As a parent, your child's nutrition is always on your mind. Maybe you breastfeed, or carefully select infant formulas that will give your baby the best start possible, and you're probably already thinking of ways to make sure your growing tot learns to love vegetables.
When a pediatrician tells you that your baby has a milk allergy it's normal to be a bit uneasy. The most important thing you can do is keep an open dialogue with your pediatrician and ideally even reach out to an allergist or registered dietitian.
Jan Kajzer, MS, RD, LD, an Abbott pediatric nutrition researcher specializing in food allergies, has some advice for concerned parents. "Managing a food allergy requires an individualized approach that considers the child's medical history, along with current feeding and growth patterns to determine the right nutrition plan," she explains.
Although diets will vary, there are certain things every parent needs to know when trying to prevent reactions while still providing the best nutrition possible. Kajzer shares a primer on crafting the right milk-free diet for your child.
Rethink Milk and Formulas For Mom and Baby
For infants, the two main sources of nutrition are breast milk or infant formula. If mom consumes cow's milk, her breast milk may contain enough of the offending protein to trigger a reaction. If that's the case for you and your baby, your pediatrician will likely advise you to eliminate cow's milk from your diet.
The protein source in most standard infant formulas is intact milk protein. If formula feeding, your pediatrician will most likely recommend a hypoallergenic formula where the protein source has been extensively hydrolyzed or broken down such as Similac® Alimentum.
If the baby cannot tolerate the extensively hydrolyzed formula, you may be advised to use an amino acid-based formula, like EleCare®. These options provide complete nutrition, so additional supplementation of vitamins and minerals is likely not necessary during exclusive formula feeding.
Transitioning to Milk-Free Beverages
Most infants transition to cow's milk after 12 months of age so it is important to work closely with your doctor to determine when this transition should begin and to identify an appropriate milk alternative beverage. However, your pediatrician may recommend that you continue formula, as a supplemental beverage, in your child's eating routine past the one-year mark.
If you are looking for beverages that do not contain cow’s milk —soy, almond, rice, coconut and oat milk — are available but many may not contain the same nutrient profile as cow’s milk so always check the label.
Not recommended: Kajzer advises that goat, camel and buffalo milk are similar to cow's milk in molecular structure and can also trigger similar allergic reactions and are not recommended as alternatives to cow’s milk. These alternate milk choices may be appropriate for the breastfeeding mom and a toddler, but they do not provide the nutrition that an infant needs.
"It's not uncommon for children with milk allergies to need some formula up to 18 months," says Kajzer. After all, infant formulas are rich in protein, vitamin D and calcium that a toddler might have trouble getting elsewhere. For instance, salmon is a great source of vitamin D, but getting a one-year-old to eat salmon might be challenging, at best.
Learn to Read Food Labels
Around four to six months of age, most babies are ready to start trying solid foods and parents will need to start looking for allergens in their new diet. Many foods, even non-dairy ones including hot dogs, cereals, breads, crackers and biscuits, can contain milk or milk derivatives, Kajzer cautions.
"Parents should read the label every time they buy the food item because labels change frequently," cautions Kajzer. If you're unsure whether a product could have come in contact with a specific allergen, call the manufacturer.
Make Sure Others Know About Your Child's Diet
Especially as your child gets older and enters daycare, playgroups and eventually school, it's important to remember that they might take food from people other than you. "Talk to administrators, personnel, coaches and anyone who could potentially give your child anything to eat," Kajzer recommends.
Any adult who regularly supervises your child should understand their unique nutritional needs and be equipped to follow them in a way that isn't isolating. Be prepared to provide milk-free alternatives for birthday parties or school functions, and teach your child that they should never eat any food that isn't given to them by an adult. The best way to avoid complications from milk allergies is to prevent them from ever happening in the first place.