What is the appropriate age for introducing cow’s milk into an infant’s diet?

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Why Do Infants Need Baby Formula Instead of Cow's Milk?

What is the appropriate age for introducing cow’s milk into an infant’s diet?
What is the appropriate age for introducing cow’s milk into an infant’s diet?

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​Many parents ask why they can't feed their baby regular cow's milk instead of breastmilk or formula. There are two main reasons: Infants cannot digest cow's milk as completely or easily as they digest breastmilk or baby formula. And, more importantly, cow's milk does not contain enough of certain nutrients that babies under a year old need.

During the current baby formula shortage, it may be OK for some babies over 6 months of age to have cow’s milk for a short period of time if no formula is available. If you aren’t able to find baby formula in stock anywhere, talk with your pediatrician and read more here.

Beyond digestion

Cow's milk contains high concentrations of protein and minerals, which can stress a newborn's immature kidneys and cause severe illness at times of heat stress, fever, or diarrhea. In addition, cow's milk lacks the proper amounts of iron, vitamin C, and other nutrients that infants need. It may even cause iron-deficiency anemia in some babies, since cow's milk protein can irritate the lining of the stomach and intestine, leading to loss of blood in the stools. Cow's milk also does not contain the healthiest types of fat for growing babies. For these reasons, your baby should not receive any cow's milk (or other non-human milk or milk substitute) until they are about 12 months of age unless no alternative is available.

Once your baby turns a year old

Once your baby is past one year old, you may give them pasteurized whole cow's milk or reduced-fat (2%) milk, provided they have a balanced diet of solid foods (cereals, vegetables, fruits and meats). But limit their intake of milk to 2 cups (about 16 ounces) per day or less. More than 24 ounces a day has been associated with iron deficiency if toddlers aren't getting enough other healthy iron-rich foods. If your baby is not yet eating a broad range of solid foods, talk to your pediatrician about the best nutrition for them.

At this age, children still need a higher fat content, which is why whole vitamin D-fortified milk is recommended for most infants after one year of age. If your child is or is at risk for overweight, or if there is a family history of obesity, high blood pressure or heart disease, your pediatrician may recommend 2% (reduced-fat) milk.

Age 2 and up

Do not give your baby 1% (low-fat) or nonfat (skimmed) milk before their second birthday, as it does not contain enough fat for brain development. After two years of age, you should discuss your child's nutritional needs with your pediatrician. However, many children at this age can transition to lower-fat milk if that is what your family uses.

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Last Updated5/11/2022SourceAmerican Academy of Pediatrics Committee on Nutrition (Copyright © 2022)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

You can introduce 3.25% homogenized whole cow’s milk at 9 to 12 months of age once your baby is eating iron rich foods at least twice a day. Continue to breastfeed your baby for up to two years or beyond. 

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From birth to 12 months of age, the base of the infant’s diet should be breast milk. According to Health Canada, for a baby who is not breastfed or is only partially breastfed, commercial cow’s milk-based infant formulas fortified with iron are the best substitute during the first year of life. 

It is recommended to wait until the baby is 9 to 12 months old to introduce cow’s milk. Why? To prevent nutrition deficiencies, kidney overload and intestinal damage. This is because the amount of cow’s milk is not suited for the baby’s needs. Cow’s milk also contains too many minerals (which put stress on the kidneys) and an insufficient amount of iron. Cow’s milk increases the risk of anemia if given to the baby before 9 months or in too large of a quantity. Finally, cow’s milk does not help protect the baby’s immune system the way breast milk does.  

How to introduce it?

In order to facilitate the introduction of cow’s milk, it may be helpful to progress over two weeks, replacing a small amount of breast milk or formula by cow’s milk. As for breastfeeding, sessions often only get shorter. The gradual introduction of cow’s milk allows both the baby and the lactating mom to adapt to the change. Once introduced, the minimal amount of cow’s milk to be consumed is 500 ml per day while the maximum amount is 750 ml per day. The child’s appetite could be affected if they drink too much milk.

What type of milk to introduce?

3.25% fat, pasteurized cow’s milk with must be offered until the age of two at least. Partially or entirely skimmed cow’s milk is not recommended before this age since it does not provide enough energy and essential fats. Fortified plant beverages are not recommended either because they do not provide enough energy and fat. After one year of age, only soy beverages should be given to the child, but their diet should be adapted to compensate for the low amount of fat in these beverages.

From the age of 2, 2% milk can be given to the child, but 3.25% cow’s milk can also be offered until the age of 5 years.

Other aspects to consider

Regular cow’s milk is not recommended in cases of intolerance or allergy. If a child is lactose intolerant, different measure might be taken so they child can still drink milk.

It is recommended to continue supplementation with vitamin D, even if the baby reaches the age of 12 months and consumes cow’s milk.

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When should cow's milk be introduced into an infant's diet?

When Should I Introduce My Child to Cow's Milk? At 12 months old (but not before), your child can be introduced to cow's milk. Before your child is 12 months old, cow's milk may put him or her at risk for intestinal bleeding.

Can I start my baby on whole milk at 10 months?

When your baby is 9 to 12 months old and eating a variety of iron-rich foods, he or she can start to drink pasteurized whole-fat cow's milk. Limit cow's milk to no more than 3 cups (750 mL) per day for children 9 to 24 months old.

Is it OK to give 6 month old cows milk?

You should give your baby only breast milk or iron-fortified formula during the first 12 months of life, not cow's milk. Starting at age 6 months, you may add solid foods to your baby's diet.

At what age can an infant be fed cows milk quizlet?

Therefore, fresh cow's milk should not be given to children before 12 months of age, as it may cause iron-deficiency anemia due to gastrointestinal bleeding.