How to get your child to progress from breastmilk/formula to cow’s milk

What type of milk?

 

If you are breastfeeding, continue as long as you and your child want. Health Canada puts the 24 month reference mark but by all means continue/stop when it is time for your family. It’s important to remember to continue with the vitamin D supplement until baby reaches 24 months (400 IU/day of vitamin D). By then, your child should have an established meal and snack routine that is healthy and age appropriate, including milk and other sources of vitamin D (such as fatty fish, dairy products and alternative dairy products) providing enough vitamin D for their needs and growth.

 

Continue breastfeeding for as long as it feels right for your family, and offer a daily vitamin D supplement until 24 months of age.

 

 

Cow’s milk and soy-beverage

 

It is suggested to introduce cow’s milk as main milk source once your child is consistently eating iron-rich foods twice daily. Typically, that will be established around 9 months of age but use your judgment and your magical parenting skills. Is your child having a well-established eating routine? Do you offer iron-rich foods 2-3 times daily, and do you feel your child is eating them with appetite?

 

No? Continue with breastmilk/formula and observe your baby’s development.

 

Yes? Then it’s probably a good time to slowly switch from formula to 3.25% cow’s milk (or continue breastfeeding). For most kids, there is no advantage to continue offering formulas past 12 months of age. What’s important here is that you offer iron-rich foods twice daily to your child (and a healthy plate).

Trust your magical parenting skills to decide if you child is ready for cow’s milk around 9 months of age

 

How to get from formula to cow’s milk?

 

If you have been offering formula to your child, offer 3.25% homo milk with meals from 9 to 24 months. Once your baby celebrates their 2nd birthday, you can switch to skim, 1% or 2% milk, following what your family typically purchases – perhaps to accompany the celebratory birthday cake! If your family drinks fortified soy-beverage, start offering it to your child only at 24 months of age. For most children, it’s not appropriate before that age as it does not contain sufficient fat and less energy for the same volume as cow’s milk and breastmilk. If your child was drinking soy-based formula for medical reasons, continue offering fortified soy-beverages starting at 9 to 12 months of age (assuming they eat 3 meals a day), but we do recommend to adjust the diet of your child to make sure all his/her needs are met. If your family, including your child, is vegetarian or vegan, offer a fortified soy-beverage (if your are not breastfeeding) with adjustment in the diet. We believe it’s a good idea to meet with your dietitian (we can help!) to ensure all their needs are covered and their growth is adequate.

 

If breastfeeding, continue as long as desired. Otherwise, switch from formula to cow’s milk around 9 months of age.

 

Coconut, rice or almond milk (fortified or not) are not suitable for children. They do not contain enough protein, calcium or calories for the needs of your child. You can use coconut, rice and almond milk in family recipes that your child will consume, but the main milk they drink should be breastmilk, cow’s milk or fortified soy beverages (with adjustment in their diet to make sure they eat enough fat and proteins).

 

Coconut, rice or almond milk (fortified or not) are typically not suitable for children. Prefer breastmilk, cow’s milk or fortified soy beverages.

 

 

How much milk?

 

Offer 2 cups per day. Not more than 3 cups as this is likely to replace other foods. It has been observed that kids who drink 3 cups and more of milk per day tend to eat less of other food and not get enough iron. Cow’s milk is not rich in iron, it can displace consumption of iron rich food (your child may be full after drinking a cup of milk), and in large volumes it can prevent iron absorption.

 

Although you want to limit cow’s milk intake, don’t restrict breastmilk to your child. Feed on demand. It’s normal that some days, your child will eat more whole food, and others, more breastmilk. If you feel your child is drinking too much and not eating sufficient whole food, it is a good idea to talk to your health care professional. Remember that their appetite will vary from day-to-day (and when teething or if sick) but we typically expect a child to follow the family meal schedule by 12 months of age.

 

Don’t restrict breastmilk intake, but do limit cow’s milk to 2 cups per day.

 

 

Ditch that sippy cup and try an open cup

 

At around 9 months, once your child is eating more and more whole foods and drinking less milk, slowly switch to an open cup rather than a bottle. When introducing new fluids like cow’s milk and water, offer it in an open cup.

 

At first, you might want to hold the cup and bring it slowly to your child’s mouth. (Yes, it is safe if done under supervision). Practice with water as your child will first have the reflex to suck as they have been doing with the breast/bottle. They will then learn to coordinate breathing, opening their mouth, and swallowing properly. And as your child’s skills develop, you will be impressed to see them grab the glass and simply drink like a pro!

 

We work towards kids giving up on bottles by 18 months, and drinking all of their fluids using an open cup… just like a grown up! After all, we are trying to teach them proper “adult” table manners. From then, your family can offer fluids in an open cup or a glass, with a straw, or in a regular water bottle you would use as an adult, but lets try to avoid these sippy cups.

 

Learning to drink from an open cup helps develop drinking skills, motor skills and coordination. It is messy. It takes time (lots and lots of trial and error) but there is no need to use a sippy cup. The sippy cup promotes a sucking movement to get the liquid out of it and drink. It doesn’t mimic the movement required to drink from a normal glass (the skills you are actually trying to teach them to adopt). An added bonus is that drinking from an open cup will likely reduce prolonged bottle feeding and night feedings that are sometimes linked to over eating, and tooth decay. So give it a try! Anyway, your child will eventually want to drink like a grown-up and imitate you…and you are probably not drinking from a sippy cup at the dinner table!

 

Ditch the sippy cup! Offer fluids from an open cup. Teach your child mature drinking skills so they can drink like grown-ups.

 

Beside milk…should your child drink other beverages?

 

Tap water. just like for adults, offer water throughout the day, more often when baby is active or if it is really hot outside.

 

Juice. simply don’t offer it. Juice is not bringing nutritional value and will likely replace whole food. It is a source of sugar that your kid simply doesn’t need. On top of that, it is linked to tooth decay, and in some cases diarrhea (even if diluted with water). Prefer whole vegetables and fruits as a snack.

 

Tea, coffee, pop, lemonade, fruit punch, ice tea… Absolutely not needed. It takes the place of whole food and adequate milk. It sometimes provides caffeine and most often too much refined sugar. Not a good idea.

 

Milk and water are the only beverages your child needs.

 

References

 

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