Cows' milk is not suitable as a main drink until baby is 12 months old. Before this time, while you can use cows' milk in cooking if you want to (assuming no family history of cows' milk intolerance or allergy), baby must drink breastmilk or infant formula as their main drink.

There are several reasons why the advice is to wait until 1 year before giving cows' milk:

• Early introduction of cow's milk has been shown to increase the chances that the baby will develop diabetes later in life, especially if there is already a family history of the disease.
• Cow's milk isn't a good source of iron, so until the baby is eating a variety of iron rich foods, the consumption of cow's milk puts the baby at risk for anemia.
• Allergies and eczema are more prevalent in children switched to cow's milk before their first birthday.
• Cow's milk isn't as nutrient rich as formula (and is certainly lacking compared to breast milk), so to ensure that your baby has the best nutritional start we are advised to wait until 12 months before weaning to cow's milk.

If you are struggling to get baby to take bottle of formula, you could try formula in a sippy cup or beaker rather than a bottle, or a different teat. You COULD also try a different brand of formula in case the taste of one or another is more palatable to them, but this would be a last resort: it's advised not to swap and change formulae as this can upset baby's tummy. If baby seems reluctant to take formula in liquid form, then one way to increase the amount they take would be to add formula to food, for example mashed potato, carrots, porridge, rice pudding made up with baby's formula etc. Make sure baby gets water with meals if this is the case.

If you are still worried about your child's intake of formula, have a chat with your HV or GP.

Cows Milk from 12 months

Once your child is over 12 months of age, you can consider moving them on to cows milk if you like, though they can continue with formula or breastfeeding for as long as you both want.

The WHO recommends breastfeeding into the second year and beyond, and there are proven benefits of what is known as 'natural term breastfeeding' - or allowing your baby to wean from the breast at their own pace and in their own way.

If you do choose to give cows milk then it should be full fat milk until your child is two at least.

Many formula manufacturers now produce so-called 'growing up' or 'toddler' milks which are intended to replace cows milk as a main drink for your young child. The jury is still out as to whether these highly fortified and modified cows milk drinks are actually better than cows milk, but as soon as we have access to any research we will post it here and in the research area of the site.

Goats Milk Formula

The UK Department of Health does not recommend the use of Goats Milk Formula for infants (under 1 year of age)

The composition of infant formula and follow-on formula is governed by European legislation. The current legislation specifically states the criteria for infant formulas and follow-on formulas to be based on cows' milk protein, hydrolysed protein or soya protein.

In 2005, the European Commission asked the European Food Safety Authority (EFSA) to review its assessment of the suitability of the use of goats' milk protein in infant formulas, as further information had been made available by a manufacturer. EFSA reviewed the dossier of additional information and concluded that the available scientific data was insufficient to establish the nutritional adequacy and nutritional safety of goats' milk protein as a protein source in infant and follow-on formula. This was due to flaws in the methodology, including insufficient sample size, restriction to anthropometric parameters only, absence of a breast-fed reference group and non-adherence to the study's protocol. EFSA also concluded that there was no convincing data, either in the literature or submitted, to support the belief that the incidence of allergic reactions is lower when feeding goats' milk based formula compared to cows' milk based formula.

The Department recommends the use infant formula and follow-on formula based on cows' milk protein or hydrolysed protein or soya protein on the advice of health professionals. In light of EFSA's opinion, the Department advises health professionals not to recommend the use of infant milks based on goats' milk protein.

Some parents may believe that infant milk based on goats' milk protein is a suitable alternative for babies who they percieve as being intolerant or allergic to cows' milk formula. However, the protein in goats' milk is very similar to that found in cows' milk and most babies who react to cows' milk protein will also react to goats' milk protein. Goats' milk protein can induce allergic reactions and is not a suitable milk source for a cows' milk allergic infant as there is the potential for cross allergenicity. Infants with proven cows' milk protein intolerance can be prescribed an extensively hydrolysed infant formula.

Formula derived from goats' milk is also unsuitable for babies who are lactose intolerant as it contains similar levels of lactose to cows' milk based infant formulas.

Also see this warning from UNICEF Baby Friendly UK http://www.babyfriendly.org.uk/items/item_detail.asp?item=13