Griebler U, Bruckmuller MU, Kien C, Dieminger B, Meidlinger B, Seper K, Hitthaller A, Emprechtinger R, Wolf A, Gartlehner G. - 46617N - Public Health Nutr 2015 ; in press.

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

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.