Download Lactose-free weaning diet

Departments of Nutrition and Dietetics and Norfolk and Norwich
University Hospitals NHS Foundation Trust
Also for use by James Paget University Hospitals NHS Foundation
Trust and Queen Elizabeth Hospital NHS Foundation Trust
Cows-Milk Free Diet for Breast Feeding Mums
This dietary advice sheet gives some general information to help you make the recommended changes to
your diet while you are breast feeding and while your child requires a cow’s milk free diet. If you need more
detailed advice, please ask your doctor to refer your child to a registered dietitian.
Your baby has been diagnosed as being allergic or intolerant to the protein found in cow’s milk. Breast
feeding is the best milk for your baby. However the proteins in foods you eat can travel through
your breast milk to your baby. This means that your baby can be exposed to cow’s milk protein
through your breast milk. To prevent this from happening it is important that all cow’s
milk-based products are removed from your own diet.
Sources of Milk
Cow’s milk is found in many foods. Some are obvious sources, however many foods contain
hidden sources. When you go shopping it is important to check the labels of foods to make
sure that they do not contain milk. Do not use rice milk for children under 4-5 years. As from December
2014 any milk in foods has to be highlighted in the ingredient panel on the label.
Obvious Sources
Cows milk
Cheese
Butter
Yoghurt
Cream
Ghee
Ice-cream
Hidden Sources
Butter fat
Milk Solids
Casein
Milk Protein
Caseinate
Non-fat milk solids
Calcium Caseinate
Skimmed Milk Powder
Demineralised Whey
Sodium Caseinate
Remember manufacturers may change the ingredients without warning
Yoghurt
Whey
Whey Protein
Lactose
Milk Sugar
Calcium and Vitamin D
When breast feeding, your body requires approximately 1300mg of calcium a day. This can be difficult to
obtain from your diet when you are avoiding cow’s milk and dairy foods such as cheese and yogurt etc. To
help you achieve a sufficient intake it is important that you try to use a calcium enriched milk free alternative.
Include non dairy sources of calcium in your diet such as tinned fish with bones, e.g. pilchards, sardines,
green vegetables, wholemeal bread and dried fruits such as apricots. It may also be advisable for you
discuss with your doctor or dietitian whether you require a calcium supplement.
The Department of Health also recommend that all breast feeding mums have a 10ug supplement of Vitamin
D, this can be obtained from pharmacies or from health food shops.
Calcium Content of Dairy
Free Alternatives
Milk Substitutes - Milk provides many nutrients that your body needs. If cow’s milk cannot be used, it is
important that you replace it with a calcium enriched milk substitute such as soya milk, oat milk, rice milk
or nut milk alternative. Other mammalian milks such as goats and sheep milk and their products contain
proteins very similar to cow’s milk and should therefore be avoided. Do not use rice milk for children
under 4-5 years of age.
Glass of calcium enriched soya milk
(280ml, ½ pint)
Glass of calcium enriched coconut milk (280ml, ½ pint)
Glass of calcium enriched almond milk (280ml, ½ pint)
Glass of calcium enriched rice milk
(280ml, ½ pint)
Glass of calcium enriched oat milk
(280ml, ½ pint)
Pot of soya yogurt
Soya custard (120g)
Pot of soya dessert
Fruit juice with added calcium (250ml)
2 tinned pilchards/2 tinned sardines with bones
2 large slices wholemeal bread
2 tablespoons cooked spring greens
7 dried apricots (56g)
1 slice calcium fortified bread e.g. Hovis Best of Both
Patient Information Leaflet for: Cows-Milk Free Diet for Breast Feeding Mums
Approved by: Patient Information Forum
Date approved: 14/10/2015
Available via Trust Docs
Version: 3
Trust Docs ID: 8711
370
336
336
335
335
150
145
135
300
270
130
70
40
191
mg
mg
mg
mg
mg
mg
mg
mg
mg
mg
mg
mg
mg
mg
Author:
Review Date: 14/10/2017
Page 1 of 2
Cows-Milk Free Diet for Breast Feeding Mums
Cows-Milk Free Diet for Breast Feeding Mums
Foods allowed
Foods to avoid
Fruit and Vegetables
All fresh and frozen fruits and
vegetables.
Tinned vegetables in brine, baked
beans.
Potatoes without butter, chips, roast
potatoes.
Plain crisps and flavoured crisps
known to be milk free.
Tinned and dried fruit
.
Vegetables tinned in a sauce
which contains cow’s milk
Instant potato with milk and/or
butter
Flavoured crisps unless known to
be milk free.
Cheese and onion flavoured
snacks
Potato or vegetable salad and
coleslaw unless known to be milk
free.
Fruit mixed with ordinary
yogurt/custard/cream/ice-cream
Biscuits and Cakes
Home-made biscuits and cakes using
milk free margarine and milk substitute
All cakes, biscuits and crackers,
unless known to be milk free.
Cake mixes and scone mixes
Meat/fish/
eggs/pulses
Plain meat/fish/eggs/pulses or in sauce
made with suitable milk
Meat/fish/eggs/pulses in sauces
made from cow’s milk
Fats, Milk, Dairy
Rice, Oat, Soya or Nut milks
Soya yogurts and desserts, soya
cheese, Rice desserts
Dairy-free margarine e.g. Pure,
supermarket own dairy-free brand.
Cow’s, goat’s and sheep’s milk
and all products made from these.
Hard cheese e.g. cheddar
Soft cheese e.g. cheese spreads,
cream cheese, and mozzarella.
Ice-cream, cream, ordinary
yogurts. Butter, ordinary margarine
chocolate, chocolate spread,
lemon curd, fudge and toffee
Sugar, jam, honey, golden syrup,
treacle, marmalade
Cereals
Bread (if no milk added)
Wheat, rye, oats, barley, rice,
semolina, sago, corn flour, tapioca,
Wheat flour, pasta
Pasta in milk-free sauces
Rice
Breakfast cereals (if no milk in
ingredients) e.g. Rice Krispies,
Cornflakes, Weetabix
Bread with milk added.
Pasta in cow’s milk based sauces.
Breakfast cereals which contain
milk/ chocolate.
Biscuits/cakes that contain milk
How long will my baby stay on a cow’s milk protein free diet?
Many infants do grow out of their allergy to cow’s milk protein, usually by 5 years old. Your Dietitian or GP
will discuss how to safely challenge your baby with cow’s milk sometime after they are 1 year old. This may
be at home or it may be necessary to have a supervised challenge in hospital.
Some babies who are allergic to cow’s milk also react to soya. Ask to speak to a dietitian if you suspect that
this may be the case with your baby.
Patient Information Leaflet for: Cows-Milk Free Diet for Breast Feeding Mums
Approved by: Patient Information Forum
Date approved: 14/10/2015
Available via Trust Docs
Version: 3
Trust Docs ID: 8711
Author:
Review Date: 14/10/2017
Page 2 of 2