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Baby’s Milk, Breast, Formula, Cow’s or A2

Feeding your baby is one of the most important and complex things you will do.  It seems like such a simple thing – babies just drink milk don’t they?  But that can be where any simplicity ends!   There is no one form of ‘milk’.  Here is a list of the types and forms of milk that you need to be familiar with:

  1. Breast milk
  2. Formula
    1. Step or stage one
    2. Step or stage two
    3. Step or stage three / Toddler milk
  3. Cow’s milk
    1. Full cream
    2. Low/reduced/no fat
    3. A2 milk

Whether you breast or bottle feed your baby, there comes a time when the type and amount of milk will need to change to take account of their growing needs. This article should give you the confidence and direction to move from milk only (whether that be breast, bottle or both) to cow’s milk.  It will also assist those for whom cow’s milk is not an option due to allergy or intolerance.

Breast Milk

All experts agree that breastfeeding is the best and most natural way to feed your baby.  Here’s why:

  • Breast milk is fresh, clean and at the perfect temperature for your baby to drink.
  • Breast milk contains the complete balance of nutrients and antibodies that your baby needs to grow and develop and to protect him from illness.
  • Breast milk is also known to foster optimum brain growth.
  • Breast milk is easiest for your baby to digest and breastfed babies rarely get constipated.
  • Babies who are fed only breast milk as their main milk drink until six months are at less risk from conditions such as asthma, eczema, allergies and food intolerance.
  • Breastfed babies may also be less likely to develop coeliac disease or juvenile diabetes.  There is also some current research that suggests breastfeeding may reduce the incidence of heart disease in later life.
  • Best of all, this remarkable food is free!

Breast milk contains all the nutrients your baby needs for the first four months of her life.  If you can, and you choose to continue breastfeeding past this first four months, it will still be the most important part of her diet throughout the first year, supplying half or more of her nutrients until her first birthday and up to one third to her second birthday. As long as your baby is getting enough nutrients from solid foods when they are introduced, there is no need to supplement with either cow’s milk or formula until you choose to finish breastfeeding.

Formula

Step/Stage ONE and TWO

A baby on formula starts off on step/stage one formula. Some of these are marketed as suitable from birth to twelve months but many others are as described as suitable from birth to six months. After this time the companies market step/stage two or a ‘follow on’ formula for babies aged six to twelve months. I have become aware of problems when babies are introduced to step two formula. I have many clients contact me when their six-and-a-half month old, previously contented baby suddenly starts night waking, early rising, catnapping and/or vomiting. After careful consideration and ruling out many things I have found the one thing that most of these babies have in common is that they have been started on step two formula. After advising parents to move back to the step one formula their babies have returned to their happy, settled and well rested selves again.

Why can there be problems with the introduction of Step/Stage Two formula?  One reason is the ratio of casein and whey.  The protein in milk can be broken down into curds (casein) and whey. The ratio of casein to whey can vary according to the type of baby formula:

Step/Stage One formula. These milks consist of mostly whey, with a casein:whey ratio of 40:60.  This is about the same as breast milk. They are suitable for your baby from birth up to about fourteen months, and are thought to be easier to digest.

Step/Stage Two formula.  These milks consist of mostly casein, with a casein:whey ratio of 80:20.  They take longer to digest and as a result are often marketed as keeping babies “full” for longer.  They can, however, disagree with bubs that have a casein sensitivity.

Step/Stage THREE

Step/Stage three formula or toddler milk is the formula suggested for toddlers aged twelve months and older.  I also advise clients to avoid these follow-on formulas as some contain a large amount of sugar. This can have the same effect as introducing cow’s milk before fourteen months in that it can make toddlers unsettled.

As long as your toddler is eating a varied and balanced diet which provides her with all the essential vitamins and minerals, there is no need for toddler milk.

TYPES OF FORMULA

Within the three formula steps or stages, there are also three main types of formula.

  • Cow’s milk-based formula
  • Hydrolysed protein formula
  • Soy-based formula

As I have previously discussed, your baby can most likely have cow’s milk-based formula unless there is an allergy or intolerance to cow’s milk.

Cow’s Milk-Based Formula

The majority of formulas are based on cow’s milk, which is modified to resemble breast milk as closely as possible.  This is done by adjusting carbohydrate, protein and fat levels and adding vitamins and minerals of cow’s milk.

Hydrolysed Protein Formula

If your baby has an allergy to cow’s milk, it is the protein in the milk that will cause and allergic reaction. If your baby has intolerance to cow’s milk, she will have difficulty digesting the lactose (sugar) in the milk.

The hydrolysed protein formulas are based on cow’s milk.  They are nutritionally the same as standard formula milk, but the protein in the milk is broken down (hydrolysed).  This means your baby is less likely to react to it.  Many of these milks are also lactose free, which means that babies with intolerance to cow’s milk can easily digest them.

