Whole Cow Milk Feeding Between 6 and 12 Months of Age? Go Back to 1976

Abstract

In 1976, the Committee on Nutrition of the American Academy of Pediatrics recommended that the non-breast-fed infant receive an iron-fortified proprietary formula during the entire first year of life.1 In 1983, the Committee on Nutrition reversed the previous recommendation and concluded, "If breast-feeding has been completely discontinued and infants are consuming one third of their calories as supplemental foods consisting of a balanced mixture of cereal, vegetables, fruits, and other foods, whole cow milk may be introduced."2 The Committee, in their report, acknowledged the fact that "there are many unanswered questions concerning the use of whole cow milk in the second half year of life." I believe that we now have answers to some of these questions and that we should return to the original recommendation discouraging the use of whole cow milk (WCM) until infants have reached their first birthday. Studies performed since the 1983 report have demonstrated that the introduction of WCM prior to the first birthday is associated with an increased risk of occult gastrointestinal bleeding3 and an increased incidence of iron deficiency anemia.4,5 In addition, iron deficiency anemia in infants less than 1 year of age has been shown to be associated with cognitive and psychomotor impairment6-8; such impairment may not be correctable with iron therapy.7-9