Here is how to supplement and transition

What you need to know about transitioning your baby off infant formula.

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With the current baby formula shortage, parents are looking for any way possible to make the formula they do have stretch as far as it can go, and they are looking for healthy alternatives for their babies, should they run out.

The American Academy of Pediatrics (AAP) recently approved the use of cow’s milk to replace infant formula for a period of no more than seven days, but there are things you need to know to ensure your baby is safe and healthy.

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We spoke with Jeannie Huang, MD, MPH, Pediatric Gastroenterologist, Rady Children’s Hospital-San Diego and Mona Amin, DO, FAAP to break down everything you need to know to safely transition your child to milk or solids during the baby formula shortage.

As always, it is advised that you only make changes to your child’s diet under the advisement and watchful eye of a board-certified pediatrician.

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Why wait until 12 months to transition from formula?

According to Amin, possible digestive issues aside, the main reason for waiting until 12 months to transition a baby away from formula or breast milk is the lack of sufficient iron levels in cow’s milk and cow milk substitutes. The higher iron levels in baby formula best mimic that of what infants get in breast milk without the need for supplements or monitoring.

Amin points out that in Canada the recommended age to transition from infant formula to cow’s milk is 9 months, so while it’s important to heed the advisement of physicians, it’s not always an exact science and—depending on the child—early transition can be an option.

“While I always recommend following the advisement of the AAP, in a time of formula shortage we do need to look at other ways to ensure all babies continue to be well-fed,” says Amin.

Who can transition from infant formula?

Only consider transitioning an infant that is under 12-months-old under the advisement of a physician.

If your infant is exhibiting normal growth and does not have any underlying digestive or health issues, they may be a candidate for early transitioning to cow’s milk. The AAP currently does not recommend using toddler formula, due to low iron levels, for more than a day or so and only recommends using cow’s milk for up to seven days under the advisement of a physician.

That being said, the CDC says that children can be introduced to cheeses, yogurt, fruits, vegetables and fortified cereals at 6 months, so there are lots of healthy options to ensure your baby is well-fed.

“Oftentimes, by 6 months of age, infants are able to take solids, and thus solid food intake can be used to ensure adequate intake of calories. However, when making this transition, nutritional intake sufficiency should be monitored carefully to ensure proper weight gain,” says Huang.

How can you transition your baby safely from formula?

According to Amin, it really depends on the child. In the best-case scenario, if you notice you are running low on formula, she recommends you start by doing a 50/50 mixture of formula and cow’s milk. Mix a half portion of baby formula as you would normally with filtered water, and then add an equal amount of milk to their bottle.

“Ideally you’ll do this [half-and-half mixture] at each feeding, both so that it’s not a new taste and to help a baby adjust to the new food,” says Amin.

Huang says it’s important to make sure you only give babies full-fat milk, and that you should not only check in with your child’s pediatrician often, you should also monitor for potential milk allergies.

“Potential signs of cow’s milk protein allergy should be monitored for,” says Huang. She adds that signs can include blood in the stool, vomiting, signs of dehydration and/or a rash.

What if you’re vegan?

Vegan? Avoid almond, coconut and rice milks. Instead rely on high-fat, low-sugar pea or soy milk/

Amin says that, if you are against animal products and find yourself in a crisis, avoid coconut and almond milk at all costs. Instead, you should reach for high-fat, low-sugar pea or soy milk instead.

“We are looking for adequate protein and fat content. Rice, coconut and almond milks do not have enough protein and can result in a baby losing too much body weight. For nutritional purposes, they should be avoided. Soy and pea milk are much better options,” says Amin.

How should you collaborate with your pediatrician?

If you decide to transition early with your pediatrician using cow’s milk, Huang recommends not only that you have regular discussions about how to ensure proper nutritional needs are being met, but that you also schedule weight checks to ensure adequate weight gain.

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“It is also customary at 1 year to check for anemia, which will be important to make sure your child has received enough supplemental iron to avoid iron deficiency anemia,” says Huang.

Communication is key

Both of our experts agree that you should never hesitate to talk with your child’s pediatrician about when and how to transition your child away from formula or supplement your formula supply in the time of a shortage. Also, if your child has special health needs always be sure to be in constant conversation with your pediatrician.

“We are here to help. There is a lot of confusing information available and this is a tough time to be a parent, but your pediatrician is there to get you and your baby through this,” says Amin.

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