The American Academy of Pediatrics recommends that babies be breast-fed for at least 12 months and thereafter for as long as mutually desired. The only acceptable alternative to breast milk is infant formula iron fortified and solid foods can be introduced gradually when the baby is 6 months old, but a baby should drink breast milk or formula, not regular cow’s milk, for a full year.

“There aren’t any rules about when to stop breast-feeding,” says Ruth Lawrence, M.D., professor of pediatrics and obstetrics at the University of Rochester School of Medicine in Rochester, N.Y., and spokeswoman for the academy. “As long as the baby is eating age-appropriate solid foods, a mother may nurse a couple of years if she wishes. A baby needs breast milk for the first year of life, and then as long as desired after that.” Formula, however, should not be continued after the first birthday. That’s the time to introduce milk. For all babies the milk, however, should be whole milk. Low-fat and skim milk do not have enough fat and calories to supply the nutritional needs of a 1-year-old, explains John Udall, chief of nutrition and gastroenterology at Children’s Hospital of New Orleans. At that age, “the child is growing so quickly, and the fat is so important for brain and central nervous system development,” he says. “The recommendation that our daily intake of fat should compose less than 30 percent of our caloric intake does not apply to children under 2 years of age.”

New on the market are special toddler formulas that claim to be better than milk. The formulas are good nutritionally, says Udall, but they’re not necessary. “A well-balanced diet with milk and juices would be just as good in a healthy, normally active, normally growing child,” says Udall.

William Klish, former chairman of the American Academy of Pediatrics Committee on Nutrition, says that if a child needs to take a vitamin supplement, the toddler formula, fortified with a full range of vitamins and minerals, including iron, can serve that purpose. In addition, the toddler formulas don’t need refrigeration, making them a convenient choice for snacks away from home.

–I.S.

About this Article:
Provided by FDA.

By Lisa Barnes

We all have heard “milk does a body good” – but what kind of milk? While some milk is fine for some, many others, especially children are allergic or intolerant from their first drink. An estimated 30 million Americans have some kind of lactose (the milk sugar in all dairy products) intolerance, and more than 100,000 babies are thought to suffer from milk allergies.

There is a difference between lactose intolerance and milk allergies. Children with lactose intolerance are deficient in lactase, an enzyme produced internally to break down lactose. This can result in stomach aches, gas and diarrhea. However children allergic to milk have reactions to some or all of the proteins: casein, whey, and lactalbumin. The adverse effects can cause gastric problems as well as skin issues such as rash, and eczema, and nasal distress such as runny nose and congestion. These reactions can come as soon as babies are breastfed (by mothers ingesting dairy products) or given milk based formulas.

The good news is that most children outgrow a milk allergy by the age of 4, according to Paul Ehrlich, M.D., pediatrician, allergist and clinical assistant professor at New York University School of Medicine. Plus he says, “the more attentive you are to keeping milk out of your children’s diet, the sooner the allergy with go away.”

Today many people are asking which milk is the best choice for their families and children. Some households have more than one kind of milk and milk alternative to satisfy different ages, dietary restrictions and tastes. In addition to considering the various cow’s milk alternatives, many parents of children who can drink cow’s milk are buying organic brands to minimize the exposure of the hormone bovine somatotropin (bST) or recombinant bovine growth hormone (rbGH), which some pediatricians and nutritionists such as Robert Pastore, Ph.D suspect as an agent of premature development in children.

So what milk or milk alternative should you buy? Here are some options. And no matter which brand or alternative you try, choose those with fortified calcium, magnesium and vitamin B-12, which makes cow’s milk such a nutritional giant. Let’s discuss your options:

Almond Milk
Not high in protein (only two grams per 8 ounces, as compared with 8 grams in cow’s milk) this naturally sweet beverage does have some beneficial fats and calcium. Because of the smooth and creamy texture it also works well for cooking and baking. Almond milk is not an alternative for those with nut allergies.

Goat Milk
Coat’s milk has only slightly less lactose than cow’s milk, making it an inappropriate alternative to those with intolerance. However it does have different proteins from cow’s milk, so may be a good choice for some with allergies. Goat’s milk is slightly sweet and salty with a fat level and consistency similar to whole cow’s milk.

