Health effects of cow's milk consumption in infants up to 3 years of age: a systematic review and meta-analysis

Public Health Nutr. 2016 Feb;19(2):293-307. doi: 10.1017/S1368980015001354. Epub 2015 May 20.


Objective: To summarize the best available evidence regarding the short- and long-term health effects of cow's milk intake in healthy, full-term infants up to 3 years of age.

Design: We conducted a systematic review and meta-analysis.

Setting: We searched MEDLINE (via PubMed), EMBASE and the Cochrane Library between 1960 and July 2013 and manually reviewed reference lists of pertinent articles. Two researchers independently reviewed abstracts and full-text articles and extracted relevant data.

Subjects: We included (randomized/non-randomized) controlled trials and observational studies.

Results: We included data from twenty-three studies (one randomized controlled trial, four non-randomized controlled trials, eight case-control studies and ten cohort studies) for the evidence synthesis. Pooled results of four studies revealed a higher risk of Fe-deficiency anaemia for infants consuming cow's milk compared with those consuming follow-on formula (relative risk=3·76; 95 % CI 2·73, 5·19). For type 1 diabetes mellitus, six out of seven case-control studies did not show a difference in the risk of developing this disease based on the age of introduction of cow's milk. We did not find negative associations for other health effects.

Conclusions: Cow's milk consumption in infancy is associated with an increased risk of developing Fe-deficiency anaemia. Limiting cow's milk consumption may be important to ensure an adequate Fe intake for infants and toddlers. High-quality patient information for caregivers is needed on how infants' Fe requirements can be met.

Keywords: Cow’s milk consumption; Infants; Systematic review.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Anemia, Iron-Deficiency / etiology*
  • Animals
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / etiology
  • Diet / adverse effects*
  • Female
  • Humans
  • Infant
  • Infant Formula / chemistry*
  • Infant, Newborn
  • Male
  • Milk / adverse effects*