In a follow up to our first blog about cow’s milk protient allergies – in this blog we focus on the importance of complementary foods and substitues.
What about the food?
If you have introduced complementary foods , it is important to read the food labels and ensure that you are restricting cow’s milk protein from your child’s foods as well. These are ingredients that you should look out for on the food labels.
All fresh produce, meat , fish, vegetables, fruit, legumes are cow’s milk protein free. Making food from scratch is often is easier for parents to know what their child is eating.
Alternative milks (which are fortified with calcium) such as oat milk, rice milk , almond milk can often be used in cooking, but should not be given as a milk substitute for children under the age of 2 years as their protein and fat content is very low.
- Cow’s milk (fresh, UHT)
- Butter milk, butter oil
- Evaporated milk
- Condensed milk
- Yogurt, fromage frais
- Butter, Ghee
- Ice cream
- Cream/ artificial cream
- Milk powder
- Skimmed milk powder
- Milk protein
- Milk sugar
- Milk solids
- Whey, whey solids
- Whey protein
- Casein (curds), caseinates
- Calcium caseinate
- Hydrolysed casein
- Hydrolysed whey protein
- Sodium caseinate
- Modified milk
What about soya formula milk?
Soya formula milk is not recommend for children under the age of 6 months. It is important to also note that infants who have CMPA may also react to soya as the proteins are quite similar. In the same sense cow’s milk proteins and other mammalian milks like goat or camel milk may also cause a reaction.
What happens if my child’s symptoms don’t improve?
If you have excluded ALL the cow’s milk proteins from the diet and your child still reacts, your child may be allergic to another food. It is important to ask your pediatrician to be referred to an allergy specialist and a dietitian to help support you in identifying what other foods he/she is reacting to.
When to reintroduce cow’s milk?
80-90% if infants develop tolerance by the age of three years. It also depends on the severity of your child’s reactions as to whether or not they will grow out of it. Introducing cow’s milk protein back in the diet should be discussed with your doctor. If your child has a history of anaphylaxis, it is advised that trials of cow’s milk protein should only be done in the hospital.
Fioccci a, Brozek J, Schunerman H, Bahna SL, von BA , Beyer, et al . World Allergy Organization (WAO) diagnosis and rationale for action against cow’s milk allergy (DRACMA) guidelines. World Allergy Organization 2010 . 3(4) :57 -161.
NICE Diagnosis and assessment of food allergy in children and young people in primary care and community settings . London 2011
Venter C, Brown T, ShahN, Walsh J, Fox A. Diagnosis and management of non- IgE mediated cow’s milk allergy in infancy – a UK primary practical guide. Clinical Translation Allergy , 2013 , 3:23
Venter C, Ashad SH Epidemiology, of food allergy. Pediatric Clin North Am 2011 58(2):327-349