Does Cow's Milk Formula Cause Diabetes? What the Research Found

If a parent or sibling has type 1 diabetes, or you have read that cow's milk might be linked to it, you may wonder whether the formula you choose matters.

The short answer: research has not shown that cow's milk formula causes type 1 diabetes. TRIGR, a randomized trial of 2,159 babies at high genetic risk (JAMA, 2018), compared a formula with no intact cow's milk protein with a regular cow's milk formula. Type 1 diabetes developed in 8.4% vs 7.6% of children randomized to each formula after a median of 11.5 years, a difference the trial could not tell apart from chance. No formula has been shown to prevent type 1 diabetes, and feeding decisions belong with your baby's pediatrician.

Formuland sells cow's milk and goat's milk formulas, including the Stage 1 formulas listed at the end of this guide; this article does not rank them. Below you will find what the TRIGR and TEDDY studies tested, what they found and what they cannot tell you. Studies, guidance pages and prices checked November 8, 2026.

Why Researchers Asked About Cow's Milk and Diabetes

Type 1 diabetes happens when the immune system destroys the cells in the pancreas that make insulin, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Genes and factors in the environment may trigger that process. Having a parent or sibling with type 1 diabetes raises the chance of developing it. CDC adds that, currently, no one knows how to prevent type 1 diabetes.

The cow's milk question came from the search for those environmental triggers. The TRIGR authors note that some studies suggest early exposure to complex foreign proteins may raise the risk in genetically susceptible children, "although others do not." One idea they tested was bovine insulin, a cow's milk protein that differs from human insulin by 3 amino acids.

This guide covers type 1 diabetes, the type these studies measured. Type 2 diabetes has different causes and was not the outcome of either study.

What the TRIGR Trial Tested

TRIGR (Trial to Reduce Insulin-Dependent Diabetes Mellitus in the Genetically at Risk) asked one question. Does giving babies a formula with no intact cow's milk protein lower the chance of type 1 diabetes? It was double-blind: neither families nor investigators knew which formula a baby received.

Both formulas were made for the study, so TRIGR compared two kinds of cow's milk protein, not two brands. "Extensively hydrolyzed" describes how the protein is processed.

What TRIGR Found

Type 1 diabetes developed in 91 of 1,081 children randomized to the hydrolyzed formula (8.4%). It developed in 82 of 1,078 children randomized to the cow's milk formula (7.6%). The 0.8-point difference had a 95% confidence interval (CI) of -1.6 to 3.2 points. Because that range includes zero, the trial could not tell the two groups apart.

A hazard ratio compares how often diabetes appeared over time in the two groups; 1.0 means no difference. Children were followed for a median of 11.5 years, and 1,744 of the 2,159 (80.8%) completed the trial.

The authors' summary: weaning to a hydrolyzed formula "did not reduce the risk of type 1 diabetes in children with an increased disease risk." They added that the trial "suggests that cow's milk does not play a critical role in the development of type 1 diabetes." Their conclusion: the findings "do not support a need to revise the dietary recommendations for infants at risk for type 1 diabetes."

What the TEDDY Study Added

The Environmental Determinants of Diabetes in the Young (TEDDY) study follows 8,676 children at increased genetic risk (8,506 were included in this analysis). They were enrolled at six centers in the U.S., Finland, Germany and Sweden. Its 2017 analysis in Diabetes Care looked at the first formula each baby received. Unlike TRIGR, TEDDY is observational: parents chose the formula, and researchers recorded what happened.

The outcome was persistent islet autoimmunity: autoantibodies, confirmed on two or more visits in a row, showing the immune system has started to attack the insulin-making cells. It can come before type 1 diabetes, but it is not a diabetes diagnosis.

• Extensively hydrolyzed vs regular cow's milk formula as the first formula in the first 3 months: no significant difference after adjustment (adjusted hazard ratio 1.38, 95% CI 0.95 to 2.01).
• Extensively hydrolyzed formula started in the first 7 days: associated with higher risk of islet autoimmunity (adjusted hazard ratio 1.57, 95% CI 1.04 to 2.38).
• Partially hydrolyzed or other formulas as the first formula: no association with risk.

The authors concluded that islet autoimmunity risk "is not reduced, and may be increased" by hydrolyzed compared with non-hydrolyzed cow's milk formula. They list limits too. Most babies given extensively hydrolyzed formula first (80.5%) were from Finland, and the data do not say why parents chose a formula. Unmeasured factors cannot be ruled out, and whether formula type relates to clinical diabetes needed further follow-up.

These are links, not proof of cause, and not a reason to stop a formula your pediatrician chose for your baby.

Correction: An earlier version of this article said a study of "over 9,000 babies" in four countries found no link between cow's milk formula and diabetes, without naming the study. We could not verify that source. The closest match we found is TEDDY, which enrolled 8,676 children in four countries and measured islet autoimmunity, not diabetes. We corrected the numbers and added the TRIGR trial on November 8, 2026.

What These Studies Cannot Tell You

Both studies are large and long, but they answer narrower questions than "is formula linked to diabetes." Keep these limits in mind:

• Only babies at genetic risk. The TRIGR authors write that their results "are not directly generalizable to the background population." TEDDY says the same about its children.
• Formula vs formula. TRIGR compared two cow's milk protein formulas. It cannot say whether giving formula at all changes diabetes risk.
• Association is not cause. TEDDY is observational, and its outcome was an early immune marker rather than diabetes.
• No brands, no goat's milk. Neither study compared brands, organic formulas or goat's milk formula.
• Type 1 only. Neither study measured type 2 diabetes.

