From the Guidelines
Babies should not have cow's milk as a primary drink until they are 12 months old. Before their first birthday, babies should be fed breast milk or iron-fortified formula as their main source of nutrition, as recommended by the Centers for Disease Control and Prevention 1, 2. Introducing cow's milk too early can cause intestinal bleeding, increase the risk of iron deficiency anemia, and put excessive strain on a baby's kidneys due to the high protein and mineral content. Cow's milk also lacks the proper balance of nutrients that infants need for optimal development. Some key points to consider when introducing milk to babies include:
- Breast milk or iron-fortified formula should be the primary source of nutrition until 12 months of age 1, 2
- Solid foods, including iron-rich foods and potentially allergenic foods like dairy, can be introduced at around 6 months, but not before 4 months, while continuing breast-feeding 3
- Whole cow's milk can be introduced as part of a balanced diet after 12 months, as toddlers need the fat content for brain development
- If there are concerns about milk allergies or intolerances, consult with a pediatrician before introduction 3
- Plant-based milk alternatives generally don't provide adequate nutrition for infants and young toddlers unless specifically formulated for them.
From the Research
Introduction to Milk Consumption in Babies
- The age at which babies can have milk varies depending on the country and recommendations 4.
- Most countries recommend waiting until 12 months of age to introduce cow's milk, while some countries suggest it can be introduced from 9 or 10 months 4.
Reasons for Delaying Milk Introduction
- The main reason for delaying introduction is to prevent iron deficiency, as cow's milk is a poor iron source 4.
- High milk intake (above 500 ml/day) can cause iron deficiency 4.
Types of Milk and Allergy Considerations
- Hypoallergenic formulas are available for babies with cow's milk protein allergy [(5, 6)].
- Extensively hydrolyzed formulas and amino-acid-based products have been shown to be effective in preventing allergy 5.
- Probiotics may also play a role in regulating cow's milk allergy in children 7.
Recommendations for Milk Introduction
- Intact protein formula should be offered to all bottle-fed healthy infants, irrespective of their allergic risk 8.
- Hydrolyzed formula may be advisable for short-term bottle feeding of otherwise breastfed babies in their first week of life 8.
- The use of prebiotic-, probiotic-, or synbiotic-enriched formulas should be considered in infants at risk of developing allergies 8.