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Blend the milk and cottage cheese in a high speed blender until smooth.
Heat the olive oil a medium saucepan over medium heat. Add the minced garlic and cook until fragrant, 1-2 minutes. Turn the heat down to medium-low and pour the cottage cheese mixture into the pan with the parmesan cheese and Italian seasoning.
Stir to melt the parmesan cheese and simmer for 8-10 minutes until the sauce is heated and reduced slightly. The alfredo sauce should easily coat the back of a spoon. Taste and add salt and pepper as needed.
While it’s simmering, make the pasta according to the package directions until al dente. Reserve ½ cup of the pasta cooking water and drain the rest from the pasta.
To serve with pasta, add the cooked pasta to the pan with the cottage cheese alfredo sauce and use tongs to gently toss. Let it simmer for 1-2 minutes and add any reserved pasta water to thin the sauce as needed. Transfer to bowls and top with meat or vegetables of choice.