by: Wyatt Myers
Most parents switch from breast milk (or formula) to pasteurized cow's milk around one year of age. A few months ago, we made the switch with our son, thinking it would be easy. But he flat-out refused to drink it—at first. We continued to try (using the tips in this article to coax!) until we finally succeeded, but a lingering question remained for me and my wife: Knowing how important breast milk and breastfeeding is for a child, was our son missing out on essential nutrients by making this switch from breast milk to cow's milk? Here, experts explain why many parents make the switch and how to handle the transition.
Why switch?
According to the American Academy of Pediatrics (AAP), once your baby celebrates his first birthday, you can begin to offer him cow's milk, provided he is eating a variety of solid foods (cereals, vegetables, fruits, and meats). Many parents continue to breastfeed beyond their child's first birthday. The World Health Organization actually recommends breastfeeding (in addition to age-appropriate solid foods) until a child is at least 2 years old given the many benefits of breastfeeding and human milk. But if you (or your baby) are ready to wean and your baby is at least 1 year old, you can safely transition to cow's milk.
Whole milk or low-fat?
Whole milk provides many of the important nutrients babies needs. If you're concerned (like we were) that your child might be missing out on important nutrients, don't be. According to Heather Russell, R.D., a pediatric registered dietitian at St. Joseph's Children's Hospital in Paterson, New Jersey, "It is appropriate to advance the child to whole milk after one year, so the child will continue to receive calcium, phosphorus, and vitamin D to help with development and growth of teeth and bones."
If a mother and her baby are ready to transition from breast milk to cow's milk, the consensus among our experts is that whole, vitamin D-fortified cow's milk is the best choice unless the child has weight issues. At this age, fat should make up about half of a baby's daily caloric intake, so the higher fat content in whole milk is essential. Babies also need the vitamin A available from whole milk.
However, according to the AAP, if your baby is overweight or at risk of being overweight, or you have a family history of obesity, high blood pressure, or heart disease, your baby's pediatrician might recommend 2 percent milk as an alternative. One percent or skim milk are not recommended until your baby reaches his second birthday. For babies with no risk factors, whole milk is preferred.
"I usually recommend whole milk until the second year of age due to its higher fat content, which is necessary for proper brain development and growth," says Russell. "However, in certain cases if the child is already overweight or has a history of cardiac issues such as high cholesterol, I would recommend 2 percent milk."
Some parents choose organic milk because of concerns over the use of bovine growth hormone in dairy cows. "There is no data concerning bovine growth hormone sufficient enough to recommend organic," says Ari Brown, M.D., a pediatrician in Austin, Texas, and co-author of Expecting 411, Baby 411 and Toddler 411. "Plus, some manufacturers of commercial non-organic milk are rBGH free now, too."
Tips for making the switch
Sometimes, switching to whole milk can be challenging not only for parents, but for the baby, too. At first, your baby might refuse to drink the milk, especially if he doesn't like the taste or isn't accustomed to drinking from a cup. Here are some tips for helping your baby transition to cow's milk:
- Gradually switch from breast or bottle to a cup before your baby's first birthday, says Dr. Russell, so that he can get used to drinking from another source.
- If your baby is rejecting the cow's milk because of the taste, start by combining it with breast milk. "Sometimes if mom can pump some milk and mix some of the cow's milk with it to get them used to the taste, that helps," says Kenneth Wible, M.D., medical director of the Pediatric Care Center at Children's Mercy Hospitals and Clinics in Kansas City. "Then they can gradually increase the percentage of cow's milk and reduce the amount of breast milk."
- Russell adds that persistence is key as you make the transition. "Parents might find it helpful to offer the milk in small spoonfuls or mixed with familiar foods until the child gets more accustomed to the new taste," she says. "Using a fun or colorful cup might also help to encourage the child to try the milk."
Generally, your 1- to 2-year-old should have between 16 and 24 ounces of milk each day. The AAP cautions parents to limit a baby's milk intake to one quart (32 ounces) per day. More than this can provide too many calories and may decrease a baby's appetite for other foods. Offer cow's milk at mealtimes, along with some water, or in between meals as a snack. If you're struggling with getting your baby to drink milk, you can try whole-fat yogurt made especially for babies, or calcium-rich vegetables like broccoli, Brussels sprouts, leafy greens, or pinto beans. Juices fortified with calcium or whole soy milk can also be good choices.
Some babies transition to cow's milk at age 1, others at age 2 or 3, and some never acquire a taste for cow's milk. Every baby is different. Your baby will let you know when he is ready for a new skill (drinking from a cup) and a new taste (cow's milk).