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The recommendations from health authorities around the world are unanimous – the optimal nutrition for the first six months of life is human milk. For those who choose not to breastfeed, an infant formula should be used. From six months of age iron-rich foods such as fortified infant cereal, meat, chicken and fish as well as fruits, vegetables and other cereal foods should be started to supplement human milk or infant formula. Dairy foods can also be offered as part of a meal, however human milk or infant formula remain the main milk drink for infants up to a year of age.

 At one year of age, toddlers can continue to be breastfed, or change from an infant formula to cow’s milk as their main milk drink. At this stage it is appropriate for toddlers to be drinking from a cup rather than a bottle. Drinking milk from a bottle after this age can lead to a number of problems. These problems particularly occur if the toddler is drinking more than 500mls of cows milk from the bottle. Drinking milk each day and/or including other dairy foods such as yogurt, cheese is important for meeting calcium requirements as well as providing a good source of protein, riboflavin and other nutrients. However, exceeding this amount of milk can lead to serious health problems. These problems include iron deficiency anaemia add tooth decay and middle ear infections if the milk is drunk from a bottle

 Toddlers who drink cows milk from bottles rather than cups, after 12 months of age, tend to drink more milk than they need. It takes much less effort for a child to drink from a bottle than a cup – and is often easier for parents as well. No mess, hunger is satisfied quickly and no food preparation is required.
Parents are often reluctant to give up the bottle as they worry that they won’t drink enough milk from a cup. It is true that children often drink less milk froma cup, however it is important to remember that children get the same nutrients from yogurt, cheese and custard. So if they are eating some of these foods they are likely to be meeting their calcium requirements.

This extra milk can fill toddlers up and therefore replace other foods in their diet, especially iron rich foods such as meat, iron – fortified breakfast cereals wholegrain foods, dried fruit and legumes. While cows milk provides important nutrients, it contains little iron. So if a child’s main food is cow’s milk, with little or no iron-rich foods they are at risk of developing iron deficiency. Iron deficiency can cause fatigue, listlessness as well as affect behaviour, cognition and motor development, physical performance and concentration.

 Other risks associated with the overuse of bottles are tooth decay and middle ear infections, especially if the child lies down while drinking or is given the bottle to go to sleep. The constant contact of the teeth with the sugar in milk or other sweet drinks given from the bottle causes tooth decay. Tooth decay is painful for children and often requires a general anaesthetic to treat it.  Recurrent middle ear infections are also painful and can have long term effects on hearing as well as requiring surgery.

So remember that:

  1. Children don’t need milk from a bottle after about one year of age
  2. Too much milk can replace other foods in a child’s diet and lead to iron deficiency
  3. Children who drink only small amounts of milk from a cup, can get enough calcium from yogurt, cheese and custard