You and baby have made it one year – hooray!  With this newly achieved milestone, your baby (now toddler) might be ready to transition from breastmilk or formula to whole cow’s milk. And you’re probably thinking, “How the heck do I do this?!”.  I know it can be challenging to transition into new routines, so in this blog post, I’m going to discuss everything you need to know about transitioning your child from breast milk or formula to whole milk.

When to start the transition

The AAP Recommendations

The American Academy of Pediatrics (AAP) recommends that babies should receive breastmilk or formula exclusively for the first six months of their lives and then gradually be introduced to solid foods.  Once your baby turns one year old (or thereabouts), they can be introduced to whole cow’s milk and wean off breastfeeding or bottle-feeding.  

Around 12 Months of Age is Safe  

In general, it is safe to transition to whole cow’s milk at 12 months old (just not before then).  Around a baby’s first birthday, his intestines have matured more and he can properly digest cow’s milk. Prior to this time, large amounts of cow’s milk can cause intestinal bleeding.  Also, the kidneys are not mature enough to handle the protein and mineral load before 12 months of age.

Their Diets Are Usually Evolving Around 12 Months of Age 

Another reason why it’s recommended to transition around 12 months of age is because children are usually eating a variety of table foods by this time, so their diets change from relying primarily on breast milk and/or formula for their nutrition to a variety of table foods with the addition of cow’s milk and other dairy products.  

There Isn’t One “Best” Time for All Children 

This transition doesn’t have to be at 12 months on the dot as each child develops and progresses with milestones at their own pace.  If your child had a slower start with solids and is still working up to big kid meals and snacks, you can wait a bit longer to make the transition to whole milk.  Talk to your pediatrician to figure out if your child seems ready to transition or needs the nutrition from breastmilk or formula a little while longer.  The appropriate time to switch is when your child accepts a variety of table foods from each food group and is eating three meals a day plus snacks in between.  That can be a better rule of thumb than relying solely on the child’s age.  

Pro tip: If you decide to wait to make the switch, you can start working on offering expressed breast milk or formula in a cup at eating times rather than a bottle.

How to Start the Transition

Look For The Window of Opportunity

It can help to think of the transition as an adding-on process rather than a taking-away process.  You actually started weaning when you introduced solid foods. And as your child gradually becomes more and more interested in eating a variety of foods at meal and snack times, they will become less interested in nipple-feedings. When you notice this decreased interest in nipple-feedings, that is the window of opportunity to wean.

Transition Gradually

One you notice the window of opportunity, you can gradually replace nipple-feedings with other sources of nourishment (including whole milk).  For example, you might start by replacing one daytime nipple feeding with a snack of crackers, fruit, and whole milk in a cup (preferably in an open-faced cup or a straw cup). Continue to gradually decrease nipple feedings, and replace them with meals/snacks.  If you do this in the window of opportunity, it won’t be such a struggle or process of depriving your child of something they hold so near and dear to them. 

Key Point to Remember

Remember that you’re not replacing breast milk/formula with whole cow’s milk alone. You’re replacing breast milk/formula with a variety of foods from each food group which includes whole milk and milk-based products like cheese and yogurt. So whole milk should never go in the bottle.  It should be offered in a cup alongside other foods.

Tips for a Smooth Transition

Some toddlers like whole cow’s milk right away (like my daughter), and others not so much (like my son).  Here are tips to make the transition smoothly:    

1. Introduce the cup gradually:

Start by offering water to your child in a small open-faced cup like this one or a straw cup like this one.  Once they are comfortable with water in the cup, you can start offering whole milk in the cup.

*Pro-tip: You can actually start practicing drinking water from an open-faced cup when you introduce solid foods around 6 months of age. 

2. Start with a small amount:

When you first introduce whole milk, offer a small amount, such as 2-4 ounces, in a cup with their regular meals. This will give them time to adjust to the taste and texture of whole milk.  If they don’t take to it right away, don’t worry.  Just keep offering it without pressure or coercion to drink it.

3. Mix it up:

You can mix breast milk/formula with whole milk to help your toddler gradually get used to the taste of whole milk. Start with a small amount of whole milk (¼ of the total volume) and the rest breastmilk/formula (¾ of the volume). For example, if you want to offer 4 ounces total, mix together 1 ounce of whole milk and 3 ounces of breast milk or formula.  Gradually increase the amount of whole milk and decrease the amount of breast milk/formula until your baby is drinking all whole milk. 

4. Offer variety:

You can offer different cups to see if one of them is more comfortable or exciting to your child.  Just keep in mind that pediatric dentists and feeding therapists recommend open-faced cups and straw cups over sippy cups. 

5. Be patient: 

It may take some time for your toddler to adjust to the taste and texture of whole milk, so be patient, keep offering it, and wait. Don’t push it – that will turn it into something she wants to avoid.  If your child doesn’t seem interested in whole milk, you can try offering it at different times of the day or mixed into other foods like a smoothie, oatmeal, or milk-soaked cheerios. But mostly, just be patient as your child gets used to it.

6. Monitor your toddler’s reaction: 

Anytime you introduce a new food or drink, always monitor your child’s reaction to ensure they are tolerating it well.  If they experience any digestive issues or symptoms indicative of an allergic reaction such as diarrhea, vomiting, or rashes, talk to your pediatrician to rule out any underlying health issues.

How much cow’s milk does my one year old need per day?

The Guidelines

Children between the ages of one and two need about 2 servings of whole milk dairy per day. 

The dairy group includes milk, yogurt, cheese, and calcium-fortified soy beverages.

One serving is equivalent to 1 cup of milk or yogurt, 1 ½ ounces of natural cheese, 2 ounces of processed cheese, or ⅓ cup of shredded cheese.

An example of what this might look like 

For a one year old, this might look like 4 ounces of whole milk at breakfast, 4 ounces of yogurt with a snack, 2-3 tablespoons of shredded cheddar cheese with lunch, and 4 ounces of whole milk with dinner. This is just to give you an idea, not to encourage you to measure out portion sizes (you don’t need to do that!).

Their intake will vary day-to-day. Some days they will eat more and other days they will eat less. If you offer these foods regularly and let their appetite guide them, it will balance out over time and they will get the amount they need.

Milk and the risks of iron deficiency anemia

One thing to keep in mind is that drinking more milk than eating solid foods can lead to iron deficiency anemia.  Sometimes kids would rather fill up on milk than eat solid foods.  If you think your child is in this category, you may want to offer milk less often to encourage intake of other solid foods including iron-rich foods to avoid iron deficiency anemia. 

In conclusion, transitioning your toddler from nipple feedings of breast milk/formula to whole milk in a cup plus a varied diet is an important milestone in their development.  By following these tips, you can help your child make a smooth transition. 

Need more support?

For one-on-one support for feeding your child with positive parental feeding practices, I invite you to fill out an application for my virtual parent feeding coaching program. I know you want your child to grow up with food and body confidence, and I’m here to help!