Offering whole milk after one year of age: Is it really necessary?
My clients and students often ask - is cow's milk something all kids need? Most parents hear from pediatricians not to provide cow's milk prior to one year of age, but after the child turns one year old, to start providing a few cups per day. Below, I examine the recommendation and the nutrition facts parents should know.
Why no whole milk before one year of age?
Whole milk is on the list of foods not to provide to your baby until they are one year old, because pediatricians do not want to replace the breastmilk or formula your child is receiving with whole milk. The nutrients in whole cow's milk are significantly different from the nutrients in breast milk and formula, and are not what your infant needs at this time. Whole milk has more protein, less fat and carbohydrates than breastmilk or formula, and a different variation of some key vitamins and minerals. For older infants starting solids or purees, using whole milk in a recipe is typically fine as are other dairy products like cheese and yogurt. I review the practicalities of this in detail in my class, Introduction to Solids.
Can I meet my child's nutritional needs without whole milk?
Yes. I recommend families start by thinking about offering a variety of fruits, vegetables, lean proteins and whole grains. At this age, variety is key. Here are some foods that are high the same nutrients that are provided by milk:
Saturated fat: full fat cheese, full fat yogurt, coconut milk, avocado, oils
Protein: fish, beef, chicken, turkey, lentils, beans
Calcium: yogurt and cheese, nuts, beans, greens, legumes, kale, salmon, chia seeds
Vitamin D: mushrooms, egg yolks, fatty fish (some doctors may recommend your child take a supplement)
[Further Reading: Cows' Milk in Complementary Feeding ]
Wait a minute- are you saying not to provide whole milk to my child?
To be clear - my primary message is that parents have choices. Milk can be part of a child's balanced diet. BUT there are alternatives if you prefer not to provide this to your child (or your child is refusing milk). Additionally, keep in mind the recommendation for milk is 16-24 oz per day (2-3 cups per day). Too much milk can fill of a child's small tummy and may not leave room for other solid foods, which can deliver some of the other nutrients such as iron. [Further Reading: American Academy of Pediatrics Committee on Nutrition: The use of whole cow's milk in infancy.]
What about non-dairy milk alternatives?
I typically do not recommend a non-dairy milk to replace whole cow's milk in a young toddler's diet. Most (not all) non-dairy milks are fortified with Calcium and Vitamin D, which is helpful, but those beverages do not have significant fat, calories or protein, which are very important after one year of age. If you are thinking about using a non-dairy milk, don't think of it as replacing cow's milk, but in addition to you child's balanced diet, and do check the nutrients listed above to be sure it is adequate. And note not all non-dairy milks are created equally, there are some non-dairy alternatives that are similar in nutrients to cow's milk, like soy and hemp milk.
Have other questions about milk? Contact me or let me know in the comments below.