Soy-based Formula

This formula is made from soya beans, modified with vitamins, minerals and nutrients to make it suitable for babies.  It’s important to know that soy formula is not recommended if your baby has a cow’s milk allergy as babies who are allergic to cow’s milk are often allergic to soy too.  Your doctor is the best person to consult if you are considering using a soy-based formula for any reason.

COW’s MILK – from fourteen-months of age

Cow’s milk has nutrients that are important for your child as she grows. Milk provides protein, calcium, magnesium and vitamins B12 and B2 (riboflavin).   However, under no circumstances should you feed your baby cow’s milk until they are over fourteen-months of age.

When moving from formula or breast milk, it’s best to give your child full-fat cow’s milk. She’ll need the energy that the fat provides. Fat also carries essential vitamins A and D, so when fat is skimmed off milk, the amount of these vitamins is reduced. Your child should be given full-fat milk until she is at least two as there is no reason for babies and toddlers to be given fat reduced milk. While we adults strive to eat and drink lower-fat versions of our favorite foods, it’s important that you start your child out with whole milk, not lower-fat varieties. ?

Lots of health professional’s recommend moving a toddler to cow’s milk soon after their first birthday. I, however, do not recommend this. I have seen very similar problems when parents try to introduce their twelve-month-old baby to cow’s milk or step three formula. The problems include runny nappies, night waking, early rising and toddler waking up soon after going to bed with tummy cramps.  While this problem does not affect all toddlers my advice is to keep your baby on step one formula from birth through toddlerhood until she is ready to drink cow’s milk.

Cow’s milk is not suitable as a baby’s main source of milk until she is over fourteen-months-old (see my advice for introducing cow’s milk below). Your baby needs breast milk or formula, which provides all the correct nutrition until she is eating a variety of foods. You can use small amounts of cow’s milk in cooking from around ten months, but watch out for a reaction which could include waking 40 minutes after settling for the night or night waking, early rising, catnapping or a combination of all these problems.

Many parents find when they first introduce cow’s milk in cooked food or as a feed or milk drink their baby or toddler wakes up during the night or 40 minutes after they first go to sleep. If this happens I suggest you cut out the cow’s milk from your toddler’s diet and try it again in a couple of months. Start with small amounts in food and build up the amount of cow’s milk until your toddler can tolerate it.

Adam’s Story

Adam was thirteen-months-old when his mummy Inga gave him cow’s milk for the first time.  She decided to introduce it slowly and first added it to his kids Weetbix in the morning, then in his morning bottle and last of all at night time in his 6.20 pm bottle. The first night on all cow’s milk Adam woke up unsettled 40 minutes after he had gone to bed. However, Adam had had his twelve-month injections two days before so Inga attributed this unsettled waking down to the injections. It wasn’t until three weeks later when Adam was waking three times a night and starting his days at 5 am that Inga contacted me for advice.

After a brief chat with Inga about Adam’s behaviour which included night waking, early rising and fussy eating I asked if anything had changed in his diet. Inga explained she had recently introduced cow’s milk. We changed Adam back to infant formula and within 48 hours he was happy contented and sleeping again. I have since heard from Inga that Adam continued to react like this to cow’s milk until he was two-years-old.

INTRODUCING COW’S MILK

The following plan is based on a toddler who currently drinks two breastfeeds or 410 ml of formula daily:

7 am: 12-minute breastfeed or 210 ml

6.20 pm: 10-minute breastfeed or 200 ml

To wean to cow’s milk

Feed Day One Day Two Day three Day Four
7am 30 ml cow’s milk followed by 180 ml formula in a different bottle or a breastfeed 60 ml cow’s milk followed by 150 ml formula in a different bottle or a breastfeed 90 ml cow’s milk followed by 120 ml formula in a different bottle or a breastfeed 210 ml cow’s milk
6.20 pm 200 ml formula or breastfeed 200 ml formula or breastfeed 200 ml formula or breastfeed 200 ml formula or breastfeed

If you are breastfeeding and your toddler refuses the cow’s milk offered, I would not offer the breastfeed. I would only suggest offering the breastfeed after your toddler drinks the cow’s milk. If your toddler drinks the cow’s milk, they will take less and less from the breast as you offer more of the cow’s milk by following the guide above.

Day four onwards

After four days you can swap any other drinks to cow’s milk – such as the morning or afternoon tea you might give in a cup, or the formula you add to meals, excluding the last milk feed of the day. The last feed of the day should remain a breastfeed or formula-feed for now. If your toddler remains settled and is sleeping well after a further two weeks you can then follow the process above to wean the last milk feed to cow’s milk as well. If your toddler becomes unsettled or begins rising early, please go back to full formula or breastfeed and try the above approach again after two months.

In summary, if your toddler was previously settling and sleeping well but is starting to wake at night or rise early, please look at her diet and food intake first as the possible cause of her sleep problems.

