Management of Cow’s Milk Protein Allergy

This is part two of a four part overview of how to not just survive but thrive with Cow’s Milk Protein Allergy. Here’s what’s coming up:

  1. Cow’s Milk Protein Allergy, the basics
  2. Management of Cow’s Milk Protein Allergy
  3. Cow’s Milk Protein Allergy and Complementary Feeding
  4. Cow’s Milk Protein Allergy, the next steps…

When you have an infant with cow’s milk protein allergy the main treatment is to avoid the proteins casein and whey. This post covers what to do whilst babies are still solely breast or formula fed. I will cover weaning onto solids in the next post.

Dairy Free Recipes
Scratching your head at what to cook on a dairy free diet? Click here!


Breastfeeding is the ideal way to feed infants and there is a raft of evidence showing benefits for both mother and child, for a fab summary see this blog post by Charlotte Stirling Reed. This blog post by Dietitian Priya Tew is also excellent and describes the ups and downs of breastfeeding which I can really relate to!

As a breastfeeding mum you could be lucky and not have to alter your diet. Often breastfeeding mums only find out that their baby has a cow’s milk protein allergy when they start complementary feeding (introducing solid food).

However, for the unlucky ones (and that included me) your baby will have symptoms of cow’s milk protein allergy with proteins that are transferred through your breast milk. In this situation the only solution is for the mother to cut out cow’s milk. Remember that your baby can continue to have symptoms for two weeks following the elimination of dairy from your diet. This is a combination of it working through your system and their digestive systems recovering.

The first 2 weeks can be really tough, especially if you’re still dealing with a very unhappy baby, but try to persevere, it does get easier! I have a food allergy and intolerance support community on Facebook, if you want a place to get encouragement and empathy come over and join us (click here ).

My top tips for a dairy free diet whilst breastfeeding:

  • Find a plant-based, calcium enriched alternative milk that you like. There are lots to choose from including: soya, oat, hemp, almond, hazelnut, coconut and rice. Just make sure it’s enriched with calcium, any organic milks will not so check the label.
  • Find a dairy free spread that you like. There are plenty to choose from:Vitalite, PURE, Flora Dairy Free or supermarket own-brands
  • Once you have dairy free milk and spreads then you can make most things dairy free – you can bake or convert recipes quite easily.
  • Take a calcium and vitamin D supplement, you need 1250mg of calcium per day and 10ug of vitamin D. You can request a supplement from your GP as it will be difficult to get this from diet alone. Or you can buy supplements in chemists for breastfeeding mums, just check the label.
  • Cocoa and eggs are dairy free so you can make chocolate cake – yay!
  • Look for vegan products and recipes. You can eat anything in vegan cafes and restaurants. Pret a Manger and Boots as well as others have vegan options.

If you need further information or are pulling your hair out drop me a line, we can have a quick, no-strings preliminary chat which wouldn’t cost you anything. I have lived through this so can help! Click here for my contact details. 

Formula Feeding

Not everyone can breastfeed and not everyone wants to. Obviously regular infant formula contains milk and therefore is not appropriate. Babies with cow’s milk protein allergy need a hypoallergenic formula. There are different brands but these are the two main types:

Extensively hydrolysed formulas contain milk protein which is broken down into very tiny bits. Most infants tolerate these and they taste a bit better.

If an infant has blood in their stools or anaphylaxis they will probably go straight onto an Amino Acid Formula. The proteins in these are completely broken down.

Your GP, dietitian or Paediatrician will advise you on the best formula for your child.

If your baby is refusing to drink the formula due to the taste you can try weaning them onto it gradually. If you are giving them 5 ounces you can try 1 ounce of the new formula to 4 ounces of the one they are used to. On day 2 increase to 2:3 and so on until they’re completely on the new formula. As a last resort you can flavour hypoallergenic formulas but in this case it is best to talk to a dietitian for further advice.

Soya formulas are available but are not suitable for infants below the age of 6 months. Again, talk to your paediatrician or dietitian for further information about soya formulas.

Gastro-oesophageal reflux

A lot (not all) of children with cow’s milk protein allergy also suffer with gastro-oesophageal reflux. This can result in vomiting or persistent crying. Some babies do not have symptoms and this can be described as silent reflux. If you are concerned about your child regarding gastro-oesophageal reflux speak to your GP or health visitor and see this link to the Great Ormond Street Hospital website.

Dairy Free Recipes
Click here  for a printable of 8 really easy and tasty recipes that you’ll be surprised are totally cow’s milk free!

In my next blog post I’ll be looking at weaning infants with cow’s milk allergy onto solid food, also known as complementary feeding. I’ll talk about label reading as well as what to give and when.

If you have any questions or comments, contact me or post them in the comments below.

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