Rice Milk
This is the least allergenic milk alternative, as it is suitable for children with milk intolerance and allergies. However it is lower in protein and much thinner in consistency than cow’s milk. Young children not getting enough protein from food sources, should not substitute rice milk.

Oat Milk
Oat milk is high in fiber however low in protein. Oat milk has a slightly sweet taste and light consistency. It is highly tolerated by most kids who have soy, rice and milk allergies. However it is not acceptable for children with celiac disease or other wheat and gluten intolerances and allergies.

Soy Milk
This is high in protein and the most popular cow’s milk alternative. However recent research and questions have arisen over soy’s phytoestrgen levels and possible link to interference with children’s hormonal and sexual development. Pediatrician’s caution not to give more than 2 serving a day to children.

About the Author:
Lisa Barnes is the founder of Petit Appetit, a culinary service devoted to the palates and health of infants and toddlers. She teaches in-home private cooking classes to parents, nannies, mothers’ groups, and parenting resources throughout Northern California and is the author of The Petit Appetit Cookbook (published by Penguin Books, March 2005). For more information on Petit Appetit, The Petit Appetit Cookbook or to sign up for a free email newsletter, go to http://www.petitappetit.com.

Before 12 Months
It seems like it would be so much easier, as your baby gets older, to just give him a bottle or sippy cup full of cow’s milk from the fridge. For formula feeding moms not only is it easier, but much cheaper. However, your doctor tells you not too. This brings up the question, why is cow’s milk bad for your baby?

Breast milk and formula are specifically designed to be sensitive for your baby’s belly. Cow’s milk has certain proteins in it that breast milk and formula do not have. A baby’s digestive system is not capable of processing these proteins, and the lack of processing can make your baby sick. Cow’s milk also has a large amount of sodium, potassium and chloride that can be hard on your baby’s kidneys.

During your baby’s first year, it is important that he get the right amount of vitamin E, zinc, iron and other vitamins and minerals that cow’s milk does not have. These vitamins are found naturally in breast milk and are added to formula. Cow’s milk could lead to an iron deficiency in your baby and in some rare cases cause internal bleeding. It can also lead to dairy allergies as your baby gets older.

There is no doubt that cow’s milk can be more convenient that formula, but until your baby turns a year you should steer clear of giving him cow’s milk.

After 12 Months
Once your baby hits his first birthday and has his one year well-check, if your pediatrician gives the ok for you to give your baby cow’s milk, there are a lot of benefits to your baby. In most cases, for that second year of life, you will be told to give your baby whole, vitamin D milk. It is because this milk has the highest concentrate of vitamins that your baby still needs to grow. A great source of calcium, phosphorus, vitamin A, and magnesium, whole milk will help your baby’s bones and teeth grow and become strong.

Now that your baby’s digestive system has matured, milk will give him the protein that he needs to run and play during the day. Calcium is important to a baby’s future health because it can help prevent later cases of certain types of cancer, high blood pressure, stroke and other medical emergencies later in life.

If Your Baby Won’t Switch
If you are lucky your baby will make the switch to cow’s milk smoothly and easily. If you are not lucky, your baby may fight the change. This could happen for any number of reasons. Milk has a different texture, temperature, color and taste from the breast milk or formula that you have been feeding your baby, and your baby may not want to adjust. If this happens try making it a gradual process. Try giving your baby cow’s milk straight from a sippy cup, instead of through a bottle. Also, try mixing cow’s milk and your breast milk or formula, slowly increasing the amount of cow’s milk, until it is only cow’s milk. If he won’t take it through a sippy cup, try spoon feeding it to him, or mixing it in with cereal and other baby food until he gets used to the taste.

To insure that your baby is as healthy as possible, ask your pediatrician about what he recommends when it comes to giving your baby cow’s milk. If you feel that your baby is not taking to cow’s milk well, then speak with your pediatrician to see if he thinks there is a problem, or has any suggestions for you to try.