Some time ago, many mothers fed their children cow’s milk. Either because they couldn’t afford formula, or because they didn’t know that giving cow’s milk to babies is not recommended for some time.

When Can Babies Drink Cow’s Milk?

Officially, milk can be a child’s primary drink at one year of age. Before this milestone, cow’s milk should not be part of a baby’s diet1.

Why Not Give It?

The baby’s stomach is not ready to digest cow’s milk in large volumes (600 to 1 liter daily, as with breast milk or formula) until they are about one year old. Cow’s milk is not recommended for babies for the following reasons:

  • Compared to breast milk and formula, cow’s milk for babies is low in iron, linoleic acid, and vitamin E
  • Cow’s milk has a lot of sodium, potassium, chloride, and protein, which can be very harmful for the baby’s kidneys.
  • Early introduction of cow’s milk can cause microscopic gastrointestinal bleeding and blood loss in up to 40% of full-term infants (this risk is higher in premature babies)
  • Cow’s milk can cause an allergic reaction; approximately 0.3 to 7.5% of all children who consume it.
  • Consumption of cow’s milk before the age of 1 has been associated with iron deficiency anemia in children2.

The Importance of Milk at the Right Age

But once the baby is ready to have cow’s milk, it will play an important role in a child’s healthy diet. According to nutritionists, cow’s milk for babies and the consumption of its derivatives ensures that children get important nutrients and have healthier diets than those who don’t. Why? Because milk:

  • Provides nutrients such as protein, calcium, and potassium;
  • Contains important vitamins, including vitamins A, B, and D;
  • Helps build strong bones, teeth, and muscles;
  • Reduces the risk of osteoporosis in old age.

How Is the Transition to Cow’s Milk Made? Understanding how to introduce cow’s milk is just as important as knowing when babies can drink milk. It’s ideal to introduce milk and its derivatives only after 1 year of age. Many mothers wonder if giving cow’s milk to a baby means they have to stop breastfeeding, but the answer is no. They can still breastfeed while transitioning to cow’s milk, remembering that the decision to stop breastfeeding is a personal one, and there is no set time limit.

How Much Milk Should Children Drink?

In general, the recommendation is around 480 ml, that is, 2 cups of milk per day. Of course, 2 cups doesn’t seem like much, but offering cow’s milk to a baby is different from giving formula or breast milk. Milk does not become the child’s main source of nutrition, and there is no need to increase the amount as the baby grows. At most, it may reach 600 ml daily, because exceeding this amount can hinder iron absorption, causing iron deficiency in the body.

Tips for Transitioning to Cow’s Milk

Some babies simply don’t like the taste of cow’s milk at first, but there are some things you can do to improve acceptance:

  • Warm the milk – The cold temperature of the milk can be a bit surprising, especially if the baby is used to the temperature of breast milk.
  • Mix with formula or breast milk – Mixing cow’s milk with formula or breast milk, gradually increasing the amount of cow’s milk, will help the baby get used to the taste and complete the transition. Eventually, the baby will get used to all types of milk.

Bottle or Training Cup?

Doctors recommend switching from a bottle to a training cup. That’s because the bottle’s nipple can cause dental problems for the baby in the future. But not all babies are ready to make both changes at the same time. First, transition to cow’s milk and then switch the bottle for a cup so the change is smoother.

How to Detect Lactose Intolerance or Milk Allergy

Sometimes children don’t drink milk not because of a problem with the taste, but because they are allergic to cow’s milk or are lactose intolerant. Usually, parents will discover this at the time of transition to milk3. There is an important difference between a milk allergy and lactose intolerance. A food allergy involves the immune system and is due to an exaggerated reaction to the food eaten, which triggers a series of unpleasant and potentially dangerous symptoms. Lactose intolerance, on the other hand, is caused by the lack of the enzyme lactase, which is needed to help digest milk. The main difference: while lactose intolerance may cause a great deal of discomfort, it will never lead to a fatal reaction, such as anaphylaxis, which can be triggered by an allergy. According to some researchers, about 2 to 3% of children under 3 years old are allergic to milk, which is why it is important not to give cow’s milk to babies before the appropriate age. Lactose intolerance in childhood is less common, but becomes more frequent with age: it is estimated that around 65% of people have a reduced ability to digest lactose after childhood. So how do you know if your child has a real milk allergy? According to Sujan Patel, MD, pediatric allergist at the Hassenfeld Children’s Hospital at NYU Langone in New York, the most common symptoms of a milk allergy are:

  • Hives or itching, usually around the mouth, neck, and arms
  • Redness all over the body
  • Vomiting
  • Diarrhea
  • Swelling of the eyes, lips, and ears during more severe reactions

Symptoms of lactose intolerance include:

  • Bloating
  • Cramps
  • Nausea
  • Gas
  • Diarrhea

“There are no skin rashes that occur with lactose intolerance,” says Patel. Another difference is that with a milk allergy, all dairy products will trigger symptoms, whereas with lactose intolerance, some dairy products that are low in lactose, such as certain cheeses like parmesan and semi-cured cheeses, may not cause problems.” If you suspect your child has a milk allergy, the best thing to do is to consult a pediatric allergist. If the child is allergic to cow’s milk, other mammalian-based milks, like goat and sheep milk, are likely also off the table, because the proteins in those types of milk are very similar to those found in cow’s milk. It is also important to know that a milk allergy may not last for life. Around 80% of children will outgrow a milk allergy by age 16, and most will overcome it by kindergarten age.

Lactose-Free Milk for Babies

Yes, for lactose intolerance, as long as the necessary amount of calcium is ensured and after 1 year, you can offer lactose-free cow’s milk and milk products. If the baby is on infant formula during complementary feeding from 6 months to 1 year, it is ideal to include a lactose-free option. Also, invest in calcium-rich foods such as broccoli, almonds, peanuts, and spinach, if the baby is older than 6 months. When a breastfed baby has lactose intolerance, it’s important for the mother to eliminate lactose-containing foods from her own diet, as they can pass into breast milk and cause symptoms such as bloating, gas, and discomfort in the baby. If the baby only uses a bottle, a lactose-free formula should be used. Nowadays, there are a variety of lactose-free milks and formulas available in stores. The important thing is to talk to your pediatrician to determine the type of milk that is right for your child. Also See: CMPA – Cow’s Milk Protein Allergy Photos: Endre Majoros