When can my baby drink cow’s milk? It’s sooner than you think
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Parents are often faced with well-meaning opinions and conflicting advice about what to feed their babies.
The latest guidance from the World Health Organization (WHO) recommends formula-fed babies can switch to cow’s milk from six months. Australian advice says parents should wait until 12 months. No wonder some parents, and the health professionals who advise them, are confused.
So what do parents need to know about the latest advice? And when is cow’s milk an option?
What’s the updated advice?
Last year, the WHO updated its global feeding guideline for children under two years old. This included recommending babies who are partially or totally formula fed can have whole animal milks (for example, full-fat cow’s milk) from six months.
This recommendation was made after a systematic review of research by WHO comparing the growth, health and development of babies fed infant formula from six months of age with those fed pasteurised or boiled animal milks.
The review found no evidence the growth and development of babies who were fed infant formula was any better than that of babies fed whole, fresh animal milks.
The review did find an increase in iron deficiency anaemia in babies fed fresh animal milk. However, WHO noted this could be prevented by giving babies iron-rich solid foods daily from six months.
On the strength of the available evidence, the WHO recommended babies fed infant formula, alone or in addition to breastmilk, can be fed animal milk or infant formula from six months of age.
The WHO said that animal milks fed to infants could include pasteurised full-fat fresh milk, reconstituted evaporated milk, fermented milk or yoghurt. But this should not include flavoured or sweetened milk, condensed milk or skim milk.
Why is this controversial?
Australian government guidelines recommend “cow’s milk should not be given as the main drink to infants under 12 months”. This seems to conflict with the updated WHO advice. However, WHO’s advice is targeted at governments and health authorities rather than directly at parents.
The Australian dietary guidelines are under review and the latest WHO advice is expected to inform that process.
OK, so how about iron?
Iron is an essential nutrient for everyone but it is particularly important for babies as it is vital for growth and brain development. Babies’ bodies usually store enough iron during the final few weeks of pregnancy to last until they are at least six months of age. However, if babies are born early (prematurely), if their umbilical cords are clamped too quickly or their mothers are anaemic during pregnancy, their iron stores may be reduced.
Cow’s milk is not a good source of iron. Most infant formula is made from cow’s milk and so has iron added. Breastmilk is also low in iron but much more of the iron in breastmilk is taken up by babies’ bodies than iron in cow’s milk.
Babies should not rely on milk (including infant formula) to supply iron after six months. So the latest WHO advice emphasises the importance of giving babies iron-rich solid foods from this age. These foods include:
- meat
- eggs
- vegetables, including beans and green leafy vegetables
- pulses, including lentils
- ground seeds and nuts (such as peanut or other nut butters, but with no added salt or sugar).
You may have heard that giving babies whole cow’s milk can cause allergies. In fact, whole cow’s milk is no more likely to cause allergies than infant formula based on cow’s milk.
What are my options?
The latest WHO recommendation that formula-fed babies can switch to cow’s milk from six months could save you money. Infant formula can cost more than five times more than fresh milk (A$2.25-$8.30 a litre versus $1.50 a litre).
For families who continue to use infant formula, it may be reassuring to know that if infant formula becomes hard to get due to a natural disaster or some other supply chain disruption fresh cow’s milk is fine to use from six months.
It is also important to know what has not changed in the latest feeding advice. WHO still recommends infants have only breastmilk for their first six months and then continue breastfeeding for up to two years or more. It is also still the case that infants under six months who are not breastfed or who need extra milk should be fed infant formula. Toddler formula for children over 12 months is not recommended.
All infant formula available in Australia must meet the same standard for nutritional composition and food safety. So, the cheapest infant formula is just as good as the most expensive.
What’s the take-home message?
The bottom line is your baby can safely switch from infant formula to fresh, full-fat cow’s milk from six months as part of a healthy diet with iron-rich foods. Likewise, cow’s milk can also be used to supplement or replace breastfeeding from six months, again alongside iron-rich foods.
If you have questions about introducing solids your GP, child health nurse or dietitian can help. If you need support with breastfeeding or starting solids you can call the National Breastfeeding Helpline (1800 686 268) or a lactation consultant.
Karleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University; Naomi Hull, PhD candidate, food security for infants and young children, University of Sydney, and Nina Jane Chad, Research Fellow, University of Sydney School of Public Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Stop The World…
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Some news highlights from this week:
“US vs Them”?
With the US now set to lose its WHO membership, what does that mean for Americans? For most, the consequences will be indirect:
- the nation’s scientists and institutions will be somewhat “left out in the cold” when it comes to international scientific collaboration in the field of health
- the US will no longer enjoy a position of influence and power within the WHO, which organization’s reports and position statements have a lot of sway over the world’s health practices
Are there any benefits (of leaving the WHO) for Americans? Yes, there is one: the US will no longer be paying into the WHO’s budget, which means:
- the US will save the 0.006% of the Federal budget that it was paying into the WHO annually
- for the average American’s monthly budget, that means (if the saving is passed on) you’ll have an extra dime
However, since US scientific institutions will still need access to international data, likely that access will need to be paid separately, at a higher rate than US membership in WHO cost.
In short: it seems likely to go the way that Brexit did: “saving” on membership fees and then paying more for access to less.
Why is the US leaving again? The stated reasons were mainly twofold:
- the cost of US membership (the US’s contribution constituted 15% of the the overall WHO budget)
- holding the US’s disproportionately high COVID death rate (especially compared to countries such as China) to be a case of WHO mismanagement
Read in full: What losing WHO membership means for the U.S.
Related: What Would a Second Trump Presidency Look Like for Health Care? ← this was a speculative post by KFF Health News, last year
Halt, You’re Under A Breast
More seriously, this is about halting the metastasis of cancerous tumors in the breast. It is reasonable to expect the same principle and thus treatment may apply to other cancers too, but this is where the research is at for now (breast cancer research gets a lot of funding).
And, what principle and treatment is this, you ask? It’s about the foxglove-derived drug digoxin, and how it stops cancerous cells from forming clusters, and even actively dissolves clusters that have already formed. No clusters means no new tumors, which means no metastasis. No metastasis, in turn, means the cancer becomes much more treatable because it’s no longer a game of whack-a-mole; instead of spreading to other places, it’s a much more manageable case of “here’s the tumor, now let’s kill it with something”.
Note: yes, that does mean the tumor still needs killing by some other means—digoxin won’t do that, it “just” stops it from spreading while treatment is undertaken.
Read in full: Proof-of-concept study dissolves clusters of breast cancer cells to prevent metastases
Related: The Hormone Therapy That Reduces Breast Cancer Risk & More
Force Of Habit
“It takes 21 days to make a habit”, says popular lore. Popular is not, however, evidence-based:
❝This systematic review of 20 studies involving 2601 participants challenges the prevailing notion of rapid habit formation, revealing that health-related habits typically require 2–5 months to develop, with substantial individual variability ranging from 4 to 335 days. The meta-analysis demonstrated significant improvements in habit scores across various health behaviours, with key determinants including morning practices, personal choice, and behavioural characteristics❞
So, this is not a lottery, “maybe it will take until Tuesday, maybe it will take nearly a year”, so much as “there are important factors that seriously change how long a habit takes to become engrained, and here is what those factors are”.
Read in full: Study reveals healthy habits take longer than 21 days to set in
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Tribulus Terrestris For Testosterone?
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(Clinical) Trials and Tribul-ations
In the category of supplements that have enjoyed use as aphrodisiacs, Tribulus terrestris (also called caltrop, goat’s head, gokshura, or puncture vine) has a long history, having seen wide use in both Traditional Chinese Medicine and in Ayurveda.
It’s been used for other purposes too, and has been considered a “general wellness” plant.
So, what does the science say?
Good news: very conclusive evidence!
