Literature review for - Flourish Paediatrics

Cow’s Milk
Search results
The initial search of the databases included 370 references on unmodified cow and/or goat
milk and infant feeding. Data were extracted from 26 references, and 17 publications were
used to form the final body of evidence statements. Sufficient evidence was found to make
statements on the proportion of infants fed unmodified cow’s milk before 12 months of age,
the potential determinants of the early introduction of unmodified cow’s milk and the effects
of feeding cow’s milk to infants less than 12 months of age. Additional evidence was found
on the association between cow’s milk intake and occult gastrointestinal blood loss (1
controlled trial, 1 cross sectional study, 1 case-control study) but the evidence was not strong
enough to develop a body of evidence statement.
THE PROPORTION OF INFANTS FED UNMODIFIED COW’S MILK BEFORE 12
MONTHS OF AGE
How many infants are fed unmodified cow’s milk before 12 months of age?
Draft Evidence Statement
Draft Grade
Component Rating Notes
Evidence Base
Consistency
The majority of infants are given cow’s milk before the
recommended age of 12 months
D
Satisfactory 6 studies [3 cohort study, 3 cross sectional study (4P,
20)]
Satisfactory All studies observed infant’s being fed cow’s milk
before 12 months of age; a cohort study in NZ reported
69% of infants were being given cow’s milk as a
beverage before the age of 12 months, in a Perth cohort
study 81.8% of infants had consumed cow’s milk as a
drink at least once before 12 months and 39.1% of the
infants were having cow’s milk daily, a cohort study in
Europe found by 12 months 50.7% of infants had
received cow’s milk
A proportion of infants less than 12 months of age are
consuming a significantly high amount of cow’s milk; a
Sydney cross sectional study reported 5% of 6-9 month
and 13% of 9-12 month-old infants consumed over a
litre of cow’s milk a day, another cross-sectional study
in Australia found at 9 months cow’s milk was the
main drink for 5% of infants, a Perth cohort study found
at 40 weeks 6.2% of infants had cow’s milk daily, a
cross-sectional study in USA 22% of infants aged 9-11
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