Child health – How much milk should my baby get per day

Q: My daughter is now 14 months old and is eating quite well (I think). I'm not sure how much she should be eating and drinking milk. Currently she has milk three times a day. Morning, after lunch and then bedtime. She normally has about 6oz each time apart from night time which she has 7oz. Lately she seems to be asking or wanting more food all the time. I don't know if this is because she sees food and wants to try some or she's genuinely hungry? I don't want to overfeed her either. Her norrmal routine would be:

6am awake
6.30am Milk (6oz)
7.30am breakfast (cereal)
12 noon lunch (hot meal)
1pm milk (6oz)
4pm tea (sandwich or light snacky food)
6.30pm milk (7oz)

Soon as I pick her up from nursery at 5.30pm and bring her home, she is in the kitchen following me and pointing at food. Is this normal? I'm also trying to wean her off the bottle now so giving her milk in a beaker in the afternoon. Nursery are trying this but she doesn't seem to be interested. They say she doesn't need that afternoon milk. She is just attached to the bottle. I'm not so sure as why is she always hungry? Also they are giving whole cow milk where as I'm mixing formula with cow milk. Do you think it's that?

Can you please advice? Give me some guideline so I know if I'm doing the right thing and when to drop the afternoon milk? 

Answer from Dr Clare Heggie

It's great news to hear that your daughter has a healthy appetite.  Please don't worry about overfeeding her.  Provided that you are giving her healthy foods and avoiding unecessary high saturated fat and sugar snacks it is virtually impossible to overfeed a toddler.  Toddlers still have quite small stomachs so most are unable to eat big meals.  As a result they often get hungry again within a few hours and so healthy nutritious snacks play an important role.  Toddlers are very active (if she is not walking yet, she will be soon) and expend a lot of energy.  A general guide to the amount of calories an average healthy toddler should be consuming per day is between 1000 to 1200 depending on height,build and sex (slightly higher for boys).
Looking at her daily routine it seems that you are doing the right thing with meal-times and snacks.  Remember to make sure the snacks are healthy, filling and nutritious, such as pieces of cheese, fruit, small sandwiches or a yoghurt.  At breakfast time, if she is eating all her cereal you could also offer her some fruit or toast.  Maybe the light snacky food or sandwich at teatime is not sustaining enough for her.  Remember that each meal should contain a good sized portion of starchy carbohydrate (to keep her feeling full) such as bread, pasta, rice, cous cous, cereals or potatoes.  If she finishes all of the food on her plate at a meal then you could offer her a bit more.
As far as milk goes I think I tend to agree with the nursery. Sometime between the age of 12- 14 months it is usual to drop the afternoon milk feed and substitute it with water in a beaker instead.  The recommended requirement of milk / dairy per day for a toddler is 500ml.  This includes milk in food such as on cereals,  in cooking, as cheese or yoghurts.  I think it is likely that she would be having plenty of dairy if she had a 6-70z milk drink at / after breakfast and 70z at bedtime provided you are using milk in her foods and I assume she enjoys cheese / yoghurts!  Remember that you should use full fat milk rather than semi-skimmed up to the age of 2.  Formula is unecessary at this age although it does contain a much broader range of vitamins and minerals than plain cows milk(which is why it is a lot more expensive too!).  As formula is often much sweeter than cow's milk is normal for many toddlers to reject cows milk at first until they get used to the taste.  As you are doing, many parents mix reconstituted formula with cows milk and gradually reduce the proportion of formula until the child is accepting plain cows milk.  This is a good idea although I wouldn't worry too much if she takes a while to come of the formula – it certainly isn't doing her any harm and many children up to the age of 2 are still given a formula drink at bedtime.
Switching to a beaker is also a good idea in theory and is recommended by health professionals.  Both milk and formula contain a lot of naturall sugars and it is thought that drinking from a bottle carries a much higher risk of tooth decay than drinking from a beaker.  That said, toddlers are independent little people and may reject their milk from a beaker, especially at bedtime when they find it most comforting.  If this is the case, I would continue with the bottle but take special care to thoroughly clean her teeth before bed (and after breakfast).  It would be a good idea to keep trying with the beaker every now and again as you will find that one day she will probably accept it.

> Back to Panel of Experts