Bad news: the conclusion is not favorable…
Scientists are known for their careful use of clinical language, and it’s very rare for a study/review to claim something as proven (scientists leave journalists to do that part), and in this case, when it comes to Tribulus’s usefulness as a testosterone-enhancing libido-boosting supplement…
❝analysis of empirical evidence from a comprehensive review of available literature proved this hypothesis wrong❞
Strong words! You can read it in full here; they do make some concessions along the way (e.g. mentioning unclear or contradictory findings, suggesting that it may have some effect, but by an as-yet unknown mechanism if it does—although some potential effect on nitric oxide levels has been hypothesized, which is reasonable if so, as NO does feature in arousal-signalling), but the general conclusion is “no, this doesn’t have androgen-enhancing properties”:
Pro-sexual and androgen enhancing effects of Tribulus terrestris L.: Fact or Fiction
That’s a review though, what about taking a look at a representative RCT? Here we go:
❝Tribulus terrestris was not more effective than placebo on improving symptoms of erectile dysfunction or serum total testosterone❞
As a performance-enhancer in sport
We’ll be brief here: it doesn’t seem to work and it may not be safe:
Insights into Supplements with Tribulus Terrestris used by Athletes
From sport, into general wellness?
Finally, a study that finds it may be useful for something!
❝Overall, participants supplemented with TT displayed significant improvements in lipid profile. Inflammatory and hematological biomarkers showed moderate beneficial effects with no significant changes on renal biomarkers. No positive effects were observed on the immune system response. Additionally, no TT-induced toxicity was reported.
In conclusion, there was no clear evidence of the beneficial effects of TT supplementation on muscle damage markers and hormonal behavior.❞
About those lipids…
Animal studies have shown that it may not only improve lipid profiles, but also may partially repair the endothelial dysfunction resulting from hyperlipidemia:
Want to try some?
In the unlikely event that today’s research review has inspired you with an urge to try Tribulus terrestris, here’s an example product on Amazon
If on the other hand you’d like to actually increase testosterone levels, then we suggest:
Topping Up Testosterone? ← a previous main feature did earlier this year
Take care!
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Lifestyle vs Multiple Sclerosis & More
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This is Dr. Saray Stancic. She’s another from the ranks of “doctors who got a serious illness and it completely changed how they view the treatment of serious illness”.
In her case, Stancic was diagnosed with multiple sclerosis, and wasn’t impressed with the results from the treatments offered, so (after 8 years of pain, suffering, and many medications, only for her condition to worsen) she set about doing better with an evidence-based lifestyle medicine approach.
After 7 years of her new approach, she would go on to successfully run a marathon and live symptom-free.
All this to say: her approach isn’t a magic quick fix, but it is a serious method for serious results, and after all, while it’d be nice to be magically in perfect health tomorrow, what’s important is being in good health for life, right?
If you’re interested in her impressive story, check out:
Doctor With Multiple Sclerosis On The Collapse Of US Healthcare
If you want to know what she did, then read on…
Six key lifestyle changes
Dr. Stancic credits her recovery to focus on the following evidence-based approaches:
The plant-centered plate
This is critical, and is the one she places most emphasis on. Most chronic diseases are exacerbated, if not outright caused, by chronic inflammation, and one cannot fix that without an anti-inflammatory diet.
An anti-inflammatory diet doesn’t have to be 100% plant-based, but broadly speaking, plants are almost always anti-inflammatory to a greater or lesser degree, while animal products are often pro-inflammatory—especially red meat and unfermented dairy.
For more details, see:
Anti-Inflammatory Diet 101 (What to Eat to Fight Inflammation)
Movement every day
While “exercise is good for you” is in principle not a shocker, remember that her starting point was being in terrible condition with badly flared-up MS.
Important to understand here is that excessive exercise can weaken the immune system and sometimes cause flare-ups of various chronic diseases.
Moving thoroughly and moving often, however, is best. So walking yes, absolutely, but also don’t neglect the rest of your body, do some gentle bodyweight squats (if you can; if you can’t, work up to them), stretch your arms as well as your legs, take all your joints through a full range of motion.
See also:
The Doctor Who Wants Us To Exercise Less, & Move More
Mindful stress management
Stress in life is unavoidable, but how we manage it is up to us. Bad things will continue to happen, great and small, but we can take a deep breath, remember that those things aren’t the boss of us, and deal with it calmly and conscientiously.