A2 COWS MILK

A2 milk is becoming more common in our shops. Toddlers seem to transition to A2 milk more easily than regular cow’s milk. A2 refers to the type of a protein (beta-casein) found in cow’s milk. A2 is the original form of beta-casein which was produced by cows thousands of years ago. Over time a second form of beta-casein known as A1 began to appear in dairy cattle and eventually became the most the common form of beta-casein in many breeds of cows. But some dairy cows still only produce the A2 type of beta-casein and their milk is used to produce A2 milk, which seems to be kinder on little ones tummies.

Water and fluid intake

If children under six years are offered a cup of milk or water at the start of their meal they have a habit of drinking it all and, because their body does not know the difference between water and solid food, they fill up on liquid and have no room left for their meal. As adults we sip drinks while we eat our food. This is a learned skill. To teach your toddler these skills only offer her a drink after she has eaten three-quarters of her meal and then only a sip of milk or water. I recommend the Amadeus 360° cup and the Anyway up cup because children can only take small sips from them. Explain to your child why it is necessary that she only take small sips. When she has finished her main meal and a second course you can offer her a cup of milk or water and allow her to have a big drink.

PROBLEM SOLVING

Milkaholics

When toddlers are over thirteen months and their diet is mainly milk-based, they are known as ‘milkoholics’. This can often happen if a baby has been introduced to solids late. If a baby has had only milk until the age of six months or later, parents often find it hard to introduce solids into their child’s diet. This can result in a toddler who still has one to six night feeds every night and four or five milk feeds during the day.

Over time I have found it easier to abruptly change a milkaholic’s diet than to slowly wean them off these extra milk feeds. If your child is over fourteen months I advise you to move her to two feeds, one in the early morning and the other in the evening as part of her bedtime ritual. For the first few days your toddler will be very tired, grumpy and hungry but after this time she will start to devour her meals. If your child is under fourteen months, slowly decrease her milk feeds over a couple of weeks. Reduce the amount of the middle of the day feed by 40 ml a day.

Milk allergies

Cow’s milk is a common cause of food allergy in infants. InAustraliaandNew Zealandaround 2 per cent (1 in 50) babies are allergic to cow’s milk and dairy products. Although most children out grow cow’s milk allergy by the age of 4 years, persistent cow’s milk allergy may sometimes occur. However, ongoing symptoms in adults are very rare.

If your child drank cow’s-milk-based formula as a baby without any problems, you can rest easy that she’ll have no problems tolerating regular cow’s milk. Even babies who were breastfed for the first year can usually handle regular cow’s milk because they’ve been exposed to cow’s milk protein in their mother’s milk (unless their mothers avoided all dairy).

The main symptoms of milk allergy are blood in the stool, diarrhoea, and vomiting. If your child also develops eczema, hives, a rash around the mouth and chin, severe nasal stuffiness, a runny nose, cough, wheezing, or breathing difficulties, it could be a sign that the respiratory system is being affected by a milk allergy. If your toddler develops any of these symptoms, talk with her doctor.

Although rare, some children have an immediate, life threatening allergic reaction called anaphylaxis after ingesting milk protein. If your child appears to have sudden and severe problems with breathing or swallowing, urgent medical attention is required.

If it turns out that your toddler is allergic to cow’s milk, you will want to be careful to avoid foods such as cottage cheese, condensed and evaporated milks, ice cream, yogurt, margarine that contains milk, butter, milk chocolate, and powdered milk. Always read labels for sources of cow’s milk protein, like casein and whey.

Lactose Intolerance

Lactose intolerance is different to an allergy to milk.  It is caused by the lack of the enzyme lactase, which helps to digest the milk sugar lactose. The symptoms are diarrhoea, vomiting, stomach pain and gas, which are similar to some of the symptoms of milk allergy. This condition is uncomfortable but not dangerous, and does not cause rashes or anaphylaxis. Small amounts of cow’s milk are usually tolerated, and yogurts and hard cheeses are usually tolerated better than milk, as they contain less or easier to digest lactose than cow’s milk. You may need to reduce or avoid giving your little one dairy products containing lactose.  You can substitute lactose free formula or milk.

Babies can often develop a temporary lactose intolerance after suffering a bout of gastroenteritis. If you baby becomes unsettled after milk feeds after having gastroenteritis you may need to swap to a lactose free formula or if breastfeeding remove dairy from your diet for 4 weeks to allow your baby’s intestines to recover. You should have no problems after this recovery time going back to normal formula and re introducing dairy back into your diet if breastfeeding. I would recommend you consult with your doctor if you suspect this.

 

COMMON QUESTIONS

How much milk should my baby drink? A newborn baby drinks approximately 600 ml of milk daily; a four to six month old approximately 1000 ml daily; a six to twelve month old approximately 600 to 700 ml daily; and a child of one to three years should still drink about 600 ml of milk a day.

 

How will I know my baby is still getting enough milk when I introduce solids?  Up until six months, milk is the most important food for your baby.  Your baby will still be getting enough if you are following my routines as the milk feeds are given first.  This means your baby will fill his tummy with milk before food.

