Do I need to stop baby formula milk?
When your baby approaches their first birthday you may start thinking about weaning off formula and on to whole cow’s milk.
Formula mimics the nutritional composition of breast milk and contains suitable amounts of nutrients like protein, fats, and minerals tailored to support optimal growth for the first year of life.
From 12 months, you can switch over to whole cow’s milk, but you don’t have to.
Formula contains far more nutrients than cows milk (or any of the plant milks) and so you may want to continue for a bit of nutritional peace of mind.
When do babies stop drinking formula?
Babies under one year of age have immature kidneys and digestive systems which aren’t fully developed to process the minerals and proteins found in milk. When cow’s milk is given in larger quantities it can also put babies at risk of iron deficiency anaemia, allergies and diarrhoea and vomiting.
This is why we recommend only giving cows milk in small quantities such as on cereal or mixed into a cheese sauce in the first year.
Current recommendations state cows’ milk as a main drink can be introduced at 1 years of age as babies are mature enough to be able to digest milk properly at this age. Therefore, this is when you can start to wean your baby off infant formula.
How much milk should a one year old be having?
After 1 year, most infants will have dropped their milk feeds down to 300-400ml per day and have these in between breakfast and lunch and lunch and dinner. They’ll likely still have a larger drink of milk at bedtime.
In fact, if they are still drinking more than this, you may need to step in and help them reduce the volume of milk they drink as having too much can make them too full up to eat well at mealtimes which means that other important nutrients are displaced.
When you might be better staying on formula
If your baby follows a special diet in order to help manage a medical condition or is on a special formula because of an allergy or because they were premature or small at birth, then it’s best to stick with the specialist formula they have been prescribed till your dietitian advises otherwise.
If you don’t have a dietitian for your baby, ask your GP to make an NHS referral.
This is important because your baby’s needs will be different to the ‘average’ baby or if they have to exclude certain food groups they won’t get the same amount of nutrition from food as other babies do.
Weaning onto cows milk, is it a good alternative to formula?
Recommendations state that pasteurised whole milk is preferred for your little one as it contains more energy and vitamin A compared to semi-skimmed or skimmed milk. Semi-skimmed milk can then be offered to your baby after 2 years of age if they are eating well, not a fussy eater and they’re developing as expected.
If they are fussy and sometimes skip meals (which is fairly typical for toddlers) I’d recommend sticking with whole milk a little longer.
Whole milk is a really nutritious drink for toddlers. It provides energy, protein, calcium and a wide range of vitamins and minerals.
What about plant based milk for babies instead?
No, unfortunately not. Think of plant milks as ‘flavoured water’ when compared nutritionally to whole milk.
The NHS website states that plant milks can be given as part of a health balanced diet from 1 year olds. But most nutrition professionals agree that this isn’t the best advice and they should be limited to just a small amount used in cooking till your baby is over 2 years of age.
If your baby is vegan they likely won’t be taking formula (none are truly vegan) and the advice is to continue breastfeeding. If you are using a soya formula (the vitamin D source is not vegan), continue till age 2 and work with a dietitian to ensure no nutrients are missed.
If your baby has a cow’s milk protein allergy then stick with the formula you have been prescribed until a dietitian tells you otherwise.
A calcium-fortified, unsweetened soy, hemp, oat, pea or nut milk may be suggested as a substitute for cow’s milk, but which one depends on the other nutrients in your baby’s diet and as all babies are individual, what suits one won’t necessarily be right for another. Your dietitian will make a dietary assessment and advise.
What about rice milk? I’ve heard it contains arsenic.
Rice contains a naturally occurring compound called inorganic arsenic and it comes from the soil in which it’s grown. People are concerned because inorganic arsenic is carcinogenic meaning it can lead to cancer in some people.
Younger children are more susceptible to having too much inorganic arsenic because they have smaller bodies therefore it’s best to avoid rice milk till the age of 5.
What about toddler milk?
No, definitely not! Toddler milks are so unnecessary. Standard formula or whole cow’s milk are perfectly fine.
Transitioning baby off formula or cold turkey?
