Cow's milk for infants and toddlers

Can infants drink cow's milk?

Infants under 12 months should only be offered breast milk and/or infant formula, not cow's milk.

Cow’s milk lacks essential nutrients like iron and zinc, has fewer calories, and is less nutritionally dense than breast milk or infant formula. Its higher protein and mineral content can strain an infant’s immature kidneys, making it hard for them to process. Excessive cow’s milk can also inhibit iron absorption. Iron is an essential mineral needed for healthy growth and development.

While babies should not drink cow’s milk (which can displace fluid volume of breastmilk or formula) they can enjoy dairy solid foods once they start solids at 6 months. Foods like cow’s milk-based yogurt, kefir, and cheese can be a healthy addition to their diet. Using cow’s milk in recipes for oatmeal, muffins, or pancakes is also appropriate. When purchasing cow's milk, choose full-fat, whole milk to supply additional calories and fats needed to support growth.

Milk-based infant formulas

Most infant formula is made with cow's milk as a base ingredient, but it is processed in a way that allows the proteins and carbohydrates to be better digested and tolerated.

When can children drink cow's milk?

Children can start drinking pasteurized cow’s milk as a beverage after their first birthday. This coincides with weaning from breast milk or infant formula. If your child has a dairy allergy or intolerance, you can offer plant-based milk alternatives like fortified, unsweetened soy or pea milk, which provide a balanced nutritional profile suitable for toddlers.

Other plant-based milks, such as almond or coconut milk, lack essential calories, macronutrients, and micronutrients needed at this stage.

Goat milk

Goat milk is considered a dairy product and it contains the same milk proteins like casein and whey as cow's milk. In goat’s milk, the ratio of whey to casein is different, which makes it easier for some babies to digest. Babies with sensitivity to cow's milk may benefit from goat’s milk formula or drinking goat’s milk at age one. If a baby has a true milk allergy, they will be allergic to goat's milk in addition to cow’s milk.

Do toddlers need to drink milk?

Although toddler growth slows compared to their first year of life, they still need additional nutrients to support healthy growth and development. Toddlers need dietary fats for brain development, protein for muscle growth, and calcium and vitamin D for strong bones and a healthy immune system. Whole cow's milk, goat’s milk milk, and fortified pea or soymilk can help toddlers meet these nutritional needs. For toddlers who don’t enjoy drinking milk, 2 to 3 servings of dairy foods like full-fat unsweetened yogurt, cottage cheese, cream cheese, or hard cheeses can provide the nutrients they need.

How much milk should a toddler drink?

Toddlers aged 1 to 3 years need about 700 mg of calcium per day, which equates to 2 to 2.5 servings of dairy daily, approximately 16 ounces of milk.

Examples of one dairy serving include:

• 8 ounces (1 cup) of cow's or goat milk
• ⅓ cup of yogurt
• ½ ounce of hard cheese

It's important not to exceed 16 ounces of milk per day. Excessive intake can lead to iron deficiency, constipation, and a reduced appetite for other nutrient-rich foods.

Does cow's milk cause constipation?

Cow’s milk can contribute to constipation in some children. Its high protein content can result in firmer stools that are more difficult to pass. Balancing milk intake with plenty of water, fruits, vegetables, and whole grains can help prevent constipation.

Milk allergy and intolerance

Most babies with mild cow’s milk protein intolerance (CMPI) outgrow it by age one, but more severe intolerances and cow’s milk protein allergies may take longer to resolve, often by 3 to 5 years. Some children do not outgrow their dairy allergy and must continue to avoid dairy in their diet. If your child has CMPI, consult your pediatrician or allergist about testing and reintroducing dairy.