Milk free diet for babies

Why a milk free diet?

Around 3% of children develop Cow's Milk Protein Allergy (CMPA). In most cases a strict cow's milk free diet is needed to treat the allergy. This information will help you avoid cow's milk whilst making sure your child gets all the nutrition they need to grow and develop well.

Which milk should be excluded?

All cow's milk including fresh, UHT, sterilised and dried milk should be avoided. The diet should be free of cow’s milk protein (casein and whey) and milk sugar (lactose). 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 milk

Milk is an important source of nutrition for babies and children. If you are breastfeeding, ideally continue to do so when introducing cow's milk free solids. This is because breastmilk can protect against developing other food allergies. 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, or if over the age of 1, they can drink Alpro Growing Up Oat or Soya drink, Oatly Oat Drink Barista Edition or the 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). This should use this as their main milk drink until they are 12 months old, or as advised by your Health Care Professional. For babies over 6 months, who are not allergic to soya, Wysoy infant formula may be considered. 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) 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.

Plant based alternatives to cow's milk 

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: soya, 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 Growing Up Soya Drink 1-3

+ Years, 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 milk and any products made from cow’s milk such as yoghurt, cheese, custard, butter and margarine. Look for the list of ingredients printed on the package and avoid foods which have 'milk' in bold on the label. Choose dairy free, plant-based alternatives eg products in the Alpro, Oatly or Koko range, or supermarket own dairy-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 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 these foods 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 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. 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!)

What about Vitamin D?

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.

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