Some parents decide to go cold turkey which means stopping formula one day and starting giving them cows’ milk the next, and this is absolutely fine.
There are no hard and fast rules on this. Your baby may love the new taste and greet it with enthusiasm.
However for some, it may take a while to adjust to the new taste of cows’ milk and sensitive babies may not be happy with the change, there may be tantrums along the way!
If this is the case for you, it’s fine to gradually wean your baby off formula and on to whole cows milk over a few weeks. A transitional plan might look something like this:
Phase-1 of Transition
Replace ¼ of the formula with whole milk.
Phase-2 of Transition
Replace ½ of the formula with whole milk.
Phase-3 of Transition
Replace ¾ of the formula with whole milk.
Phase 4 of Transition
Replace all the formula with cow’s milk.
How to ensure a smooth switch between formula to milk?
Whichever method you choose, make sure that you give your little one lots of praise when they do drink cow’s milk. You can explain that their new milk is for ‘big boys’ or ‘big girls’ which often is encouragement enough.
It’s also important for your toddler to see you drinking milk and say how much you love it. You are your baby’s mist trusted adult and toddlers love to copy their parents. And if they have an older sibling or friends at nursery they can also be highly influential if seen drinking milk too.
You can try adjusting the temperature, formula is often warm and so mild directly from the fridge may not be what your little one wants.
Managing the transition from bottle to cup
Actually a cup should be introduced for milk at around 6 months which is the recommendation from the Department of Health for dental health, but from what I’ve seen in my practice this is rarely the case. However by 12 months the bottle should be actively discouraged.
Rather than any old sippy cup, introduce a beaker with a free-flow lid or an open cup for daytime milk and once your baby has accepted the cup for those feeds you can start on switching the bottle at bedtime for a cup.
Avoid cups that are bottles in disguise with teats.
Have the same cup for milk and water so there aren’t extra skills to learn but choose a different colour so that your baby knows what to expect before they take their first sip.
Consequences of prolonged bottle feeding
Continued usage of a bottle for milk are linked to the following issues:
An increased risk of tooth decay. Studies have shown that drinking from bottles can allow sugar (also in milk) to be in close contact with the teeth over long periods of time which can lead to progressive dental damage.
Delayed speech development due to sucking on bottles which reduces specific muscle use.
Iron deficiency anaemia. Because milk is easy to drink from a bottle, large intakes are likely, especially with those babies who love their bottle and get a great deal of comfort from sucking. Unfortunately this displaces nutrients from food and iron deficiency anaemia can occur. I’ve experienced this first hand with my baby who loved to drink milk! . This has also been linked to fussiness in food which can limit consumption of iron rich foods.
Links to obesity, as studies have shown that long usage of bottles can increase the risk of being overweight.
What might go wrong during the switch?
Your baby may outright refuse to drink whole milk from a cup and this might fill you with worry.
You can however replace the nutrients through dairy foods instead.
125g pot of yoghurt provides the equivalent of 200ml milk
30g cheese provides the equivalent of 200ml milk
You can also use milk in cooking such as in porridge, on cereal, in sauces, milk jellies and mousses.
Keep offering milk periodically as toddlers need to learn to like foods and sometimes this can take a lot of exposures!
What about dehydration?
Parents often worry that a reduced milk intake will result in dehydration. However this is extremely unlikely. Dehydration occurs when babies can’t drink rather than wont drink.
Nevertheless you should be aware of the signs of dehydration in babies:
Dry lips, mouth and eyes and crying without tears.
Sunken fontanelle (the soft spot on the top of your babies head) if your baby is less than 18 months old
Less wet nappies than usual
Dark yellow urine (wee)
Floppy and tired
Cold and blotchy hands and feet
If you are concerned about dehydration see advice from your health visitor or GP.
Baby & toddler Supplements
It is worth reminding you that once your baby is taking less than 500ml per day of formula, you will need to give them a supplement containing vitamins A, C and D. My favourite is Nature & Nurture as the exact dose of all 3 vitamins is given in a tiny 0.5ml dose!
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