06/02/2026
La Leche League International Position Statement on the supplementation of breastfed infants with cow’s milk formula to prevent cow’s milk allergy
For immediate release:
Raleigh, North Carolina, USA, March 2026 – La Leche League International (LLLI) is very concerned about recent recommendations given by some allergists and pediatricians suggesting regular cow’s milk formula supplementation for breastfed infants to prevent cow’s milk allergy, especially when given in the first three days after birth.1
Research has shown that it is best to avoid supplementation of cow’s milk formula in order to prevent cow’s milk allergy. Although there have been limited studies recommending supplementing cow’s milk formula regularly for a few months to prevent allergies, these studies have insufficient or conflicting evidence.2
Routine use of cow’s milk-based formula in the critical newborn period, serves the interests of commercial formula companies rather than the babies themselves.3 Research has shown that an exclusively breastfed infant who never had cow’s milk formula is not at higher risk of cow’s milk allergy and may be at a lower risk. It is the exposure to the formula in the early days of life that heightens the risk of cow’s milk allergy in susceptible babies.4
“A harmful strategy is to keep infants on cow’s milk formula to induce tolerance, when the intention is to exclusively breastfeed. This increases the risk of premature weaning, violates the agency and rights of the mother to decide how to feed her infant, and increases the risk of morbidity and mortality for both mother and infant.” (Dr. Anne Eglash, a physician on the Medical Advisory Team of La Leche League International)
The recommended global standard for optimal infant feeding for the health of mother and child is exclusive breastfeeding for the first six months of life and continued breastfeeding for two years and beyond.5 The recommendation to supplement cow’s milk formula does not consider the risk of infants developing other illnesses in the absence of exclusive breastfeeding, changes to baby’s gastrointestinal (GI) tract, or the physical and emotional impact on those who wean earlier than planned.6 Premature babies who are not exclusively fed human milk have been shown to experience higher rates of necrotizing enterocolitis, which can be life-threatening.7
Recommendations to provide and continue regular supplementation of cow’s milk formula can sabotage exclusive breastfeeding. Supplementation is a major reason for premature weaning.8 Premature weaning increases morbidity and mortality for both the mother and infant, even in high-income countries. Parents may face objections from healthcare professionals who are concerned with prevention of allergy, even though the prevalence of cow’s milk allergy in children living in high income countries is only approximately 2 to 3%.9
Since 1956, La Leche League (LLL) has supported families worldwide in meeting their breastfeeding goals. Extensive global experience shows that exclusive breastfeeding remains an achievable goal, even when early formula supplementation occurs.
LLLI concludes that there is insufficient evidence to support the continued use of cow’s milk formula supplementation to prevent cow’s milk protein allergy. Supplementation during the early days after birth should be avoided unless medically indicated or unless it is the parent’s informed choice after counseling by the health care provider. If supplementation is medically necessary, the mother’s own milk or donor milk is preferred.4,5 This is particularly important in view of the established risks of unnecessary cow’s milk formula supplementation to maternal and infant health. If expressed breastmilk or human donor milk is not available, the infant’s age, the family’s resources and the impact on establishing breastfeeding should be considered in weighing the health risk of any use of regular or specialized commercial formula.4,10
La Leche League will continue supporting exclusive breastfeeding as an important goal regardless of supplementation status in the early days after birth.
