Milk and soya free diets for babies

Why a milk and soya free diet?

Around 3% of children develop Cow's Milk Protein Allergy. Some children who are allergic to cow's milk protein are also allergic to soya protein so this may need to be excluded from the diet too. It can take longer for children to recover, but many 'grow out' of cow's milk and soya protein allergy. This information will help you avoid cow's milk and soya whilst making sure your baby gets all the nutrition they need to grow and develop well.

Which milks should be excluded?

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. Do not use other mammalian milks (from 4-legged animals such as goat, sheep, camel and buffalo) as their milk protein structure is similar to cow’s milk and may still cause an allergic response.

Replacing cow's and soya milk

Milk is an important source of nutrition for babies and children. If you are breastfeed your baby, ideally continue to do so when introducing cow's milk and soya free solids. Breastfeeding Mums may need to follow a milk free diet, see ‘Milk free diet for breastfeeding Mums’ (see milk free diet when you are breastfeeding). If your baby is taking an infant formula, it needs to be a ‘hypoallergenic’ milk free formula, unless over the age of 1 in which case they can drink Alpro Growing Up Oat drink, Oatly Oat Drink Barista Edition or Oatly Oat Drink Whole.

Specialised infant formula

Your baby may be prescribed a hypoallergenic formula such as Alimentum, Althera, Aptamil Pepti or Nutramigen LGG (or more rarely Alfamino, Puramino or Neocate). They should use this as their main milk drink until 12 months old, or as advised by your Health Care Professional. Most babies aged 6-12 months need approximately 600ml (20oz) formula each day to ensure they are meeting their nutritional needs, especially calcium. Over the age of 1, this amount reduces to around 350ml (12oz). These amounts vary according to the child and their diet.

Alternatives to cow's milk and soya milk for cooking

Always choose plant-based dairy milk alternatives that are fortified with vitamins and minerals, in particular calcium (at least 120mg calcium/100mls) and iodine. These are available to buy from most supermarkets and can be used in cooking from six months of age but not as a main milk drink until your child is over one year old. Brands include supermarket own label, Alpro and Oatly: oat, almond, cashew, coconut, hazelnut and hemp drink. Rice milk should not be given to children under 4½ years old. Please be aware that not all organic versions have vitamins and minerals added and some milk alternatives may not be suitable for other allergies. Please discuss with your Health care professional or Dietitian if unsure.

A plant-based drink designed for 1-3 year-olds or a Whole/Barista oat milk such as Alpro Oat Growing Up Drink 1-3+ Years, Oatly Oat Drink Barista Edition and Oatly Oat Drink Whole are the most nutritionally appropriate main milk drink once your child is over the age of 1.

Foods to avoid

Avoid cow’s and soya milk and any products made from these such as yoghurt, cheese, custard, butter and margarine. Look for the list of ingredients printed on the package and avoid foods which have 'milk' or ‘soya’ in bold on the label. Choose dairy free, plant-based alternatives eg products in the Alpro, Oatly or Koko range, or supermarket own dairy/soya-free brands. When eating out, food outlets need to provide allergy information by law, so always ask.

Check with your Pharmacist about tablets or medicines which may contain milk or soya proteins and/or lactose.

Introducing solids (weaning) For general weaning advice see the NHS website www.nhs.uk and type ‘weaning’.

For babies with a confirmed milk allergy, new research shows it could be beneficial to introduce 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. More information is available from the British Society for Allergy and Clinical Immunology www.bsaci.org.

Adapting recipes

Many ordinary recipes can be adapted by using your milk alternative. Use a milk and soya free margarine instead of butter and milk alternatives in place of milk. Try making up batches of milk and soya free meals/puddings and freezing them in ice-cube trays to allow you to serve small portions with less waste. Also see Milk free recipes by clicking on the following link

What about calcium?

Calcium is needed for strong teeth and bones. Babies under 1 need 525mg/day, 1-3 year olds need 350mg/day

Sources of calcium (portion size are not necessarily baby size!)

 

Best source - Food providing 250mg of calcium Portion size
Sardines - canned (including bones) 60g or half a tin
Calcium-enriched milk alternatives 200mls
Foods providing 150mg of calcium Portion size

Fortified breakfast cereal (check label for 'soya' and 'milk)

30g
Calcium fortified coconut or oat yoghurt 125ml pot
Food providing 100mg of calcium Portion size
Tinned salmon 106g or half a tin
Scampi in breadcrumbs 100g
Baked beans / kidney beans 200g or half a tin
Calcium fortified bread 1 slice
Calcium fortified infant cereal 20g
Food providing 50mg of calcium Portion size
White/ Wholemeal bread 1 slice
Pitta bread/ chapatti 1 portion (65g)
Spring greens 75g
Tahini paste (sesame seends paste) 20g
Foods providing 25mg of calcium Portion size
Egg 1 medium
Hummus 50g
Dried fruit e.g. raisins, apricots 50g or 2 tablespoons
Orange 1 medium
Broccoli 85g (2 spears)

What about Vitamin D?

Vitamin D is needed by the body to absorb calcium and 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.

Target group Recommended supplement (SACN 2016) Do not exceed
Breastfeeding mothers Equivalent to 10 micrograms/day or 400IU 100 micrograms/day
Breastfed babies up to 12 months Equivalent to 8.5-10 micrograms/day or 350-400IU 25 micrograms/day
Formula fed babies up to 12 months Only if less than 500mls formula/day 25 micrograms/day
Ages 1-4 years Equivalent to 10 micrograms/day or 400IU 50 micrograms/day

NB micrograms (mcg) can also be written as μg.

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.

 Vitamin supplements are available to purchase in pharmacies and supermarkets and are also available from the Healthy Start Scheme https://www.healthystart.nhs.uk

Useful website for further help and practical tips: http://www.cmpasupport.org.uk/