 

My maternal health nurse has advised me to move my baby’s milk and solid feeds around so I am giving solids first.  What do you think?  I come across this time and time again and am still not sure why some advisers recommend this change.  With my routines, the solids are already at proper meal times so if they were swapped with milk feeds, you would be giving lunch at 11 am and dinner at 4 pm.  Some of my clients have made this change only to find their babies start to wake again in the night.  By giving the milk an hour beforehand, the milk is nearly digested by mealtimes.  This leaves baby’s tummy with more room for solids!  But when you turn it around and give the milk second, the solids are not yet digested so the baby does not take as much milk.

 

My toddler doesn’t seem to want cow’s milk.  What is the best way to introduce it?  Cows milk has a different texture, taste, and even temperature than breast milk, which can make it a difficult transition for some children.  One trick is to mix a little whole milk with some breast milk or formula at first.  Slowly increase the amount of whole milk until he is drinking 100% whole milk.

 

Soy or milk-based formula: Which is better for my baby? Soy formula has no nutritional advantage over milk-based formula and vice versa. Both are fortified with the same vitamins and minerals. ??Usually parents choose soy formula when their baby is sensitive or allergic (or potentially so) to cows’ milk protein, or when a baby is having trouble digesting lactose or milk sugar. However there is little evidence that this is successful. In fact, most babies who are allergic to cows’ milk protein are also allergic to soy protein. If this happens, your child’s doctor may ask you to try other brands of formula that don’t contain cows’ milk protein. Sometimes, you might need to change brands a few times to find what’s best for your baby.

 

Are all formulas the same? Most formulas are basically the same.  When it comes to the most important nutrients, all formulas are created equal.  The price of infant formula is not necessarily a guide its quality as all infant formulas sold are required by law to conform to quality control standards (inAustralia andNew Zealand they are regulated by the Australia New Zealand Food Standards Code; inIreland by the Food Safety Authority of Ireland).  Prices can vary from shop to shop, and between brands, so it is a good idea to shop around.

There are, however, many specialised formulas for specific situations. Formulas designed for premature and low-birth-weight babies, for example, contain more calories than other types. Formulas for babies with reflux have rice or other thickeners added to it. Soy or hydrolysed formulas are used for infants with possible allergies or an intolerance to milk protein.

To read more information of my advice regarding food and feeding please see my new book – PRE – ORDER Tizzie Hall – Save Our Sleep ® – Feeding

La gach dea-ghui, Tizzie

33 Responses

  1. Hi Tizzie!

    Just a quick suggestion: maybe add something about goat’s milk too… well, if it’s not too late!

    Thanks! This is helpful 🙂

    Lynn

  2. Hi Tizzie,
    Quick questions regarding weaning: my son was only breastfed (no formula at all) and is now down to 2 feeds/day and I’m trying to wean him into cow’s milk. What type of bottle/cup do you recommend for your transitioning to cow’s milk routine? Also, what are your strategies for after day 4 and dropping the evening breastfeed totally?
    Thank you!

  3. Hi Tizzie, thanks very much for this timely information. Quick question in relation to the 12 – 14 month period – my daughter is 12 months and I am returning to work so I have slowly reduced the mid morning feed and it is now gone and I’m doing the same with the mid afternoon feed which I plan to finish today. I will continue the 7am and 630pm feeds. Following your advice I wont introduce cows milk until 14 months so what do I do over the next 2 months? Will she need formula during the day? Thanks, Theresa

  4. “A child of one to three years should still drink about 600 ml of milk a day.”

    in the toddler book it says a child should have 400ml of milk/dairy a day….has this now changed?

  5. My baby is 12 months and up until now has been exclusively breastfed. I have started introducing the bellamy’s stage 1 formula to commence. At this stage I am using it in cereal and offering a taste in a cup. My baby has become very restless with her sleeping and is now night waking. Could this be due to this? She has had natural Yougurt and cheese for some time and was settled on that.

  6. Hi tizzie,

    Since my 13 month old moved to cows milk a month ago he’s been refusing solids and also his afternoon sleep. He seems constipated and not his happy self. My doctor told me to cut formula at 12 months but it doesn’t seem to be agreeing with him. Would you recommend soy milk or back to formula for a bit longer? He didn’t tolerate most of the formulas in his first year, constantly bringing up little bits of formula up to 4 hours after having a bottle.

    Thanks

  7. Hi- need some serious advice.
    My son is 9 months and a doctor has tested for milk protein allergy and he has tested positive. Not to cows milk just the sugar in milk so he is on lactose formula. Now that he is getting older he is after more food but seeing as he is limited to what he can eat (and being fussy) this process isn’t an easy one. I very much want to give him food and not have reactions to it (belly pain)
    How much should a 9month old be eating?
    How many times a day?
    All he is having to eat is a bottle at 6am, breakfast at 8am rafters garden, bottle at 1030, lunch is three ice book sizes of puréed pear. Dinner is one ice cube of puréed chickpea n one ice cube of beef. And then an 180ml bottle (which sometimes he wants another 120ml). (All day time bottle are 180ml)
    Shouldn’t he be eating more?
    What snack foods can I give him?
    Thank you

  8. I’d like to seek some advice about introducing cow’s milk into my toddlers diet? My son is 15 months old now. This week I have started to replace 1/4 of his formula with A2 whole milk but I am starting to notice an increase in looser bowel movements. He eats yogurt and cheese daily and has done without issue for many months. Even though the amount of milk he is drinking is quite small, is it possible that at 15 months the milk is difficult for his body to digest? Or should I be looking for other causes (drooling due to teething for example)?

