Whole milk instead of formula?

My nephew and his wife had a son who is now 4/12 months. A few weeks ago they announced that the baby is drinking whole cows milk instead of formula! They said their doctor said it was ok if they gave him infant vitamins. Last week they said the vitamins constipated him so they stopped giving them to him.

He eats cereal, applesauce and drinks whole milk - that is his diet. He is still very constipated so they give him water with corn syrup in it (doesn't work I guess his stools are like little stones). I am so upset and worry about him. They just say he's tuff, he's fine.

Please advise.

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Sue Gilbert

Sue Gilbert works as a consulting nutritionist. For many years she worked with Earth's Best Organic Baby Food, integrating nutrition and... Read more

Dear Darry,

You are right to be concerned about your nephew. Milk instead of formula is very inappropriate for a baby, and particularly for a five month old. The American Academy of Pediatrics Committee on Nutrition advise against it. There are several reasons for this that you may want to share with your nephew.

First: Whole cows milk (WCM) is very low in iron, lower than formula or breast milk. Independent studies done by very reputable organizations have shown the infants fed WCM have iron intakes below the recommended daily allowance, even with iron fortified cereal in their diet. Because your nephew's son is not on formula and is no longer taking vitamins, it is likely his iron intake is too low. Too little iron at such a formative age (his brain and nervous system are growing very rapidly) can have life long, irreversible, negative effects.

Additional recent studies suggest that iron deficiency in early childhood may lead to long-term changes in behavior that may not be reversed even with iron supplementation later on. Also, the composition of whole cow's milk (ie, high calcium, high phosphorous, and low vitamin c) may decrease the absorption of iron from baby cereal.

Second: WCM further contributes to iron deficiency anemia due to the fact that it causes intestinal bleeding in infants. The blood loss may not be visible to the parent, but is detectable through a test for stool hemoglobin.

Third: The nutrient composition of WCM is inappropriate for infants. Babies who drink WCM instead of human milk or formula have a markedly increased intake of sodium, potassium, chloride, and protein. The sodium intake of WCM fed infants substantially exceeds the estimated minimal requirements, placing a burden on the kidneys. The increased amount of sodium could cause the kidneys to draw water from the body, putting the baby at risk for dehydration. Four: Substitution of WCM for formula reduces the intake of vitamin C to a marginal level, and reduces the intake of linoleic acid ( an important fatty acid in the diet) to well below the recommended level.

Studies of the past several years have clearly shown the difficulty of providing a balanced diet for infants when WCM replaces breast milk or iron fortified formula. Nutrients from commonly consumed solid foods do not complement nutrients from WCM but rather they exaggerate the deficiencies (iron, linoleic acid, vitamin C) and the excesses (sodium, potassium, chloride and protein) in the infants diet.

The whole cows milk is most likely the culprit in this baby's constipation because fluids are being used to dilute the load on the kidneys and so are not available to help soften the stools.

Babies may be 'tough' but that doesn't mean they aren't affected by things. Your nephew's son is certainly not in any life threatening sort of situation, and in fact, may do fine. However, he will not do optimally. He is not being provided with the best for him. The price he will pay may be substandard growth, both physically and mentally. It is a price he may pay for the rest of his life.

With such overwhelming evidence, with recommendations from those who know best (AAP), and with a parent's love and desire to provide the best they can for their child, I bet your nephew will want to make the switch back to an iron fortified formula for his son once he is aware of the issues. Please share them with him.

Thank you for writing.

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