All cow's milk and soys milk including fresh, UHT, sterilised and dried milk should be avoided. The diet should be free of cow's milk protein (casein and whey), milk sugar (lactose) and soya proteins. Other mammalian milks are not suitable alternatives to cow's milk as their protein structure is similar and may still cause and allergic response. Therefore, do not use milks such as goats, sheep, camel and buffalo milk.
Milk is an important source of nutrition for babies and children. If you breastfeed your baby, ideally continue to do so when introducing cow's milk and soya protein free solids. This is because breastmilk can protect against developing other food allergies. Breastfeeding mothers should also follow a milk and soya free diet (see 'milk free diet when you are breastfeeding').
If your baby is taking an infant formula, it needs to be a milk free formula.
Your baby may have been prescribed an allergy formula such a Similac Alimentum, Althera, Nutramigen LGG, Aptamil Pepti (or more rarely Alfamino, Puramino, Neocate or Pepti-Junior). They should continue this until 12 months or as advised by your Health Care Professional.
For babies over 6 months, Wysoy is a soya based infant formula to consider. This does not need to be prescribed as it is available to buy from pharmacies and larger supermarkets at a similar price to standard infant formula.
Most babies aged 6-12 months need approximately 600ml (20oz) each day to ensure they are meeting their nutritional needs, especially Calcium and Vitamin D. Over 1 year this amount reduces to around 350ml (12oz). These amounts do vary according to the baby and their diet. Check with your Health Visitor or Dietitian if you have concerns about their calcium needs.
Alternatives to milk that are fortified with calcium are available to buy from most supermarkets. They can be used in cooking from six months of age or as a main drink after one year old.
Examples include: Soya, Nuts (Almond, Coconut, Cashew, Hazelnut), Oat or Hemp milks. Brands include Supermarket's own range, Alpro range or Oatly range. Rice milk should not be given to children under 4.5 years old. Always choose a milk alternative that is fortified or enriched with calcium - they should provide at least 120 mg of calcium/100mls. Organic versions do not usually have calcium added - check the label.
Please be aware that some milk alternatives may not be suitable for other allergies and some may be low in calories, protein, calcium and/or other vitamins and minerals. Discuss with your Health Visitor or Dietitian if unsure.
Some of the foods to avoid are obvious. However, many other foods may contain cow's milk and/or soya proteins and these should be avoided too. Look for the list of ingredients printed on the package and avoid foods which have 'milk' in bold on the label. When eating out, food outlets need to provide you with allergy information by law, so always ask.
Check with your Pharmacist about tablets or medicines which may contain milk proteins and/or lactose.
New research has found that for babies with a confirmed milk allergy, it could be beneficial to introduce food, especially foods containing peanuts and/or eggs, from 4 months. This should only happen if your baby is ready. This is because starting food earlier can protect some babies against developing more food allergies as they grow up. Ideally you be supported with this by a Health Professional, individually or in a group. More information on early feeding and allergy prevention is available from the British Society for Allergy & Clinical Immunology.
Many ordinary recipes can be adapted by using your milk alternative. Use a milk free margarine instead of butter, milk alternatives in place of milk, and soya/vegan cheese in place of ordinary cheese. Try making up batches of milk free meals/puddings and freezing them in ice-cube trays to allow you to serve small portions with less waste.
Calcium is needed for strong teeth and bones. Babies under 1 need 525mg/day, 1-3 year olds need 350mg/day
Vitamin D is needed by the body to absorb calcium an the best source is from the action of sunlight on the skin, however young children should not be exposed to the sun for long. Vitamin D is only found in a few foods so a supplement is recommended for everyone.
A supplement containing Vitamins A, C and D can be given from 6 months, rather than Vitamin D alone (Department of Health advice). This is a precaution because growing children may not get enough of these vitamins, especially those not eating a varied diet, such as fussy eaters. Supplements are available to purchase in pharmacies and supermarkets, or may be available online. Ask your Health Visitor or Dietitian for advice. Vitamins are also available from the Healthy Start Scheme.
NB micrograms (mcg) can also be written as μg.