  9. Hi, You suggest freezing food in ice cube trays and recommend specific number of cubes per meal. What size are the cubes equal to?

    Thanks

  10. Hi I was just wondering if you know much about the new A2 formula on the market and if you would recommend it?? As you have said that toddlers find it easier to transition to an A2 milk rather then regular?? It is more expensive and there is not many reviews as it is a new product

    Thanks,
    KD

  11. Hi Tizzie,

    My daughter is 10 months old and has been exclusively breast fed the entire time. I haven’t expressed before therefore she has never taken the bottle but drinks her water out of a Sippy cup. She currently has 3 breast feeds a day.

    I am going back to work next week and I was wondering what to do about my afternoon milk feed?

    I am still able to give her breast milk for her morning and night time feed.

    What do I do if she refuses the formula from the Sippy cup? Do you have any suggestions/strategies?

    Thank you.

  12. Hi Ali:

    Thank you for your post. I’m sorry to hear that your little one is having such a difficult time with her sleep.

    There are a few things we would get you to look at, the first is her bedding. Please look at the bedding guide and make sure he has enough bedding. You can get to it via this link http://sosnews.ecommetrix.com/newsletter.asp?n=E393C841E490485E

    The next thing we would look at is her diet and check that she is eating meals that have a good amount of protein in them, and that the textures are appropriate for her age. She needs to be having 1/3 meat, chicken or fish in two of her meals a day, and pureed smooth. All her meals should be 2 courses (one savour and one sweet), both fed until full, and then followed with finger foods/foods from the family table. For more details on this please see the Feeding book, page 170.

    There are other things to look at like is she having any dairy (yoghurt or milk etc) or is she having any custard. We would also look at her bedtime routine, and ensure that she is having 20 mins of fun active play before bed at 7pm, and that she is going to be awake and unaided. We would also look at other routine changes, such as having her on a 6.30am-6.30pm routine if you need to have her up at 6.30am each day.

    If you need anymore support from here we ask that you join the forum so I and other mums can help you there.

    Online Advcie – AUD $64.95 http://shop.saveoursleep.com.au/product/1805/49457/

    The Save Our Sleep Pnline Advice offers a friendly, supportive online community where parents can help other parents establish and follow Tizzie’s routines and advice and help answer any questions that may come up along the way. The Online Advice is a safe and secure environment where you can chat, help each other and share in the day to day joys, achievements and challenges of parenting. Tizzie and members of her team are actively involved in this area and the Save Our Sleep moderating team checks all advice given and a member of Tizzie’s team will step in if incorrect, misleading or potentially unsafe advice is given.

    The Online Advice membership also gives you READ ONLY access to Archived Reading area where you can read further advice of experienced Save Our Sleep parents as well as the Save Our Sleep team. You will be able READ threads in the Archive Library area but you will not be able to post as this area is now closed.

    Kind Regards,
    Kate.
    Save Our Sleep®

  13. I also have trouble getting her to drink her bottles. She only drinks about 350mls per day. She has a bottle when she wakes but only about 130ml before not wanting any more then at lunch time 90mls and 100-150mls at night. I’ve tried offering it in various cups but she won’t touch them at all. She just throws her milk bottle away when she’s had what she wants and refuses to drink any more. She does drink water with meals but only about 50-100mls throughout the day. Whilst she still seems to be growing at a steady rate, I worry that she isn’t getting the nutrition she needs.

  14. Hi Kristy

    Thank you for your comment regarding your daughters milk intake. It is hard to offer any advice as you have not mentioned how old your baby is, therefore I have copied an extract from Tizzie’s feeding book which might help.

