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At present, there are differences in the age at which it is recommended to introduce cow's milk into the diet of infants in developed countries. In most of them, it is recommended to wait until 12 months of age, but some, such as Canada, Sweden or Denmark, propose its introduction at 9 or 10 months of age.
For a breast-fed infant, it is clear that cow's milk is not necessary as long as an adequate supply of breast milk is maintained and, according to the WHO, it should be maintained at least up to 2 years of age. However, combining cow's milk and breastfeeding, when the supply of breast milk is not enough, is also possible.
When the baby is fed with formula milk, it is when an age of introduction of cow's milk can be established, that is, change the formula for cow's milk as the main dairy contribution.
Formula milk tries, as far as possible, to be as similar as possible to breast milk, since it is the most appropriate and recommended milk to feed an infant, however, breast milk, like milk from cow, from approximately 6 months, does not provide sufficient amounts of iron to the infant, being necessary to provide this mineral through complementary feeding. The formulas, being fortified and made 'à la carte', contain higher amounts of iron.
Thus, the main reason for delaying the change from formula to cow's milk is to prevent possible iron deficiencies, since cow's milk is a very poor source of this mineral. In fact, iron deficiencies have been observed in infants in which cow's milk was the only milk supply and their main food, especially when the change was made at a very early age, around 6 months. The infant's iron stores come from what was accumulated during pregnancy and they are favored by a late clamping of the cord, ensuring the necessary iron up to 6-12 months, depending on each individual case.
In addition, cow's milk has a very low content of linoleic acid, although the ratio of linoleic acid / alpha linoleic acid is more favorable than in formula milk. The ratio of linoleic acid / alpha linoleic acid seems to be the reason why children who drink cow's milk have more favorable levels of docosahexanoic acid (DHA) than those who drink formula milk, although, again, when they are made ' à la carte ', they can be supplemented with DHA (omega3).
Summarizing, cow's milk is low in iron, and formula milk, except for specific fortifications, poor in long-chain polyunsaturated fatty acids. In breastfed infants, cow's milk is not necessary, and although it can be offered to the infant, it does not present any benefit over breast milk. If the infant is fed with formula milk, the introduction of whole cow's milk can be done at some point between 12 and 18 months, not before the infant consumes a diet rich in iron, or what is the same, never before introducing red meat.
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