timing of when to introduce cow's milk

Last reviewed 06/2022

Both the American Academy of Pediatrics (AAP) and the Institute of Medicine (IOM) recommend delaying the introduction of cow's milk until after 1 year of age due to its low absorbable iron content (1).

• early introduction of cow's milk is a strong negative determinant of iron status
• unmodified cow's milk does not meet nutritional requirements of infants although it is acceptable to add small volumes of cow's milk to complementary foods (2)
• cow's milk protein allergy has a prevalence ranging from 2 to 7%, and the age of recovery is usually around 2-3 years (2)

There is study evidence (1) that there is an association between the introduction of cow's milk before 1 year of age and an increased rate of delayed developmental milestones after 1 year of age.

Goat's milk (2):

• unmodified goat's milk is not suitable for infants because of the high protein and minerals content and of a low folate content
• goat's milk has no clear nutritional advantage over cow's milk and is not less allergenic

Reference:

• Bennett WE Jr et al. Early cow's milk introduction is associated with failed personal-social milestones after 1 year of age
• Turck D. Cow's milk and goat's milk. Turck D.World Rev Nutr Diet. 2013;108:56-62.