From Formula to Cow’s Milk


A KidNutriYum reader has asked me to discuss the transition from baby formula to cow’s milk. There are three main questions that need to be addressed namely, when, why, and how?

The recommendation for the average healthy baby is to transition from formula to cow’s milk at one year. That being said, if your child is under or over weight, or your baby is not eating at meal time, you should discuss when the optimal time for the transition is for your baby with your doctor. (also consult with your doctor regarding the guidelines for cow’s milk as discussed below)

The reasons for which we do not transition prior to one year are as follows:

  • An infant’s digestive system is too immature to digest cow’s milk proteins

  • There is simply too much sodium, potassium, and chloride in cow’s milk (an infant’s Kidneys cannot handle this)

  • Baby formula is fortified with all the vitamins and minerals required for growth in the first year

  • Giving cow’s milk to an infant can increase the risk of having an allergic reaction

The reasons for which we do transition to cow’s milk at one year are as follows:

  • Milk is a great source of calcium, phosphorous, and Vitamin A, and most milk is fortified with Vitamin D to help calcium absorption.

  • A one year old baby should start getting increasing levels of nutrients from food (fortified formulas should not be their main source of nutrition).

The following are guidelines for cow’s milk:

  • Parents should be transitioning their babies to 3.25% milk since they require the higher fat and calories for growth and development

  • A one year old baby should drink between 16-24 ounces of milk per day. Too little can result in a lack of calcium for proper bone and teeth development, and too much milk can hinder iron absorption. In addition to this, if the baby is drinking too much milk, this will decrease his or her appetite for mealtime.

Some babies transition to cow’s milk seamlessly. If your baby is generally easy going and adapts well to change, you may consider going cold turkey. Unfortunately it isn’t always that easy and the transition may take several weeks. If your baby does not adapt easily, here are a few recommendations that will help smooth out the transition period:

  • Try offering small amount of cow’s milk on a spoon as “desert” and wait for your baby to ask for more

  • Start mixing it into cereal (if you haven’t already) so that your baby acquires a taste for it

  • Dilute the formula slowly with cow’s milk. Start with ¾ formula and ¼ cow’s milk and gradually work your way through to the full transition

  • If your baby drinks cow’s milk, but simply won’t consume the 16 oz minimum, try sneaking it into meals and snack time – make puddings, shakes, soup with milk, milk based pasta sauces, etc.

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