    MILK INTAKE AND SOLIDS
    With my routines you give your baby milk before solids because for the first year of your baby’s life milk is the most important food. If you give solids first, your baby will be too full to drink her full milk feed. If you are not following my routines, I recommend you feed your baby solids an hour after her milk feed for breakfast and lunch and two hours after her milk feed for dinner. I have had parents following my routine swap this around for one reason or another and settling and sleeping problems are never far behind this change.
    Some health professionals recommend parents give their baby solids first and then their milk feed an hour later, which would have the baby’s day starting at 7 am with a solids feed repeated four hours later throughout the day.
    While your baby may remain settled and sleeping well on this feeding schedule at first, I have never found it to work long term without the baby developing some sleep and settling problems. There also comes a point where you need to move your baby’s mealtime to the same time as the family’s mealtime, which is more difficult with this feeding schedule. As with most things it is easier to start out the way you would like to continue for most of your baby’s childhood.
    If you are following my routines and feeding your baby milk first followed by solids, you need to be aware that at your baby’s nine-month check your maternal and child health nurse might suggest you swap your baby’s milk and solids around. This advice is based on the fact that most parents are giving solids first followed by milk and is therefore aimed at encouraging parents to swap to milk first followed by solids to establish the baby on normal mealtimes. But you will not need to swap your baby’s milk and solids around if you are following my advice because your baby is already eating at common mealtimes.
    Some parents delay introducing solids because they are concerned their baby will not drink enough milk once they get a taste for food. But I have found that all babies start to reduce their milk intake at around sixteen weeks, even if they don’t start solids at this time. It’s a stage they go through; it’s nothing to do with starting solids. This is why I recommend adding expressed breastmilk or formula to all your baby’s solids. When you are calculating your baby’s milk intake you will include the milk you add to her solids. So for example if your baby is bottle-fed and five months old, you would calculate her milk intake as follows:
    7 am milk feed: 180 ml formula
    8 am breakfast: 80 ml formula mixed into her breakfast
    11 am milk feed: 160 ml formula
    12 noon lunch: 80 ml of formula in her savoury and 30 ml formula in her second course of lunch
    3 pm milk feed: 180 ml
    5.20 pm dinner: 80 ml formula in her savoury and 30 ml formula in her second course of lunch
    6.20 pm milk feed: 180 ml
    10.30 pm dreamfeed: 140 ml
    So when you add all of her milk intake up, she has had 1,140 ml in the 24-hour period.

    If you need anymore support from here I ask that you join the Online Advice area so Tizzie and other mums can help you.

    Advice Area – $79.95 http://shop.saveoursleep.com.au/ecms/category.asp?cid=475

    The Save Our Sleep Advice area offers a friendly, supportive online community where parents can help other parents establish and follow Tizzie’s routines and advice and help answer any questions that may come up along the way. The advice area is a safe and secure environment where you can chat, help each other and share in the day to day joys, achievements and challenges of parenting. Tizzie and members of her team are actively involved in this area.

    The Advice Area membership also gives you READ ONLY access to Archived Reading area where you can read further advice of experienced Save Our Sleep parents as well as the Save Our Sleep team. You will be able READ threads in the Archive Library area but you will not be able to post as this area is now closed.

    Kind regards,
    Kate.
    Save Our Sleep®

  15. Hi,
    I’m just wondering if I can use cows milk in cooking…ie in mash potatoe. bub is 5 months old.
    Thanks

  16. Hi Kylie :

    Tizzie does not recommend using cow’s milk in cooking until at least 10 to 12 months of age for the same reasons as those listed in the above BLOG. You would start with small amounts and watch for any reaction or change in your baby’s behavoiour or sleeps – for example waking 40 minutes after going to bed or night waking, early rising, catnapping or a combination of these issues.

    From 10-12 months you can start adding cows milk to your cooking to slowly introduce it to your little one’s diet however, if you notice any changes return to using formula or EBM in cooking and try again in a further 8 weeks.

    Kind regards,
    Kate.
    Save Our Sleep®

  17. Hi Angela :

    Thank you for your post. The breastfeeding routines are based on establishing and maintaining good breastmilk supply. If you are planning on mixed feeding your baby and doing some formula feeds then Tizzie recommends that you follow the breastfeeding routines. This will ensure that your breasts are stimulated frequently enough to ensure good supply. For more detail about mixed feeding and Tizzie’s routines I would recommend having a look at Tizzie’s Feeding book which covers this information in more detail.

    If you feel that you need further support from here we ask that you join the Online Advice so that out members can help you look at everything in more detail.

    Online Advice – AUD $79.95 http://shop.saveoursleep.com.au/product/1805/49457/

    The Save Our Sleep Online Advice offers a friendly, supportive online community where parents can help other parents establish and follow Tizzie’s routines and advice and help answer any questions that may come up along the way. The Online Advice is a safe and secure environment where you can chat, help each other and share in the day to day joys, achievements and challenges of parenting. Tizzie and members of her team are actively involved in this area.

    The Online Advice is a community of like-minded parents who willingly share their experiences, baby advice and support new members. The Save Our Sleep moderating team checks the advice given and a member of Tizzie’s team will step in only if incorrect, misleading or potentially unsafe advice is given. This area is a Forum only and does not entitle members to support directly from either Tizzie or her team or guarantee you a reply.

    The Online Advice membership also gives you READ ONLY access to Archived Reading area where you can read further advice of experienced Save Our Sleep parents as well as the Save Our Sleep team. You will be able READ threads in the Archive Library area but you will not be able to post as this area is now closed.

