Updated Recommendations on Introducing Cow’s Milk to Babies
Parents often find themselves overwhelmed by conflicting advice regarding what to feed their babies. The World Health Organization (WHO) has recently updated its guidelines, suggesting that formula-fed infants can transition to cow’s milk at six months. However, this differs from the advice given in some countries, such as Australia, where it is recommended to wait until 12 months. This discrepancy can lead to confusion among parents and healthcare professionals alike.
What Does the Latest Guidance Say?
Last year, the WHO revised its global feeding guidelines for children under two years old. As part of these updates, the organization stated that babies who are partially or fully formula-fed can be introduced to whole animal milks, such as full-fat cow’s milk, starting at six months. This recommendation was based on a comprehensive review of research comparing the growth, health, and development of babies fed infant formula with those receiving pasteurized or boiled animal milks.
The review found no significant differences in growth and development between the two groups. However, it did highlight an increased risk of iron deficiency anemia in babies consuming fresh animal milk. This issue can be mitigated by ensuring babies receive iron-rich solid foods daily from six months onward.
According to the WHO, animal milks suitable for infants include pasteurized full-fat fresh milk, reconstituted evaporated milk, fermented milk, or yogurt. Flavored or sweetened milk, condensed milk, or skim milk should be avoided.
Why Is There Controversy?
Australian government guidelines currently advise against giving cow’s milk as the main drink to infants under 12 months. This seems to contradict the WHO’s updated recommendations. However, it is important to note that the WHO’s guidance is primarily directed at governments and health authorities rather than directly at parents.
The Australian dietary guidelines are currently under review, and the latest WHO advice is expected to influence this process.
The Importance of Iron for Babies
Iron is essential for everyone, but it is particularly crucial for babies due to its role in growth and brain development. Babies typically have enough iron stored from the final weeks of pregnancy to last until they are at least six months old. However, certain factors—such as premature birth, early umbilical cord clamping, or maternal anemia during pregnancy—can reduce these iron stores.
Cow’s milk is not a good source of iron. Most infant formulas are made from cow’s milk and contain added iron. Breastmilk, while low in iron, has higher bioavailability compared to cow’s milk. Therefore, babies should not rely solely on milk for their iron intake after six months. The WHO emphasizes the importance of introducing iron-rich solid foods, including:
- Meat
- Eggs
- Vegetables, such as beans and green leafy vegetables
- Pulses, like lentils
- Ground seeds and nuts (e.g., peanut or other nut butters, without added salt or sugar)
Allergies and Other Concerns
Some parents worry that giving whole cow’s milk to babies may cause allergies. However, there is no evidence to suggest that whole cow’s milk is more likely to cause allergies than cow’s milk-based infant formula.
Options for Parents
The WHO’s recommendation that formula-fed babies can switch to cow’s milk from six months could be cost-effective. Infant formula is significantly more expensive than fresh milk, which can be a financial relief for many families. In cases of supply chain disruptions, such as natural disasters, fresh cow’s milk can serve as a viable alternative.
It is also important to note what has not changed in the latest feeding advice. The WHO still recommends exclusive breastfeeding for the first six months, followed by continued breastfeeding up to two years or more. Infants under six months who are not breastfed or require additional milk should continue using infant formula.
Toddler formula for children over 12 months is not recommended. In Australia, all infant formulas must meet strict nutritional and safety standards, meaning the cheapest options are just as effective as the most expensive ones.
Key Takeaways
The key message is that babies can safely transition from infant formula to fresh, full-fat cow’s milk at six months as part of a balanced diet that includes iron-rich foods. Cow’s milk can also be used to supplement or replace breastfeeding, provided it is accompanied by appropriate solid foods.
If you need assistance with breastfeeding or introducing solids, local health organizations can provide support and guidance.
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