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Newborn and Infant Care

Breastmilk to formula

03/12/2007

Question:

My infant will be 9mo in about two weeks. I breastfeed him. I don`t mind breastfeeding at night but I don`t want to pump anymore. What alternative can he use for during the day. Should we try switching him to a formula or to 2% milk. If formula is best which kind?

Answer:

How wonderful that you are breastfeeding your son! That's a terrific gift of good health and good nutrition!

The American Academy of Pediatrics recommends that young children receive iron fortified formula until 12 months of age. The reason for this is to prevent iron deficiency anemia. Research has shown that iron deficiency anemia is associated with irritable behavior and a permanent lowering of IQ.

In addition, milk intolerance resulting in gas and diarrhea is more common with the introduction of cow's milk prior to a year of age. Although the intestines are formed and working at birth, their function matures over the first 3-4 years of life. We also know that young children, especially in their first year of life, are far more prone to food allergies and sensitivities than are older children and adults.

Good formula choices include any of the cow's milk based formulas such as Similac Supreme with iron and Enfamil Lipil with iron. Carnation Good Start with iron may be a good first choice since the cow's milk protein is already partially broken down and this may be helpful as your baby transitions from breastmilk protein to cow's milk protein. Any of the toddler formulas with iron are also acceptable.

You may want to mix breastmilk and the formula of your choice to gradually adapt your baby's digestion to the formula. Start with 1/4 formula and 3/4 breastmilk for a day or two, then 1/2 formula and 1/2 breastmilk the next day or two, and then 3/4 formula and 1/4 breastmilk for a day or two, finally transitioning him to full formula.

This is a good time to introduce a cup if you have not already done so. If you start with a sippy cup, by 12 months of age switch to an open cup. Developmentally normal children master use of an open cup by 18 months of age at the latest if they are given the opportunity to practice drinking from an open cup. It's also healthier for their teeth.

For your own comfort, it is a good idea to decrease your number of pumpings by 1 every other day to slowly decrease your milk supply. An abrupt cessation of pumping can result in very painful, full breasts.

I hope this information is helpful!

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University