Doctors’ Notes

Transitioning From Breastmilk or Formula to Milk

As your baby closes in on her 1-year birthday, you may be thinking about how her diet has changed and will change in the coming months. How long to breastfeed? When to stop formula? What to give instead? Read on!

Why We Don’t Recommend Other Milk Before 1 Year

While your baby can sample many new foods in later infancy, we don’t recommend introducing cow’s milk or other alternative beverages before about 1 year. For one thing, cow or other milk is not the complete source of nutrition that breastmilk or formula is.

We want infants to continue to get that nutrition while they are getting used to solid foods, and if they drink a lot of extra fluid, they won’t be hungry enough for breastmilk or formula. Additionally, adding too much cow’s milk into a baby’s diet can cause anemia. Adding dairy such as cheese or yogurt or even milk to things before 12 months is ok, just not quantities of milk as a drink.

What Kind of Milk?

The most common milk used after 1 year is plain whole cow’s milk, which contains fat, protein, and calcium/vitamin D that help babies grow.

Of course, many babies and families can’t consume dairy or choose not to. A healthy diet is definitely possible without dairy. You could use an alternative beverage such as almond milk (which is fortified with calcium/vitamin D) or many others.

Keep in mind, milks from plant sources don’t have as much protein or fat as whole cow’s milk, so it’s important to offer other sources to the rest of the diet (like nut butters, avocado). We’ll be watching your child’s growth carefully at Well Visits while reviewing diet and nutrition.

For the Breastfed Baby

There’s certainly no rush or medical reason to wean your baby at 1 year. The choice to wean is always yours.

If you continue nursing past 1 year, your baby doesn’t necessarily need to add additional milk in her diet. Talk with your provider at your baby’s well visit about her diet to determine what is best. It’s fine to offer some milk from a cup at mealtimes to get her used to it.

Because cow’s (or other) milk doesn’t have the same nutritional value as breastmilk, think of it as just part of the diet, or a food group. Infants over 1 should get 3-4 servings of something with calcium and vitamin D per day (dairy being the easiest way to achieve this). If they’re getting breastmilk, eating cheese, yogurt, or other calcium-containing foods, those count too!

Don’t forget our Breastfeeding Center of Pittsburgh is always a great resource for things like nursing a toddler or tips for weaning.

For the Formula-Fed Baby

As your baby approaches 1 year, think about the transition from formula. There’s nothing magic about the 10year birthday, so I usually recommend to start using up your formula supply around 11½- 12 months.

You can keep the favorite bottles — usually morning and night — while starting to introduce milk in a sippy cup during the day. Because cow’s (or other) milk does not have the same nutritional value as formula, think of it as just part of the diet, or a food group.

Infants over 1 should get 3-4 servings of something with calcium and vitamin D per day (dairy being the easiest way to achieve this). If they’re eating cheese, yogurt, or other calcium-containing foods, those count too!

Aim to be completely done with formula and bottles between 12-15 months.

During the Transition

I usually recommend offering cow or other milk from a sippy cup, cold from the fridge as it comes. This will also accomplish weaning from bottles. As babies get more teeth, keeping a bottle with anything other than water can contribute to cavities.

Don’t worry if your little one doesn’t drink as much milk as he was formula or breastmilk. Remember, cow’s milk is just part of the diet now. We recommend no more than 16-24 ounces per day, but if they’re eating a good variety, less than that is ok too.

It may take a few weeks for them to get used to the new flavor and temperature. Don’t worry! Just offer it with meals and let them get used to it.

Dr. Amy Maddalena, a Kids Plus Provider since 2006, is the Medical Director of our Breastfeeding Center of Pittsburgh.