Mindfulness-Based Stress Reduction is of course the evidence-based “gold standard” for this, but whatever (not substance-based) method works for you, works for you!
About MBSR:
No-Frills, Evidence-Based Mindfulness
Good sleeping habits
Getting good sleep can be hard for anyone, let alone if you have chronic pain. However, Dr. Stancic advocates for doing whatever we can to get good sleep—which means not just duration (the famous “7–9 hours”), but also quality.
Learn more:
The 6 Dimensions Of Sleep (And Why They Matter)
Substance intake awareness
This one’s not so much of a “don’t do drugs, kids” as the heading makes it look. Dr. Stancic assumes we already know, for example, that smoking is bad for us in a long list of ways, and alcohol isn’t much better.
However, she also advises us that in our eagerness to do that plant-based diet, we would do better to go for whole foods plant-based, rather than the latest processed meat substitutes, for example.
And supplements? She bids us exercise caution, and to make sure to get good quality, as poor quality supplements can be worse than taking nothing (looking at you, cheap turmeric supplements that contain heavy metals).
And of course, that nutrients gained from diet will almost always be better than nutrients gained from supplements, as our body can usually use them better.
And see also, some commonly-made supplements mistakes:
Do You Know Which Supplements You Shouldn’t Take Together? (10 Pairs!)
Human connection
Lastly, we humans are a social species by evolution; as individuals, we may enjoy relatively more or less social contact, but having access to such is important not just for our mental health, but our physical health too—we will tend to deteriorate much more quickly when we have to deal with everything alone, all other things being equal.
It doesn’t mean you need a busy social life if that’s not in your nature, but it does mean it’s incredibly beneficial to have at least a small number of people that you trust and whose company you enjoy, at least relatively accessible to you (i.e., their life need not revolve around you, but they are the kind of people who will generally happily spend time with you and provide support when needed if they can).
As for how:
How To Beat Loneliness & Isolation
Want to know more from Dr. Stancic?
We recently reviewed this very good book of hers, which goes over each of these six things in much more detail than we have room for here:
What’s Missing from Medicine – by Dr. Saray Stancic
Enjoy!
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Eye Drops: Safety & Alternatives
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Before important business meetings my father used to use eye drops to add a “sparkle” to his eyes. I think that is a step too far, but what, short of eye drops, can we do to keep our eyes bright throughout the day?❞
Firstly, we’d indeed not recommend eye drops unless advised to do so by your doctor to treat a specific health condition:
- Infections from over-the-counter artificial tears
- Are my eye drops safe to use?
- More eye drops recalled due to infection danger
Those eye drops that “add sparkle” are often based on astringents such as witch hazel. This means that the capillaries in the eye undergo vasoconstriction, becoming much less visible and the eye thus appears much whiter and thus brighter.
There isn’t a way to do the same thing from the inside, as taking a vasoconstrictor will simply increase your general blood pressure, making the capillaries of your eyes more, rather than less, visible.
However, what you can do is…
- look after your general vasculature (cardiovascular health)
- in particular, reduce hypertension
- that includes limiting salt
- stay away from vasoconstrictors (including caffeine)
- reduce your resting cortisol levels
- that certainly also means reducing alcohol consumption
- maintain good hydration
Take care!
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Managing Major Chronic Diseases – by Alexis Dupree
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Our author, Alexis Dupree, is herself in her 70s, and writing with more than three decades of experience of surviving multiple chronic diseases (in her case, Multiple Sclerosis, and then a dozen comorbidities that came with such).
She is not a doctor or a scientist, but for more than 30 years she’s been actively working to accumulate knowledge not just on her own conditions, but on the whole medical system, and what it means to be a “forever patient” without giving up hope.
She talks lived-experience “life management” strategies for living with chronic disease, and she talks—again from lived experience—about navigating the complexities of medical care; not on a legalistic “State regulations say…” level, because that kind of thing changes by the minute, but on a human level.