    Kind Regards
    Kate
    Save Our Sleep

  18. Hi tizzy,
    I have been following your routines from when my baby was 8 weeks old. My now 6.5 month old is now refusing the 11am feed but still appearing to be hungry. I tried to express and give it to him that way (he usually takes a bottle) but he doesn’t want that either. He is on 3 meals of solids. Do you have any suggestions of how I can be sure he is getting his recommended milk intake? He is primarily breast fed with an introduction of a formula feed for the dream feed only a week ago. Thank you! Rebecca

  19. Hi Angela :

    Thank you for your post. Tizzie recommends continuing to offer this feed to your baby as normal, and to help keep up your baby’s milk intake Tizzie recommends that you add expressed breast milk or formula, and rice cereal to the savoury course of both lunch and dinner. When looking at your baby’s milk intake across the day you need to include the amounts that you use in breakfast, lunch and dinner. The average amounts that Tizzie recommends adding to meals are detailed in the Feeding book for you.

    If you feel that you need further support from here we ask that you join the Online Advice so that out members can help you look at everything in more detail.

    Online Advice – AUD $79.95 http://shop.saveoursleep.com.au/product/1805/49457/

    The Save Our Sleep Online Advice offers a friendly, supportive online community where parents can help other parents establish and follow Tizzie’s routines and advice and help answer any questions that may come up along the way. The Online Advice is a safe and secure environment where you can chat, help each other and share in the day to day joys, achievements and challenges of parenting. Tizzie and members of her team are actively involved in this area.

    The Online Advice is a community of like-minded parents who willingly share their experiences, baby advice and support new members. The Save Our Sleep moderating team checks the advice given and a member of Tizzie’s team will step in only if incorrect, misleading or potentially unsafe advice is given. This area is a Forum only and does not entitle members to support directly from either Tizzie or her team or guarantee you a reply.

    The Online Advice membership also gives you READ ONLY access to Archived Reading area where you can read further advice of experienced Save Our Sleep parents as well as the Save Our Sleep team. You will be able READ threads in the Archive Library area but you will not be able to post as this area is now closed.

    Kind Regards
    Kate
    Save Our Sleep

  20. Sorry – that should have been Rebecca! I still had the previous post in my head from Angela 🙂

    Kind Regards
    Kate
    Save Our Sleep

  21. My baby got cow’s milk allergy. I was very worried. However i found that some substitutes can be given. I gave him substitutes and he is drinking them without any problem. Here are some substitutes.

  22. My little one has always been a picky eater-even today at 20months old. We read that when you take the little one off forumla and onto cows 3.25% milk the appetite should pick up, but that did not work for us. We even tried 2% milk -both which were introduced after 14months old. There was a period of bad pain (constipation) and not much eating at all (no variety despite the persistent attempts) so we went back to the formula. On the formula the little one is still a picky eater- should we simply stay on the formula until 2 years old to make sure nutritional needs are being met (ie. iron, DHA, calcium, fat(energy( or should we do something else? All advice is appreciated.

  23. Hi Garnet and Family :

    Thank you for your post. Do you have a copy of Tizzie’s Feeding book? (https://shop.saveoursleep.com.au/product/2390/71862/ ) This book covers all of Tizzie’s advice for fussy eaters in detail, and will guide you through what foods to offer at this age, and what technique to use when your daughter is being fussy about her meal. Tizzie also talks in the book about toddlers who she refers to as milkaholics; When toddlers are over thirteen months and their diet is mainly milk-based, they are known as milkaholics. This can often happen if a baby has been introduced to solids late. If a baby has had only milk until the age of six months or later, parents often find it hard to introduce solids into their child’s diet. This can result in a toddler who still has one to six night feeds every night and four or five milk feeds during the day. Over time Tizzie has found it easier to abruptly change a milkaholic’s diet than to slowly wean them off these extra milk feeds. If your child is over fourteen months Tizzie advises to move to two feeds, one on waking at 7am and the other in the evening as part of her bedtime ritual(being sure its finished 20 mins before bedtime so she gets some active play before bed). For the first few days your toddler will be very tired, grumpy and hungry but after this time she will start to devour her meals.

    In regards to what milk to offer your baby, Tizzie recommends A2 milk. You can read Tizzie’s advice on A2 milk here in the recent Facebook post – https://www.facebook.com/SaveOurSleep/posts/10155561127515508 .

    If you feel that you need further support from here we ask that you join the Online Advice so that our members can help you look at everything in more detail.

    Online Advice – AUD $79.95 http://shop.saveoursleep.com.au/product/1805/49457/

    The Save Our Sleep Online Advice offers a friendly, supportive online community where parents can help other parents establish and follow Tizzie’s routines and advice and help answer any questions that may come up along the way. The Online Advice is a safe and secure environment where you can chat, help each other and share in the day to day joys, achievements and challenges of parenting. Tizzie and members of her team are actively involved in this area.

    The Online Advice is a community of like-minded parents who willingly share their experiences, baby advice and support new members. The Save Our Sleep moderating team checks the advice given and a member of Tizzie’s team will step in only if incorrect, misleading or potentially unsafe advice is given. This area is a Forum only and does not entitle members to support directly from either Tizzie or her team or guarantee you a reply.

