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Weaning on a cow's milk free diet
Weaning is when you steadily introduce solid foods to your baby. It is recommended that you start weaning around 6 months old.
Weaning a baby with a cow’s milk allergy should be the same as weaning a baby who isn't allergic. But, you will need to avoid cow’s milk protein. This includes all food and drink made with cow’s milk.
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Supporting your baby's diet without cow's milk
Supporting your baby's diet without cow's milk
When your baby starts having solid food, you will need to follow a cow's milk free diet. A cow’s milk free diet means avoiding the proteins in cow’s milk which are called whey and casein.
You should also avoid all mammal milks including, goat, sheep, mare and buffalo milk. These contain similar proteins to cow’s milk which your baby may also react to.
The British Dietetic Association has created a helpful guide about a cow's milk free diet for infants and children.
Different types of milk for babies 0 to 12 months old
Up until your baby is 1 year old, they should have breast milk or infant formula as their main drink.
Plant-based alternatives
Alternative milks can be used in cooking and on cereal in babies from 6 months old. These include those based on plants such as oat, soya, hemp and pea. If your baby has previously reacted to one of these types of milk, do not try giving it to them again.
Choose a plant-based milk that contains added calcium and provides at least 40 calories and 1g protein per 100ml.
Milks to avoid
- Rice milk is not recommended for children under 5 years old.
- Soya milk is not recommended for babies under 6 months old. Some babies who react to cow’s milk protein also react to soya. If your baby is over 6 months old, soya milk can be given with food if they have eaten foods which contain soya and not shown a reaction.
There are a wide range of plant-based yoghurts that can be included in your baby’s diet if you wish. Many of these contain added calcium but check the food label to make sure.
There are also hard and soft plant-based cheeses available, though not as many of them contain added calcium and vitamins.
How much milk should your baby drink?
Once babies start weaning, some prefer food over milk and do not drink as much as expected. If your baby is gaining weight appropriately, pooing regularly and having plenty of wet nappies, do not worry. Continue to offer food and milk regularly according to their appetite.
If your baby is having less than 500ml (17oz) of infant formula a day, they should have a supplement containing vitamin A, C and D. Read more about vitamin requirements.
Always check food labels
Cow’s milk is often an ingredient in pre-packaged foods and drinks. For example, bread, biscuits, baked goods, processed meat and fish, crisps, breakfast cereals, sweets and ready meals.
Under current laws, if cow’s milk (or any common allergen) is an ingredient in a pre-packaged food or drink, it must be highlighted or emphasised in bold.
Ingredients list example
Ingredients: Water, Vegetable Oils (37%) [Rapeseed Oil, Palm Oil], Olive Oil (22%), Whey Powder (from Milk), Salt (1.1%), Emulsifier (Mono- and Diglycerides of Fatty Acids), Stabiliser (Sodium Alginate), Pre-servative (Potassium Sorbate), Colour (Carotenes), Flouring, Vitamin A, Vitamin D.
There are many ways in which milk can be labelled, so carefully check the ingredients list on food items.
Foods sold without packaging don’t need to be labelled. But you can ask someone behind the counter for allergen information to see whether these products contain milk.
Foods labelled ‘may contain milk’ will not have milk within the ingredients. Although they may contain traces of milk due to being manufactured on the same equipment. You do not need to avoid foods that are labelled ‘may contain milk’.
Lactose-free foods and drinks still contain cow’s milk protein and are not recommended as alternatives.
Introducing other food allergens
Even though your child has a suspected cow’s milk allergy, you should still aim to introduce other food allergens early in weaning. These include egg, fish, wheat, peanuts and tree nuts (serve crushed or ground, for example smooth peanut butter for peanut) and seeds (serve crushed or ground, for example tahini for sesame).
Recent evidence suggests that early introduction of allergen foods to those babies who have eczema or a family history of allergy may be beneficial in preventing food allergy. See the following links for more information:
Soya
Some babies who react to cow’s milk protein do react to soya. It is best to introduce soya as a minor ingredient first such as offering foods containing soya flour. If these are tolerated, you can slowly move on to soya yoghurts and then soya milk if you wish.
If your child reacts at any step of introduction, exclude those forms of soya. You can choose dairy alternatives made from oat or coconut instead.
Vitamin requirements
Vitamin D is important for babies to grow bones and help their muscle health. Our main source of vitamin D is sunlight. Due to the climate in the UK, all adults living in the UK are recommended to take a daily vitamin D supplement of 10mcg. While some vitamin D is passed onto your baby through breastmilk, there is not enough for your baby.
- If you are exclusively breastfeeding your baby, they should be given a daily vitamin D supplement containing 8.5 to 10mcg of vitamin D.
- If you are mixed feeding your baby with less than 500ml of formula a day, they should be given a daily vitamin D supplement containing 8.5 to 10mcg of vitamin D.
- If your baby is having more than 500ml of formula a day, they do not need a vitamin D supplement.
From 6 months to 5 years old it is recommended you also give your baby a daily vitamin A and C supplement. If your baby is having more than 500ml (17oz) of infant formula a day, they do not need a vitamin A or C supplement.
Make sure you read the label of your vitamins to check they are age appropriate.