If Type 1 Diabetes Runs in Your Family

Start with your baby's pediatrician. TRIGR studied babies with a parent or sibling with type 1 diabetes and genes linked to it, and its authors saw no need to revise their feeding recommendations. Switching formula is therefore not a prevention step; it is a feeding decision to make with your doctor.

• Switching for another reason? Ask the pediatrician first, prepare each formula with its own scoop and label directions, and never combine two powders in one bottle.
• Screening. NIDDK says a health care professional may suggest an autoantibody test when a parent or sibling has type 1 diabetes. The TrialNet research network offers this testing to some family members.
• Symptoms. NIDDK lists common symptoms in children: urinating more often, eating more but losing weight, and feeling very thirsty. Call your pediatrician promptly if you notice them.
• Emergency signs. Diabetic ketoacidosis (DKA) can be life-threatening, according to CDC. CDC says to call 911 or go to the emergency room right away for fruity-smelling breath, trouble breathing, or vomiting with no food or drink kept down.

Cow's Milk Formula Is Not Plain Cow's Milk

Infant formula made from cow's milk is a different product from the milk in your fridge. The American Academy of Pediatrics (AAP) says babies should not have cow's milk until about 12 months unless no alternative is available; if you cannot get formula, call your pediatrician before using any other milk. Its protein and minerals can stress a newborn's kidneys, and it lacks enough iron, vitamin C and other nutrients. For the move to milk after the first birthday, see our guide to transitioning from formula to milk.

FDA says it does not approve infant formulas before they can be marketed. All formulas marketed in the U.S. must meet federal nutrient requirements, and manufacturers must notify FDA before marketing a new formula. FDA's infant formula regulations page puts that submission at 90 days before marketing (21 U.S.C. 350a).

Formulas made for the European Union follow Regulation (EU) 2016/127. It requires DHA in infant formula and sets a general limit of 0.01 mg/kg per pesticide active substance, with listed exceptions. That is a different rulebook from U.S. requirements; ask your pediatrician which formula fits your baby.

Is There Sugar in Cow's Milk Formula?

Usually yes, and it is mostly lactose, the sugar found naturally in milk. The UK Kendamil Classic First Infant Milk label lists 56 g of carbohydrate per 100 g of powder. Of that, 53 g are sugars and 51 g is lactose, with the footnote "Sugars derived from milk."

EU rules decide which carbohydrates can go in. Regulation (EU) 2016/127 sets a minimum of 4.5 g of lactose per 100 kcal for most infant formula. It allows sucrose and glucose only in formula made from protein hydrolysates, with sucrose capped at 20% of total carbohydrate. For Aptamil or any other brand, the ingredient list on your can shows which carbohydrates it uses.

Neither study above looked at sugar. For lactose questions, see our guide to lactose-free formula.

What About Goat's Milk Formula?

Some formulas are made from goat's milk instead of cow's milk. The NHS says they are produced to the same nutritional standards as cow's milk formula and are not less likely to cause allergies. They are not suitable for babies with cows' milk allergy, because the proteins are very similar. The UK Kendamil Goat label says the same: "Not suitable for children with cow's milk allergy."

No study summarized here shows that goat's milk formula changes diabetes risk. Plain goat's milk, like plain cow's milk, is not infant formula and is not a main drink before 12 months.

If you suspect a milk allergy, the diagnosis and the formula choice belong to your pediatrician. For a diagnosed cow's milk allergy, the NHS describes a prescribed formula with fully hydrolyzed proteins.

Stage 1 Cow's Milk and Goat's Milk Formulas at Formuland

Formuland ships European and UK formula with duties included, free U.S. shipping on orders of $100 or more, and Subscribe & Save at 7% off eligible items. The table lists a few Stage 1 formulas from birth by milk base, in alphabetical order. It is not a shortlist, and none of these formulas is shown to change diabetes risk.

Prices checked November 8, 2026, one-time price for one can or box. Per-ounce figures are for powder, not cost per bottle, because mixing ratios differ. Follow the age range and directions on each label, which differ by brand. Our guide on how to prepare and store baby formula covers water, scoops and storage times.

Powdered formula is not sterile. FDA lists babies 2 months and younger, born prematurely or with weakened immune systems as higher risk for Cronobacter infection, so ask your pediatrician which formula and preparation method fit them. Mix exactly the water and powder the label lists, never more or less.

CDC says to use prepared formula within 2 hours of preparation and within 1 hour from when feeding begins, and to throw out formula left in the bottle after a feed. A bottle you will not use within 2 hours goes in the refrigerator and is used within 24 hours (FDA).

Browse the full HiPP, Holle, Kendamil and Aptamil ranges and our goat milk formula collection, or read our guide to formula for newborns.

Disclosure: Formuland sells every formula and brand named in this guide and does not rank them. This article summarizes published research and public guidance from NIDDK, CDC, AAP, FDA and the NHS for general information. It is not medical advice: your baby's pediatrician and your formula's label come first.

Frequently Asked Questions About Cow's Milk Formula and Diabetes