When should cow's milk be introduced to an infant's diet, and what is the current recommendation regarding milk intake?

When should cow's milk be introduced to an infant's diet, and what is the current recommendation regarding milk intake?

• A. Cow's milk should be introduced at 6 months; limit to 8 ounces per day.
• B. Cow's milk should be introduced at 9 months; unlimited milk allowed.
• C. Cow's milk should not be introduced before 12 months; the recommendation is to avoid excessive milk intake.
• D. Cow's milk should not be introduced before 24 months; no limit.

Answer: (C)

Introducing cow's milk after the first year is the time when it can fit safely into an infant’s diet. In the first 12 months, breast milk or iron-fortified formula provides the nutrients and iron newborns need, while cow's milk lacks adequate iron and can crowd out iron-rich foods if given in large amounts. Once past one year, cow's milk can be started, but the amount should be moderated to support overall nutrition—roughly 16–24 ounces (about 480–720 mL) per day—so it doesn’t displace iron-rich foods or lead to iron-deficiency anemia. Whole milk is typically recommended for this age range to provide essential fats for development, with a later switch to lower-fat milk as advised by a clinician. Excessive milk intake is the concern, not the idea of drinking milk at all. Options proposing introduction at 6 or 9 months or unlimited/no limit contradict these guidelines because they either prioritize too early exposure or fail to protect iron status by allowing excessive intake.

Introducing cow's milk after the first year is the time when it can fit safely into an infant’s diet. In the first 12 months, breast milk or iron-fortified formula provides the nutrients and iron newborns need, while cow's milk lacks adequate iron and can crowd out iron-rich foods if given in large amounts. Once past one year, cow's milk can be started, but the amount should be moderated to support overall nutrition—roughly 16–24 ounces (about 480–720 mL) per day—so it doesn’t displace iron-rich foods or lead to iron-deficiency anemia. Whole milk is typically recommended for this age range to provide essential fats for development, with a later switch to lower-fat milk as advised by a clinician. Excessive milk intake is the concern, not the idea of drinking milk at all. Options proposing introduction at 6 or 9 months or unlimited/no limit contradict these guidelines because they either prioritize too early exposure or fail to protect iron status by allowing excessive intake.