: Cow's milk not suitable for babies during
most of the first year
DEAR DR.PAUL: My daughter is almost one year old and has
been on baby formula all of her life. When should I stop giving
her formula? I am also feeding her baby food. Thanks.
PEDIATRICIAN DR.PAUL ANSWERS:The answer to your question
today, differs from what I would have replied over 10 years
ago. Currently, The Canadian Pediatric Society recommends breast
milk or iron-fortified formula for the first 9-12 months.(The
American Academy of Pediatrics recommends that babies not be
given whole cow's milk for the first 12 months of life). There
are many reasons for this, but the most important is related
to the iron needs of a child. Iron is an essential part of red
blood cells. When the body does not have enough iron to make
red blood cells "anemia" (or decreased level of red blood cells)
will develop. Normally, babies are born with enough iron in
their body for the first few months of life. However by 3-4
months, extra iron is needed. This extra iron should come from
the child's diet and this is why iron-fortified formula is recommended
for infants who are not breast-fed.
For a variety of reasons, whole cow's milk is considered to
be a very poor source of iron. In addition, the protein in cow's
milk is not easy to digest by babies. By far, the best source
of iron, and other nutrients for a baby is breast milk. For
this reason breastfeeding should continue for as long as possible.
However when breastfeeding is not an option, baby should be
drinking iron-fortified formula which contains enough iron and
all other essential vitamins and nutrients to support normal
growth and development. In addition, infant formulas contain
modified cow's milk protein that a baby can more easily digest.
Prior to the current recommendation, babies were switched to
whole cow's milk at 6 months of age, or even earlier. The reason
that the period on iron-fortified formula or breast milk has
been extended is that studies have shown a surprising amount
of iron deficiency anemia in children less than a year of age.
We also now recognize that iron deficiency anemia in the first
year has been linked to developmental delays, that unfortunately,
in some cases are not reversed by adding iron to the diet later.
Therefore prevention of iron deficiency anemia is our
goal.
As you can see, whole cow's milk is not suitable for most of
the first year of life. While the exact timing of the switch
should be discussed with your doctor, whole cow's milk should
only be introduced when baby is eating adequate amount of solid
foods containing iron and vitamin C, preferably between 9 to
12 months of age. On a final note, remember, when the switch
is made, it should be to be to whole cow's milk only, as skim
or 2% milk are not recommended for children less than 2 years
old.
The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
