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There's a common belief that it's "dangerous" to give cow's milk to a baby before he or she is 12 months old.

Numerous sites say to avoid giving cow's milk to babies under 12 months, however, they vary greatly in their reasoning. Some sites cite the immediate safety concerns (such as overtaxing the baby's kidneys) while others discuss the indirect effect of cow's milk causing the baby to receive insufficient nutrients.

His body won’t be able to digest the proteins in cow’s milk and he may develop an allergy to it

It could overtax his kidneys: Cow’s milk has more sodium, potassium and chloride than a baby can process.

Cow's milk doesn't contain the necessary nutrients such as iron, vitamin c that are present in formula and breast milk. At least not in high enough quantities for your baby to thrive.. However, by the time your baby is 1-year-old, they’re able to compensate for many of those lost nutrients with a well-rounded diet comprising fruits, vegetables, lean protein, dairy, and whole grains..

What scientific evidence exists to support any, or all, of the above reasons given to avoid cow's milk? For example, what evidence exists that cow's milk would "overtax" a baby's kidneys if given before 12 months?

Also, both of the articles above suggest waiting until the infant is 12 months before adding milk to his diet. However, an article published by TodaysParent.com states that:

"Official guidelines recommend parents hold off until babies are between nine and 12 months old before introducing cow’s milk".

I think that for many parents, the "extra" three month span from 9 and 12 months is a big deal because many moms lose their ability to produce breast milk right around 9 months and would love to immediately transition to bovine milk if it is safe to do so.

Is it really necessary to wait 12 months before adding milk to a baby's diet or is 9 months sufficient?

S.O.S
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    Note that "can cow milk be safely added to a baby’s diet?” and “can cow milk replace breast milk/ formula?” are two entirely different questions. – TimRias Jan 06 '21 at 09:16
  • Lest we forget: [Nestlé baby milk scandal has grown up but not gone away](https://www.theguardian.com/sustainable-business/nestle-baby-milk-scandal-food-industry-standards). – Weather Vane Jan 06 '21 at 14:23
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    Brucellosis is a risk in raw milk. The risk is low in US because of tests done on cows but I don't know about the rest of the world. – blacksmith37 Jan 06 '21 at 16:43
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    @mmeent And the answer to replacing breast milk, in case it isn't obvious, is a very solid **NO**. Only baby formula can replace breast milk. – Nelson Jan 07 '21 at 00:43
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    @blacksmith37 a LOT of the guidance you find repeated has it's origins in WHO advice against cows milk and formula because they have to consider the global position, with many billions of mothers being in countries where cows milk and water are less safe than breast milk; in most western countries those concerns are unfounded. – JeffUK Jan 07 '21 at 08:03
  • @mmeent the problem with that distinction is that babies can only eat a very small volume; so by giving them anything you are necessarily removing their opportunity to give them something else. – JeffUK Jan 07 '21 at 08:06
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    Note that there is a massive difference between the cow milk fresh from the cow in the backyard versus cow milk from a carton box from the super market both in terms of nutrition and food safety. I assume you mean the latter? – quarague Jan 07 '21 at 10:37
  • There is also a difference between cow's milk as a drink and cow's milk in food: for example the [UK NHS advises](https://www.nhs.uk/conditions/baby/weaning-and-feeding/babys-first-solid-foods/) "Cows' milk can be used in cooking or mixed with food from around 6 months of age, but should not be given as a drink until your baby is 1 year old." – Henry Jan 07 '21 at 11:08
  • My understanding is that cow's milk is great (highly nourish) for developing baby COWS. I would not particularly, however, place any human babies in this category, Perhaps, a mother's breast milk? – AJKOER Jan 08 '21 at 14:11
  • What level of evidence are you looking for. AAP and NHS both have clear guidelines to avoid cows milk as a drink until 12 months, and to use formula (which has the appropriate nutrition for human infants) instead of cows milk (which does not) if not breast feeding. – De Novo Jan 08 '21 at 21:38
  • @DeNovo I want to know the evidence behind those recommendations. I also want to know which, if any, of the reasons given are valid. If the recommendation is based on low iron intake, iron can be supplemented. If it's based on potential of "overtaxing" the kidney it's a different story. Even then, replacing one bottle is not the same as replacing all bottles with cow's milk as @ _mmeent wrote. Once we have the actual evidence, we should be able to answer most of the questions in the comments. – S.O.S Jan 10 '21 at 01:02
  • @quarague I assume fresh cow's milk has superior nutritional status and cow milk from a carton box has better safety profile? In either case, if there's a difference between the two in relation to feeding infant < 12 months it should be delineated in the answer. – S.O.S Jan 10 '21 at 01:02
  • @S.O.S this is textbook level material, but yes, the reasons are valid, though the general guidelines re: avoiding allergens have changed. The primary literature establishing renal physiology in the developing infant and challenges of iron absorption is probably going to be very old. Direct evidence for the harm of cows milk is also probably going to be old, and observational. I expect an answer that meets your desired level of evidence is going to take a good deal of time and good library access. – De Novo Jan 10 '21 at 08:14

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Cow's milk contains both casein and whey protein. Both contain the same amino acids, but casein is "slow release" and whey is digested more readily. Like most animals, 80% of cow's milk protein is casein and 20% is whey.

UK figures suggest that 7% of babies under 1 year old are allergic to casein protein, and therefore this is removed when making formula from cow's milk. Note that Mum's milk still contains casein, but at a much lower level: 30% to 70% whey.

Allergies manifest as skin swelling or rashes, upset stomach / vomiting / diarrhoea, or a blocked / runny nose.

When possible, Mum should breastfeed as her milk not only has the right proteins but also antibodies to help baby fight infection.

Boodysaspie
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