Milk Transition-When, Why, and How (Pedcast)



Transcript: “Milk Transition, When, Why, and How”



Welcome to another edition of


Thanks for joining me today, I am your host, Dr. Paul Smolen.


Frequently asked question by parents about the composition of milk and can they stop buying formula.


Parents anxious to change to whole milk because of convenience and cost.


To understand, need to know some immunology and chemistry.


While we are at it, let me give you some practical advice about making the change from baby milk to big people milk.


How do breast milk, cows milk based formula, and whole cow milk differ? To answer lets detour down science lane.


Compared with breast milk and formula, whole cows milk has less sugar…not as tasty…naturally some resistance by junior.


Compared with breast milk  and formula, whole cows milk has more protein and thicker, less soluble proteins…more curds…slower transit, more fermentation into cheese , therefore harder stools for little Janie or Johnny.


Compared with breast milk, whole cows milk has proteins that can frequently provoke allergic reactions, especially children under 6 months.  The allergic reaction in the gut can cause bleeding gut wall.  Subsequent anemia can develop and anemia in first year really bad associated with various serious health issues. That’s why we don’t give whole cow’s milk  to babies under 1 year!


Compared with breast milk and formula, whole cow’s milk has almost no iron, which as you know, is a vital nutrient for children.


Compared with breast milk and formula, whole cow’s milk is missing some fats and vitamins that others have but solids should make up for this.


When milk is the whole ballgame, early infancy, we need to get it right.


In the second year, not as important because of so many other nutrients and much of brain development has already occurred.


The bottom line is that whole cow’s milk is not appropriate food for infants( children in the first year).  I repeat, whole cow’s milk is not appropriate food for infants.




Time for a call in question from Boris: ”What do the experts recommend for my little comrades?”


Their recommendation is a strong one: breast milk or formula until at least one year.  Remember, those Doc Smo pearls, “Breast is best” and “Longer means stronger” and “Mom is de-bomb.”

But all good things come to an end. At some point must give up the breast.


When you do transition, make sure you go to whole milk, which is about 5% fat.  Nothing leaner; not 2%, not skim.  This is because your child’s brain is made of fat and consumption of fat is essential for proper brain development.


Most parents transition to whole cow’s milk at around 1 year but not all.  Many cultures breast feed long into childhood.  Nothing wrong with that. Cultures evolve and change.  50 years ago almost no one breastfed in the US. Science is overwhelming that breast milk is the best food for babies.  Maybe we are headed for a cultural change, longer breast-feeding with a delay in weaning?


What kind of problems do parents experience when transitioning to whole cow’s milk?


1. Not as sweet.  Baby may refuse since whole cow’s milk is not as sweet as breast milk or formula. I recommend you mix the whole cow’s milk with formula or breast milk and slowly wean your child away from the sweet taste.


2. More protein and different proteins can mean more constipation… The savvy parent is ready for this with more fruit, fiber, and water.


3. Less iron can also spell trouble. Again, the savvy parent is ready with iron rich foods. Meats (any are fine), infant cereals, green leafy veg, and dark purple fruits, raisins, plums, prunes.  These are foods all of which are rich in iron.


4. Whole cow’s milk like breast milk and formula may not supply your child with enough Vitamin D.  Vitamin D, 400 IU needs to be continued throughout childhood.


So let’s sum it all up.


Whole cow’s milk is not appropriate food first year, pure and simple.


Breast is preferred, but when it is not available, infant formula is the only substitue in the first year of life.


Most parents transition their children to whole cow’s milk at around 1 year to whole. Experts warn against using not leaner mil in the second year because babies at that age need a lot of fat in order to grow properly.  Whole cow’s milk is a good food for children in the second year of life but should be given along with a good variety of other nutrients given.  Milk alone is not a complete food.


Problems that parents may encounter when transitioning to cow’s milk are resistance to taste because not as sweet and constipation because of protein content and composition is different. To counter these problems, I recommend you reduce the sugar content slowly and make sure infant has high fiber intake during transition.


Many children are tired of milk from their first year. Be persistent with milk since for many children, this is an acquired taste. I feel that your child’s choices of drink during childhood should be either milk or water.  Stay away from juices and other sweetened beverages, even diluted.


Vitamin D supplement need to continue and limit milk intake to no more than 24 ounces per day.  And those bottles, they need to go at your child’s first birthday.


That’s it for this week from studio 1E, you know, the first child’s bedroom on the east side of the house.


Thanks for joining me.


Comments are welcome as always.


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Dr Paul Smolen, hoping your child’s transition to milk goes smooth as silk.


Until next time.

