increase milk production. Though farmers are not required by law to label whether or not their cows are treated, many producers who do not treat their cows include “rBGH-free” on their label. This is important information to know because rBGH has been banned in Europe and Canada, and cows that are given rBGH injections are more prone to numerous health problems.

The rBGH-free/rBST-free label only lets you know that the milk comes from cows that have not been treated with the growth hormone. It does not tell you anything about the type of feed the cows were fed.

Non-GMO Project Verified

Non-GMO Project Verified milk goes a step further than rBGH-free milk: It comes from cows that are not treated with rBGH and that are also fed non-GMO feed. Some dairy farmers go to Non-GMO Project Verified on the pathway to becoming certified organic.


According to organic regulations put in place by the U.S. Department of Agriculture, USDA organic milk must come from cows that have not been treated with antibiotics and have not been given hormones—for either reproduction or growth. Additionally, at least 30 percent of the cows’ diet must come from pasture. (That’s the minimum. Farmers in more temperate regions are expected to let their cows graze on pasture as much as possible.) And the rest of the cows’ feed must be grown without chemical fertilizers, pesticides, or GMOs. Organic milk brands include Amish Country Farms Organic and Clover Organic. Other good organic brands can be found on the Dairy Report and Scorecard on the Cornucopia Institute website (


The term “grass-fed” is not regulated by the USDA, and some milk products with “grass-fed” on their labels aren’t derived from 100 percent grass-fed cows. That’s unfortunate, because grass—not grain or soy—is the natural food for cows. Grass-fed cows are healthier, and their meat and milk are more nutritious, than their corn-fed counterparts. Grass-fed dairy products contain higher amounts of beta-carotene, omega-3 fatty acids, and conjugated linoleic acid. And the manure from pasture-raised cows replenishes the soil, improving the quality of the crops grown in it, which in turn reduces erosion and water pollution. Look for products labeled “100% grass-fed.”

My take: If you’re going to use milk, seek out organic and 100% grass-fed brands, such as Maple Hill 100% Grass-fed Organic Milk. Grass-fed gives you the best nutrition, and organic is the best way to avoid GMOs and pesticides.

A Word about Milk Alternatives

Unlike milk, which comes from animals, milk alternatives are derived from plant foods. If you have a milk allergy, you can find substitutes made from almonds, cashews, coconut, hazelnuts, flax, rice, or soy in natural food stores.

Unlike milk, which comes from animals, milk alternatives are derived from plant foods. If you have a milk allergy, you can find substitutes made from almonds, cashews, coconut, hazelnuts, flax, rice, or soy in natural food stores. Beware: Each of these can be allergenic to some people, so be careful about the substitute you choose.

Also, many milk alternatives are sweetened with sugar or other sweeteners. For blood sugar and weight control, look for unsweetened varieties.