Young children who drank nondairy replacement milks instead of cow’s milk were more like to have low levels of vitamin D in their blood, a new study found.

Parents often choose non-dairy beverages, such as almond, soy, or rice milk, for kids who have milk allergies or lactose intolerance. Some parents believe these beverages have health benefits even for kids who can drink regular milk.

“Parents ask their child’s doctor quite frequently whether alternate milk is good for their children,” Dr. Jonathon Maguire told Reuters Health in a phone call.

“And we as doctors have trouble answering that question – it depends on a lot of factors, and one of the things it depends on is whether they can maintain children’s vitamin D stores as well as cow’s milk,” said Maguire, a pediatrician at St. Michaels’ Hospital in Toronto, Ontario who led the study.

Vitamin D helps the body absorb calcium, so it’s essential for strong bones and teeth. It’s normally produced by the body after the skin is exposed to sunlight. Manufacturers also add it to certain foods, such as milk and dairy products.

In the U.S. and Canada, cow’s milk must be fortified with vitamin D, but there is no such requirement for non-dairy alternatives, Maguire said.

“Our findings suggest that children are about half as likely to maintain adequate vitamin D levels when drinking non-cow’s milk and it behooves us as parents to be aware that both in Canada and United States, non-cow’s milk is not legislated to contain vitamin D,” Maguire said.

For a study reported in the Canadian Medical Association Journal, Maguire and colleagues collected information on amounts and types of milk consumed by 2,831 Toronto preschoolers who also had tests for vitamin D levels.

Eighty-seven percent of the children drank predominantly cow’s milk, and 13 percent drank non-cow’s milk.

The researchers found low vitamin D levels in 5 percent of children who drank only cow’s milk, compared to 11 percent of children who drank only the milk substitutes.

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