Cow's milk at 12 months

Why wait until 12 months?

Before 12 months, cow’s milk shouldn’t be your baby’s main drink. The AAP and CDC explain why:

• It has too much protein and too many minerals for a young baby’s kidneys to handle easily.
• It doesn’t have the right amount of iron, vitamin C and other nutrients babies need.
• It can irritate the lining of the gut and cause small amounts of bleeding, which can lead to iron-deficiency anemia.

Small amounts of cow’s milk in cooking or mixed into food are fine from about 6 months (NHS), and so are plain yogurt and pasteurized cheese (CDC). The CDC says not to give cow’s milk before 12 months. If you follow US advice, use breast milk or formula instead. For serving ideas by age, see the cow’s milk food page.

What to offer from 12 months

From their first birthday, your child can drink plain, pasteurized cow’s milk without added sugar (CDC). By now, food is becoming the main source of nutrition, and milk is a drink alongside meals.

• Infant formula is no longer needed (NHS). That includes follow-on formula and “toddler” or “growing-up” milks. The AAP says toddler milks are unnecessary, cost more and usually contain added sugar.
• Breast milk can continue as long as you and your child want. The AAP supports breastfeeding for 2 years or beyond.
• Never give unpasteurized (raw) milk. It carries a higher risk of food poisoning (NHS, CDC).
• Skip flavored milk. Chocolate and strawberry milks have added sugar, which the US Dietary Guidelines (2025–2030) and the NHS say to avoid up to age 4.

How much milk?

The AAP says to limit milk to about 16 oz (480 ml), or 2 cups, a day or less for children aged 12 to 24 months.

More isn’t better. The AAP says more than 24 oz (710 ml) a day has been linked to iron deficiency, because milk fills toddlers up and leaves less room for iron-rich foods. Keep offering iron-rich foods like beef, lamb, lentils, tofu and iron-fortified cereal. See iron-rich first foods.

Water is the other everyday drink: about 8–32 oz (240–950 ml) a day at this age (AAP).

Whole or lower-fat milk?

In the US: the AAP recommends whole milk from 12 to 24 months for most children, because they still need the extra fat. Your pediatrician may suggest reduced-fat (2%) milk if your child is overweight or there’s a family history of obesity, high blood pressure or heart disease. Don’t give 1% or skim milk before age 2.

In the UK: the NHS says whole or semi-skimmed milk can be a main drink from age 1. Skimmed and 1% milk aren’t suitable as a main drink before age 5, but can be used in cooking from age 1.

How to make the switch

There’s no need to switch overnight. A few ideas:

• Use a cup. The AAP suggests finishing the move from bottle to cup between 12 and 18 months, and the NHS says bottles should be discouraged from age 1. You can offer cow’s milk in a cup from the first day. See weaning from the bottle.
• Go gradually. The AAP suggests keeping bottles to mealtimes at first, then slowly dropping the others, including naps and bedtime. Extra cuddles or a story can help at bedtime.
• Serve milk with meals and snacks, not as a drink to carry around all day (AAP).
• Expect some protest. The AAP says it’s normal for children to resist giving up the bottle. Be patient, and ask your pediatrician if it turns into a struggle.

Plant-based drinks

Some families choose plant drinks, or need them because of a milk allergy.

• Soy: the AAP and US Dietary Guidelines say fortified, unsweetened soy drink is the only plant drink that’s nutritionally similar to cow’s milk. If your child has a milk allergy, ask your doctor first (see below).
• Oat, almond, coconut and others: most have less protein than cow’s milk and aren’t always fortified with calcium and vitamin D. The US Dietary Guidelines say unsweetened versions can fit in small amounts in the second year, but they don’t count as dairy.
• Rice drinks: the NHS says children under 5 should not have rice drinks, because they may contain too much arsenic. The AAP also advises against rice milk as a dairy substitute. See rice and arsenic.

If your child can’t have cow’s milk, the reason changes what you can offer:

• Cow’s milk allergy. This is not the same as lactose intolerance (ACAAI). Yogurt, cheese and lactose-free milk are all made from cow’s milk, so none of them is a safe swap. Soy needs care too: the AAP says soy should also be avoided after a cow’s milk protein allergy diagnosis, because about half of babies with that allergy may also react to soy. Talk to your pediatrician, health visitor or GP before choosing any milk alternative; a dietitian can help make sure your child gets enough nutrients. See cow’s milk allergy.
• Lactose intolerance. The AAP says children who can’t drink cow’s milk can meet their dairy needs with yogurt and cheese, though they may need a vitamin D supplement, because not all yogurts have vitamin D added. The US Dietary Guidelines list lactose-free milk as another option.

See also allergens and plant-based babies.

Where US and UK advice differs

• Fat content. AAP: whole milk from 12 to 24 months, lower-fat after 2. NHS: whole or semi-skimmed from 1, and no skimmed or 1% as a main drink before 5.
• How much. AAP: about 16 oz (480 ml), or 2 cups, a day or less, because more than 24 oz (710 ml) has been linked to iron deficiency. NHS: at least 350 ml (12 oz) of milk a day, or 2 servings of milk-based foods like cheese or yogurt.
• Plant drinks. AAP and US Dietary Guidelines: only fortified soy drink is an equal swap for cow’s milk. NHS: unsweetened, calcium-fortified soya, oat or almond drinks are fine from age 1 as part of a balanced diet. Both say no rice drinks.
• Other animal milks. The NHS says pasteurized goats’ and sheep’s milk can be a main drink from age 1.
• Vitamins. The NHS recommends a daily supplement with vitamins A, C and D for all children aged 1 to 4. In the US, ask your pediatrician whether your child needs one.