Sleeping baby suckles.

Congratulations on making it to a major breastfeeding milestone! The American Academy of Pediatrics (AAP) recommends exclusively breasetfeeding for the first 6 months of life and continued breastfeeding (after solid food introduction) for at least the first year of life. You made it!!! That’s a huge deal. But you may be wondering what happens after one year.

At your baby’s one year well child visit, your pediatrician probably mentioned that you can now transition your baby from breastmilk to whole cow’s milk.

This can leave breastfeeding mamas sometimes feeling confused or uncertain about how to make this transition, especially if they plan to continue breastfeeding beyond one year. If this is you, you’re in the right place! Keep reading to learn when to introduce whole milk, how much is necessary to meet your baby’s needs, how to make the transition and some other factors to consider. 

When to transition?

The AAP recommends whole cow’s milk between 12 to 24 months of age. It’s important to wait until your baby is about one year old because introducing cow’s milk earlier could decrease the amount of breastmilk your baby consumes, and breastmilk is nutritionally much more complete compared to cow’s milk. Breastmilk provides everything your baby needs for growth and development with the possible exceptions of adequate iron, vitamin D and omega-3 fats, which your baby can get from solids foods or your pediatrician may recommend a nutrition supplement.

Is it necessary to offer cow's milk if you're still breastfeeding?

Not necessarily. After your baby turns one year old, her growth slows drastically compared to how rapidly she was growing during infancy. Therefore, her nutrition needs also decrease at this age. For example, in the second half of infancy (6-12 months), your baby needs at least 24 ounces of breastmilk/formula per day (3 servings). But at one year of age, that decreases to only 16 ounces per day (2 servings). Many parents are surprised by this, because it’s so much less milk than they were used to offering previously.

So, as long as your baby is consuming at least 16 ounces of breastmilk per day (nursing ~3-4 times per day) after her first birthday, then whole milk is not nutritionally necessary. 

Whole milk is recommended between 1-2 years of age (instead of low-fat milk) because the extra fat is good for your baby’s brain development. However, breastmilk is also a great source of fat for your baby and contains many other additional nutrients that cow’s milk lacks. If your baby is nursing 1-2 times per day, supplementing with one serving (8 ounces) of whole milk or other whole fat dairy foods should be sufficient. You know your body best. Your goal is 16 ounces per day so depending on how much milk your baby is getting from you, that will determine the amount you’ll want to supplement.

How to make the transition?

If you or your baby is ready to wean, a gradual transition to whole milk is best! Some babies will refuse the taste of whole milk at first, and it can also be a shock to their digestive tract, so I recommend to start by mixing breastmilk with whole milk and slowly increasing the ratio of whole milk to breastmilk. For example, you might start by offering 4 ounces of breastmilk mixed with 1 ounce of whole milk. Then after a few days or a week go to 3 ounces of breastmilk to 2 ounces of whole milk and continue this process until your baby will accept whole milk by itself. It can sometimes take a period of about 2 weeks for your baby’s belly to adjust to the transition, but you can call your pediatrician if you’re concerned about constipation or any other out of the ordinary symptoms. 

At about 12 months of age, it’s also a good time to start transitioning your baby from a bottle to a cup, if you haven’t already. This won’t happen overnight, so don’t worry if your baby is still taking a bottle. In order to help with this transition, whole milk can be offered in regular or sippy cups. Offering only water in bottles, instead of milk, will also help some babies have less interest in bottles and transition to drinking from a cup. 

A good rule of thumb is to offer whole milk at mealtimes and water for snacks or between meals. 

If your baby is refusing whole milk despite your efforts, continue mixing it with breastmilk and most babies with time will make the transition eventually. I know it can feel tough, especially if you’re ready to wean, but it won’t last forever! Resist the urge to add flavors, powders or syrups to whole milk as these can be high in sugar. Hang in there, mama! You’re doing a great job. Continue fighting the good fight. In the meantime, you can also supplement your baby’s intake of whole milk with whole fat yogurt or cheese, add whole milk to other cooked foods such as oatmeal or mix it with frozen fruits in a smoothie. 

Other factors to consider...

If you want to continue breastfeeding beyond one year instead of offering whole milk, talk to your pediatrician about continuing a vitamin D supplement for your baby as long as you’re breastfeeding. Whole milk is generally fortified with vitamin D, and your breastmilk alone may not provide an adequate amount. 

Weaning from breastfeeding is something that’s unfortunately not talked about much! There’s a lot to say about weaning so stay tuned for another post on all things weaning. But, generally speaking, weaning slowly will prevent issues like engorgement, plugged ducts and mastitis. If you notice your breasts becoming full, nursing or pumping to comfort rather than fully draining your breasts will tell your body to decrease your supply over time. Dropping a single feeding at a time or slowly increasing the time between feedings, rather than quitting cold turkey, will help you transition more smoothly. 

If your baby is allergic has an intolerance to cow’s milk, talk to your pediatrician about other acceptable substitutes that will provide enough fat, protein, calcium and vitamin D for your baby. 

Sweet mama, I know this transition can feel overwhelming, but you’ve got this! And don’t let anyone tell you that you need to quit breastfeeding at one year if you’re not ready. You and your baby are the only people who get to make that decision for you. In many cultures, it’s very normal for babies to nurse well into childhood. Breastfeeding continues to be an excellent source of nutrition beyond one year, and it also prevents many infections and diseases. Whether you choose to wean at one year or continue to breastfeed, you’re a great mama!


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