Fort Worth, Texas,
15:55 PM

5 Simple Rules for Transitioning From Breast Milk/Formula to Cow's Milk

Doc Smitty with guidelines on moving from breast or bottle feeding

So, your baby is 1 year old and everything is changing …They are starting to take a few steps and babbling a ton (maybe even saying a word or two). Just when you thought you had this all figured out, everything changes.

They were doing great, breastfeeding or taking a bottle and eating some solids but now what?!??! You're expected to change everything. First off, remember that if you plan to continue to breastfeed (which is awesome if that’s your choice!), some of this won’t apply to you but some of it will.

With everything else going on, I’m here to tell you it doesn’t have to be that complicated.

Here are my 5 simple rules for transitioning to milk at 1 year of age (and only two low-stress choices for you to make):

1. Remember that there’s nothing magical about milk.

Cow’s milk is an easy source of calcium, calories, and protein but if they are eating those things then they actually don’t have to drink milk at all. Especially keep that in mind when you make the change if their milk intake falls off. It’s OK. I generally recommend 18-24 ounces per day. This should be enough to get your baby some extra calories, but not be so much that it can lead to constipation. Also remember that yogurt and cheese have similar nutritional content so they can be included in the total as well.

2. Transition to a cup before 15 months.

The closer to 1 year that you can transition to a cup, the better. Hopefully you’ve been offering some water at meal times with a cup for a while. Don’t buy any large quantities of a cup until you find out what your baby likes. Put the cup in front of them, they’ll eventually drink.

3. Decide on a milk. You have some choices.

Remembering rule  No. 1, it’s OK to give yourself some flexibility in the milk that you choose. I’m not worried about cow’s milk or dairy intake as a general rule. Depending on baby’s weight, I am Ok with either whole milk or 2% milk. Talk to your doctor about which might work for your child. There are a few milk alternatives that closely resemble cow’s milk in nutritional content (pea and soy milk are examples) but there are others that are basically water (almond milk). I don’t routinely recommend toddler formula unless medical indicated or recommended by your doctor.

4. Decide on a plan for your transition.

I’ve seen families make the change cold turkey the first day it was possible. I’ve seen families slowly transition by adding in milk alternating bottles with formula. I’ve also seen families mix some formula and some milk in individual cups. I haven’t seen any one particular strategy work better than another. I think most babies would do fine with a quick transition or cold turkey swap…but every baby is different.

5. Try not to stress too much about this.

There are plenty of things to worry about in parenting. Deciding what to give them to eat and drink shouldn’t add to your stress. Provide them plenty of fruits and vegetables. Decide on your milk choice and your method of transition and don’t stress the rest.

They will have good days and bad days (just like us).

But, I promise everything is going to be OK in the end.

Get to know Justin Smith, M.D.

Justin Smith, M.D., is a pediatrician in Trophy Club  and the Medical Advisor for Digital Health for Cook Children's in Fort Worth, Texas. Dr. Smith is an experienced keynote speaker for a variety of topics including pediatric/parenting topics, healthcare social media and physician leadership. If you are interested in having Dr. Smith present to your conference or meeting, please contact him at

He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” open now. Click to learn more. To make an appointment, call 817-347-8100.


Comments 1 - 4 (4)
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Justin Smith
Thank you Kimberly. When urine becomes more concentrated it can become darker and have a stronger smell. If this continues, please call your doctor.
Honestly thank you for this post. I will screen shot this and keep it as a reminder that everything will be OK! I resently went cold turcky from breastfeeding to cows milk. My daughter just turned a year and i knew that if i didnt do it now i would be breastfeeding till she’s 3. Is it normal though for her pee to change. Shes been peeing less and it smells strong. I’ve been giving her alot of fluids since she was use to breastfeeding all day and night.
Justin Smith
Thank you for your question Austria. People make the transition all different ways. Many babies can just make a "cold turkey" switch and do just fine. In terms of what milk to choose, that's a great question to discuss with your chlid's pediatrician.
Austria J Greenblatt
My baby is 15 months and I have him on toddler formula. Tonight will be the last bit of formula left. Can I just give him lactaid milk I’m his bottle as the last milk cold turkey? I’m afraid! His pediatrician said to just do it, I just want some insight. I haven’t done this in 17 years, I’m super super rusty!!! Help!