    The Online Advice membership also gives you READ ONLY access to Archived Reading area where you can read further advice of experienced Save Our Sleep parents as well as the Save Our Sleep team. You will be able READ threads in the Archive Library area but you will not be able to post as this area is now closed.

    Kind Regards
    Kate
    Save Our Sleep

  24. Hi Vanessa,

    Thank you for your post. One of the team will be in contact via email with some tips for you 🙂

    Kind regards,
    Kate.
    Save Our Sleep.

  25. Hello

    Firstly, thank you! Your routines have worked really well for us!

    A question regarding formula feeding. My 4.5 month old is currently having 5 feeds per day. According to the tin, Aptimal AR, for 4-6 months, the guide is 250ml water and 5 scoops. However, if I do the calculation of 120ml per kilo (6kgs) per day divided by the amount of feeds, it works out to be 144mls per feed which is a massive difference!

    I know these are only guides but I’d like to know what your thoughts are on this?

    My little one will drink whatever amount we give him!

  26. Hi Lisa,

    Thank you for your post. Tizzie recommends when feeding your baby you should always feed each feed until full. This means when bottle feeding you want to aim to always have at least 30ml left in the bottle when your baby is done, so that you can be sure that he has definitely had enough. The guides on the tin and the body weight guide are just a rough guide and really shouldn’t be used to determine how much to feed your baby, but more as a guide on how much to make up while you are just learning how much your baby needs.

    Also in relation to the body weight guide if you have a look at page 47 of the latest edition of the baby book the formula Tizzie advises for a baby this age (as a very rough guide) is 150ml per kilo of body weight divided by the number of feeds. So for your baby this would be (150 * 6)/5 which would equal around 180ml per feed. As explained this is a very rough guide as is the amount on the tin. In general at this age we would see the amount babies drink average around 180-240ml, but this is just a guide and many babies drink more or less than this and that is normal for them.

    Please have a read of Tizzie’s case study on page 48 of the latest edition of the baby book, as this talks about the importance of feeding baby until full. Often we see babies drink very large feeds the first few times they are offered until full if they are used to being given only a set amount, but once baby is used to being offered as much as they like we generally see them settle back to more average amounts.

    If you feel that you need more detailed advice and support then you may like to consider joining the Save Our Sleep® Online Advice, where our coaches can help you look at everything in detail as Tizzie’s website is not a place where we can offer you advice about your baby. http://shop.saveoursleep.com.au/category/1805/ .

    Kind regards,
    Kate.
    Save Our Sleep.

  27. Hi Tizzie,
    I have read your book and find it so helpful.
    My son is 6 months, on formula now- we BF until 3 months. My question to you is do you think it is vital children go to cows milk at 14 months. I understand they need the Calcium, vitamin d and all the other vitamins and minerals it provides. But what if we just did yogurt and cheese ? Would that not be enough diary in his diet. I am currently trying to do the research and make a decision.

    Thanks so much

  28. Hi Hope :

    Thank you for your question. This may be something that it would be best to discuss with your child’s GP or health professional. Cow’s milk does contain lots of essential vitamins and minerals and as well as essential good fats that are very important for children, however if you are unable to feed your child cow’s milk or are choosing not to there are other ways you can get these important things into your child’s diet.

    By discussing it with your child’s health care professional they will be able to work out what will be the best thing for your individual child, and make sure that they are getting everything they need for their development.

    Kind regards,
    Kate.
    Save Our Sleep.

  29. Hi Ann :

    Thank you for your question. I will paste below a little excerpt from Tizzie’s Feeding book to help you (from page 190) –

    INTRODUCING COW’S MILK

    Many health professionals recommend moving a toddler to cow’s milk soon after their first birthday. I, however, do not recommend this. I have seen very similar problems when parents try to introduce their twelve-month-old baby to cow’s milk or step three formula. The problems include runny nappies, night-waking, early-rising and the toddler waking up soon after going to bed with tummy cramps. While this problem does not affect all toddlers, my advice is to keep your baby on step one formula from birth through toddlerhood until she is ready to drink cow’s milk.

    Kind regards,
    Kate.

  30. With Regards to Tizzys comments. I strongly disagree.

    Like my first child my second who is 8 months I have started him on A2 milk with Breast Milk and by 10 months he will be completely on Full Cream A2 milk.

    My daughter who is now 4 and Kindy had no issues and transistioned well. My Little boy has taken to A2 milk quite well and his poos are still solid – Mind you I did start him on Solids from 5 months.

    He has 7 teeth and will be 8 months on 27th Feb and sits crawls and pulls him self up won’t be long till he starts walking – Health nurse esitmates by 9 months. Also I purely express for him.

    So In regards to your comments – I totally disagree from experience. I have in been in consultation with the health nurse throughout the whole period. Last Point – I DISLIKE FORMULA – hence the main reason why fresh is best and Breast is NUMBER ONE.

    thank you Nadia

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