Bennett, William E.Hendrix, Kristin S.Thompson-Fleming, Rachel T.Downs, Stephen M.Carroll, Aaron E.2016-11-032016-11-032014-07Bennett, W. E., Hendrix, K. S., Thompson, R. T., Downs, S. M., & Carroll, A. E. (2014). Early Cow’s Milk Introduction is Associated with Failed Personal-Social Milestones After One Year of Age. European Journal of Pediatrics, 173(7), 887–892. http://doi.org/10.1007/s00431-014-2265-y1432-1076https://hdl.handle.net/1805/11349Both the American Academy of Pediatrics (AAP) and the Institute of Medicine (IOM) recommend delaying the introduction of cow's milk until after 1 year of age due to its low absorbable iron content. We used a novel computerized decision support system to gather data from multiple general pediatrics offices. We asked families whether their child received cow's milk before 1 year of age, had a low-iron diet, or used low-iron formula. Then, at subsequent visits, we performed a modified developmental assessment using the Denver II. We assessed the effect of early cow's milk or a low-iron diet on the later failure of achieving developmental milestones. We controlled for covariates using logistic regression. Early cow's milk introduction (odds ratio (OR) 1.30, p = 0.012), as well as a low-iron diet or low-iron formula (OR 1.42, p < 0.001), was associated with increased rates of milestone failure. Only personal-social milestones (OR 1.44, p = 0.002) showed a significantly higher rate of milestone failure. Both personal-social (OR 1.42, p < 0.001) and language (OR 1.22, p = 0.009) showed higher rates of failure in children with a low-iron diet. CONCLUSIONS: There is an association between the introduction of cow's milk before 1 year of age and the rate of delayed developmental milestones after 1 year of age. This adds strength to the recommendations from the AAP and IOM to delay cow's milk introduction until after 1 year of age.en-USPublisher PolicyChild DevelopmentDevelopmental DisabilitiesetiologyInfant Nutritional Physiological PhenomenaMilkadverse effectsArticle