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What to do if your child is a ‘potty refuser’ (Pedcast)

Weaning children off of diapers isn’t always an easy task. Doc Smo helps parents potty train these so called “potty refusers” by enrolling them in his school of natural consequences. Listen to this pedcast to glean practical tips for getting reluctant toddlers to use the toilet.

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It is an almost everyday occurrence that I see in the office an otherwise normal three year old who comes for his checkup and is wearing diapers. Let’s face it: for a three year old, life is good in diapers! It’s all play, no interruption, and Mom or Dad takes total responsibility for keeping him clean. Well, when I see these 3 year olds in diapers who are otherwise developmentally normal, it’s time for Potty Boot Camp. It’s time to enroll them in the “School of Natural Consequences.” I love the School of Natural Consequences; it’s tuition-free, and the learning comes fast. Sort of “in-your-panties learning.”

Today’s episode of Doc Smo addresses the question of what to do when your child refuses to transition from diapers to underwear during the day. Before we get into today’s talk, let’s preface by saying that this discussion assumes a child who is both developmentally and physically normal; they have no problems with control of lower part of the body, and they have no intellectual or developmental delays of significance. Johhny is just refusing to keep himself dry while he’s awake. Or worse, nobody has even asked him to do so during the day.

So how do we approach this situation?

Let’s take a look at the tools we have in our parenting toolbox:
• The first and most obvious tool is rewards. Rewards for appropriate potty behavior include stickers, stars, parent’s praise, candy, and potty presents. Reward is a powerful motivator, and I definitely recommend that you use this tool.
• Let the natural consequences happen…don’t get in the way. Let your child deal with it. Let them deal with their inaction. Make the potty waste their problem!!!! They will quickly learn that it is in their best interests to use the potty.
• The final tool, which I don’t recommend you use in this situation, is punishment. I don’t think you should force your child to sit on the potty, I don’t think you should yell at them, and I don’t think you should belittle them. Remember, your message is lost once you emotionally charge a situation with young children. You don’t want to create negative associations with the toilet. You want your child to want to please you, you want them to take responsibility, and you losing control or creating anything that they find punishment is not going to help with their toilet behavior.

Doc Smo Pearl: “Children learn quickly when consequences of their actions (or inactions) matter.”

Corollary to that Pearl: “Once your child has taken ownership of a problem, they will find a solution.”

So what should you do if you have a three year old (or older) who is clinging to diapers?
I recommend the powerful 1-2 approach to dealing with the Potty Refuser. We are going to use the combination of rewarding good potty participation with enrollment in the School of Natural Consequences. This approach is a powerful combination of motivators. How can they refuse?

Here are the details of this approach:
• Step 1: get them on board mentally with the idea that they will be wearing big-kid undies. Give them some warning, get them pumped. Show them fun underwear, get some pretty panties, talk it up. Create excitement about the process.
• Step 2: Set up some rewards, and make sure they are comfortable with the potty setup. These rewards could be stickers, stars, check marks, presents, or even candy. At the same time, make sure your child is comfortable with the potty itself and with the words they’re going to use.
• Step 3: When the big day comes, get out of the way. Let them be responsible for what happens. Don’t chase them around the house reminding them to use the potty; only say something to them about the potty when they will be leaving the house and be away from the potty.

When they have an accident, don’t get mad. Remember, you change the subject completely when you get angry. Your response should be…”Oh honey, YOU HAVE A PROBLEM. You need to clean that up.” Your child should then be responsible for:
• Cleaning up the mess with paper towel
• Taking their dirty clothes to the laundry
• Taking care of washing with a cloth
• Getting clean clothes

Your attitude throughout this process needs to be matter of fact. The theme here is, “This is your problem, not mine.” Children don’t like to clean the floor, do laundry, clean themselves, or stop playing for anything. While this whole process is going on, explain that if they had used the potty, they would have gotten a gift AND be playing already.

As I said before, this is a powerful approach. It is a good lesson for the future as well: this is your problem, you craft a solution, I’ll help.

I personally have never seen an otherwise normal child not be effectively potty trained in 2 weeks. Most children transition in few days, unless parents make one of the following mistakes:

• Don’t make the big mistake…changing back and forth between pull-ups and underwear to avoid inconvenience (such as preventing accidents in public). Give this new approach a reasonable trial.
• Don’t chase Johnny or Janie around watching for clues they are about to pee. They need to take the initiative. This is their problem remember.
• Don’t inject emotion into the learning process. When you yell or belittle, it changes the subject. Learning new things, especially something big like this, is hard. Expect that there will be accidents, and it’s okay.

Do use your most powerful weapon—your praise—even for the least bit of success. Deep down, your child always wants your love and affection.

This approach usually works great for urination, but many children rebel about pooping between 3-4 years of age…That’s a whole other episode of DocSmo.