Cow’s milk has been a staple of UK children’s diet for years now, but did you know that, as a drink, it is not recommended for babies under 12 months?

In this blog we’re going to help you understand the different milks you might have seen or heard about, so you can know what’s actually necessary and when you can start giving them to your little one.

Babies under 12 months: What milk should they be having?

First infant formula is usually based on cows' milk and is the only suitable alternative to breast milk in the first 12 months of your baby's life.

Follow-on formula is not suitable for babies under 6 months, and you do not need to introduce it after 6 months either. First infant formula, follow-on formula and growing-up milk are not needed once your baby is 12 months old. In 2013 the European Food Safety Authority (EFSA) produced a scientific opinion which stated: ‘No unique role of young-child formulae with respect to the provision of critical nutrients in the diet of infants and young children living in Europe can be identified, so that they cannot be considered as a necessity to satisfy the nutritional requirements of young children when compared with other foods that may be included in the normal diet of young children.’

As mentioned above, cows' milk can be introduced as a main drink from 12 months.

What is ‘Growing-up milk’?

‘Growing-up milk’ and other milk specifically marketed for children aged 1 year and over are mainly composed of powdered milk (based on cow’s milk) or individual milk components, vegetable oils, and free sugars. The carbohydrate source of these milks is usually maltodextrins (produced from starch from maize or potatoes), which are easily hydrolysed in the mouth to free sugars by salivary amylase, and the addition of lactose. Lactose that is naturally present in cows’ milk is not classified as free sugar, but lactose that is added to a product is. Experts across Europe have agreed that young children do not need these fortified milk to obtain particular nutrients.  The main areas of concern related to drinks marketed as ‘growing-up’ and ‘toddler’ milk are the free sugar content of these products, and the taste profile of ultra-processed milk drinks encourages the liking of a sweet taste and does not accustom young children to the tastes of the unprocessed and minimally processed foods that will provide a healthy diet in childhood.  

The transition to cow’s milk

The change from breastmilk or infant formula to cows’ milk involves a taste transition for infants who should become accustomed to a less sweet taste in their main milk drink. The naturally occurring sugar in milk is lactose, but this does not give milk an overly sweet taste. Plain animal milk has a composition which may be protective against the development of insulin resistance and chronic disease and therefore if alternatives to this increased risk of chronic disease, this is of concern to public health. The consumption of free sugars can stimulate excessive postprandial hypoglycaemia and insulinaemia, which may be linked to risks of obesity, type 2 diabetes and coronary heart disease.  

Children will get the majority of nutrients from food in their second year and beyond, and there is some evidence that giving lots of extra nutrients in fortified drinks to children who don’t need them may be bad for their health in the long term. The products are also relatively expensive. There are implications for both the diet of the toddler and the rest of the family if expensive unnecessary products are purchased which reduce the amount of household income available for buying unprocessed and minimally processed food.

Why is milk good for your little one?

Milk is a rich source of energy, protein, calcium, vitamin A, riboflavin, iodine, phosphorus, potassium, zinc and vitamin B12, although the exact nutrient composition is dependent on the type of milk, geographical location, season, diet of the animals and husbandry practices. Animal milk is one of the richest sources of calcium and the calcium from dairy products is well absorbed.

From 1 year of age, your little one should be enjoying 3 regular meals per day (including dairy/fruit-based dessert) and potentially 1-2 snacks. The need for milk reduces as food provides greater nutrition. If a toddler continues to drink milk in large volumes then this will reduce their appetite for meals and can lead to nutritional deficiency (particularly iron deficiency).  

Ideally, move away from offering milk into a baby bottle and onto an open cup for 1 year. From 12 months formula-fed babies can transition to cow’s milk or unsweetened fortified milk alternatives. Avoid giving skimmed milk or 1% fat milk to children under the age of 5 years old, but from 12 months children can be given pasteurised semi-skimmed or full-fat (whole) cow’s milk. Your decision which one may depend on what your family already have at home and on how well your little one is growing.

Balancing milk and appetite

Whilst milk is one of the best drinks for children (alongside water) it is useful to remember that it is also a ‘food’ and it is important that milk consumption is gradually reduced as food intake at meals and snacks increases. On average, a 1-2-year-old is likely to need no more than 400ml of milk a day as a drink (about 2/3 pint) and a 3-4-year-old is likely to need no more than 300ml of milk a day as a drink (about 1/2 pint).  

There are no formal recommendations on how to transition a baby from infant formula to cows’ milk once they reach 12 months of age. If a child is struggling to accept cows’ milk when directly switched from infant formula, one practical suggestion would be to mix a little cows’ milk with formula to begin with and gradually increase the amount of cows’ milk in subsequent milk feeds until the child is accepting the cows’ milk alone. If this approach is taken and powdered infant formula is used it is essential that the formula is made according to the NHS guidelines to mitigate the risk of any bacterial contamination from the water or powdered milk. Any of the prepared milk and infant formula mix that is left over in the cup should be treated as if it were infant formula only and disposed of immediately after use.

Where there are concerns about the quantity and quality of food consumed, health professionals may recommend continued use of first infant milk into the second year, but this is rare, and food should be the main source of nutrients for toddlers. From 1 year of age, children should get the majority of their energy and nutrients from food.

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