The Ministry of Health’s Healthy Eating Guidelines for New Zealand Babies and Toddlers (0–2 years old) recommend exclusive breastfeeding for the first six months of life and then continued breastfeeding alongside the introduction of solid foods (from around six months). When breastfeeding is not possible, infant formula is the only recommended alternative to breast milk for babies under 1 year of age.
The Ministry of Health’s advice is that cow’s milk should not be given to babies under one year of age. This is because cow’s milk does not provide enough energy and is not nutritionally equivalent to breast milk or infant formula. Cow’s milk is also low in iron and high in protein and therefore may lead to iron deficiency and anaemia if given (instead of breast milk or infant formula) to babies under 1 year of age.
Recently, the World Health Organization (WHO) changed its infant feeding guidelines, stating that cow’s milk was acceptable for infants from six months of age. The WHO recommendation around animal milk was classified as based on conditional, low certainty evidence. WHO guidance covers high, medium and low-income countries and each country needs to consider the guidance and determine what is appropriate for their specific context.
The Ministry of Health has performed an initial review of the evidence on which the WHO based its guidance and considered that in a country like New Zealand, the Ministry of Health’s current guidance is still appropriate.
Of concern, the WHO review of evidence found an increased risk of iron deficiency and anaemia for babies aged 6–11 months when fed cow’s milks. The review was unable to assess all aspects of growth and development, for example brain development.
After one year of age, breast milk or whole-fat pasteurised cow’s milk (dark blue label) provides important extra nutrients to help with growth and development, and plain water is also important for hydration. Soy milk fortified with calcium and vitamin B12 is recommended for toddlers over 12 months who need an alternative to cow’s milk.
