The 12-month check up is a major moment of transition.  A one year-old is no longer an infant:  he is a toddler.  You can keep calling him “baby,” but a baby he is not.  While the mothers of toddlers can be encouraged to continue breastfeeding, those who are bottle-fed formula face a major change:  the bottle and the formula have to go.  Remember, bottles are for babies and your one year-old is not a baby anymore.  By this time, most kids are not taking more than 3-4 bottles of formula per day, and many are actually taking less.  Eliminating one bottle per week can be an effective one month strategy to transition to whole milk in a cup.    It should be stressed here that whole milk never belongs in a baby bottle.  (By the way, juice should never be poured into a baby bottle either!)  Eliminating a mid-day (nap) bottle first and the bedtime bottle last makes the most sense.  Changing the bedtime routine completely at this age is a good idea:  milk in a cup in the kitchen (you don’t need spills of milk on a bedroom or family room carpet!), followed by toothbrushing and, then, winding down on your lap with a pile of books and a  sippy-cup of water.  This strategy works.  And it has to.  Continued use of a baby bottle by a toddler is a quick ticket to tooth decay.  But it’s also a bad idea from a developmental standpoint:  a bottle is for babies!  Your baby is a toddler and deserves age-appropriate utensils.

One question I often get asked at this age is:  “How much whole milk should my toddler be drinking?”  I’ve always replied:  “Zero to 24 ounces per day is acceptable.”  A recent study in Pediatrics puts the number at 2 cups (16 ounces) per day.  Nicholas Bakalar at explains:

The study, published online in the journal Pediatrics last week, found that after adjusting for other factors, two cups a day was enough to maintain sufficient vitamin D (more than 30 nanograms per milliliter of blood) without affecting iron levels. But bottle use, season of the year, skin pigmentation and body mass index had significant effects on the optimal amounts of milk. Children with darker skin, for example, needed three to four cups of milk to get sufficient vitamin D in winter. Those who used only a bottle failed to maintain sufficient stores of vitamin D and iron.

We’ll be covering more on feeding toddlers later this week at The PediaBlog. article here.

Abstract in Pediatrics here.