Cow’s milk for infants and children

In 1992, the American Academy of Pediatricians released their statement regarding the use of whole cow’s milk during infancy. The findings were published in “Pediatrics” volume 89, number 6 in June of 1992. Plainly stated, the Academy recommended that whole cow’s milk and low-iron formulas not be used during the first year of life.

Infants fed whole cow’s milk receive inadequate amounts of Vitamin E, iron, essential fatty acids, and excessive amounts of protein, sodium, and potassium. These levels may be too high for the infant’s system to handle. Additionally, whole cow’s milk protein and fat are more difficult for an infant to digest and absorb.

The most dramatic effects are on iron levels in the body. Infants fed breast milk or iron fortified formula have normal iron levels. Recent studies show infants often have depleted levels when started on cow’s milk at six months of age.

Optimal nutrition in an infant involves selecting the appropriate milk source and eventually introducing the infant to solid foods. In achieving this goal, the American Academy of Pediatrics recommends that infants be fed breast milk or iron-fortified formula during the first twelve months of life. Between the ages of four to six months, appropriate solid foods may be added. Taking breast milk or iron-fortified formula, along with the age-appropriate solid foods and juices during the first year of life, allows for more balanced nutrition.

Skim or 2% milk:
Under one year of age, skim and 2% (low-fat) milk have no place in the diet. They supply too much protein, potassium, and sodium while not enough calories for the growing infant. Children also need the fat for proper growth and development including brain development.

Low fat milks are not the answer for an overweight baby. The desirable diet is the same as that of a normal weight infant; the amount is the only difference. Conferring with a registered dietitian or physician is recommended. The recommendation will probably be a reduction in the amount of intake, not the type of intake. A slight reduction of calories by reducing the amount will allow the infant to “grow into his weight” without a rapid change in body fat. Rapid weight loss can be dangerous, particularly in a small child. An extreme reduction of fat stores might not leave enough energy stores for the infant to combat a serious illness. Many physicians question the serious unknown consequences of a rapid loss of fat.

Suggested Intake - Infants:

  • Breast Milk:       o every 1-3 hrs for infants 0-3 months       o every 2-4 hrs for infants 4-5 months       o every 3-4 hrs for infants 6-8 months       o every 4-5 hrs for infants 9-12 months  
  • Iron fortified Formula:       o 18-40 oz. for infants 0-3 months       o 24-45 oz. for infants 4-5 months       o 24-37 oz. for infants 6-8 months       o 24-31 oz. for infants 9-12 months  
  • Dairy:       o none for infants 0-3 months       o none for infants 4-5 months       o none for infants 6-8 months       o small servings for infants 9-12 months

Suggested intake - children 2 to 5 years of age:

  • cow’s milk       o 6 servings/day       o one servings equals:           + 1/2 cup milk, yogurt, pudding           + 3/4 oz. cheese           + 1 cup cottage cheese

Suggested intake - teens and adults (The equivalent of one of the following is recommended):

  • milk/yogurt (1 cup)       o 3-4 servings/day  
  • 1 1/2 oz. natural cheese       o 2-3 servings/day  
  • 2 oz. processed cheese       o 4 servings/day

Johns Hopkins patient information

Last revised: December 4, 2012
by Amalia K. Gagarina, M.S., R.D.

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