Perhaps most practically: how to advocate strongly for yourself while still treating medical professionals with the respect and frankly compassion that they deserve while doing their best in turn.
But also: how to change your attitude to that of a survivor, and yet also redefine your dreams. How to make a new game plan of life—while working to make life easier for yourself. How to deal, psychologically, with the likelihood that not only will you probably not get better, but also, you will probably get worse, while still never, ever, giving up.
After all, many things are easily treatable today that mere decades ago were death sentences, and science is progressing all the time. We just have to stay alive, and in as good a condition as we reasonably can, to benefit from those advances!
Bottom line: if you have a chronic disease, or if a loved one does, then this is an immensely valuable book to read.
Click here to check out Managing Major Chronic Diseases, and make life easier!
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Black Cohosh vs The Menopause
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Black Cohosh, By Any Other Name…
Black cohosh is a flowering plant whose extracts are popularly used to relieve menopausal (and postmenopausal) symptoms.
Note on terms: we’ll use “black cohosh” in this article, but if you see the botanical names in studies, the reason it sometimes appears as Actaea racemosa and sometimes as Cimicfuga racemosa, is because it got changed and changed back on account of some disagreements between botanists. It’s the same plant, in any case!
Read: Reclassification of Actaea to include Cimicifuga and Souliea (Ranunculaceae)
Does it work?
In few words: it works for physical symptoms, but not emotional ones, based on this large (n=2,310) meta-analysis of studies:
❝Black cohosh extracts were associated with significant improvements in overall menopausal symptoms (Hedges’ g = 0.575, 95% CI = 0.283 to 0.867, P < 0.001), as well as in hot flashes (Hedges’ g = 0.315, 95% CIs = 0.107 to 0.524, P = 0.003), and somatic symptoms (Hedges’ g = 0.418, 95% CI = 0.165 to 0.670, P = 0.001), compared with placebo.
However, black cohosh did not significantly improve anxiety (Hedges’ g = 0.194, 95% CI = -0.296 to 0.684, P = 0.438) or depressive symptoms (Hedges’ g = 0.406, 95% CI = -0.121 to 0.932, P = 0.131)❞
~ Dr. Ryochi Sadahiro et al., 2023
Source: Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis
Here’s an even larger (n=43,759) one that found similarly, and also noted on safety:
❝Treatment with iCR/iCR+HP was well tolerated with few minor adverse events, with a frequency comparable to placebo. The clinical data did not reveal any evidence of hepatotoxicity.
Hormone levels remained unchanged and estrogen-sensitive tissues (e.g. breast, endometrium) were unaffected by iCR treatment.
As benefits clearly outweigh risks, iCR/iCR+HP should be recommended as an evidence-based treatment option for natural climacteric symptoms.
With its good safety profile in general and at estrogen-sensitive organs, iCR as a non-hormonal herbal therapy can also be used in patients with hormone-dependent diseases who suffer from iatrogenic climacteric symptoms.❞
~ Dr. Castelo-Branco et al., 2020
(iCR = isopropanolic Cimicifuga racemosa)
So, is this estrogenic or not?
This is the question many scientists were asking, about 20 or so years ago. There are many papers from around 2000–2005, but here’s a good one that’s quite representative:
❝These new data dispute the estrogenic theory and demonstrate that extracts of black cohosh do not bind to the estrogen receptor in vitro, up-regulate estrogen-dependent genes, or stimulate the growth of estrogen-dependent tumors❞
Source: Is Black Cohosh Estrogenic?
(the abstract is a little vague, but if you click on the PDF icon, you can read the full paper, which is a lot clearer and more detailed)
The short answer: no, black cohosh is not estrogenic
Is it safe?
As ever, check with your doctor as everyone’s situation can vary, but broadly speaking, yes, it has a very good safety profile—including for breast cancer patients, at that. See for example:
- Black cohosh efficacy and safety for menopausal symptoms: the Spanish Menopause Society statement
- Black cohosh (Cimicifuga racemosa): safety and efficacy for cancer patients
- The safety of black cohosh (Actaea racemosa, Cimicifuga racemosa)
Where can I get some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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