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Printed at: 10:25:51 / 28-02-2021

Following a cow’s milk free diet whilst breastfeeding

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You have been given this guide because you have been advised to follow a milk-free diet. This is because your child may have a suspected or confirmed cow’s milk allergy. When you are breastfeeding, it is important to follow a healthy diet that includes:

• At least five portions of a variety of fruits and vegetables a day.
• Starchy foods such as wholemeal bread, pasta, rice and potatoes.
• Protein such as lean meat and chicken, fish (but no more than two portions of oily fish per week), eggs, pulses, soya and tofu.
• Calcium-rich foods.
• A good fluid intake.

Required additional dietary supplements
Dairy products are an important source of calcium. During breastfeeding, calcium requirements are increased and women have a total daily requirement of 1250mg. You need to aim for 50 calcium points every day (see overleaf for ideas). If you do not feel you are meeting your calcium requirement through diet alone every day it is recommended to take a supplement that contains 1000mg of calcium daily. These can be bought from chemists, health food shops or supermarkets. It is important to have an adequate intake of Vitamin D to help the body absorb calcium
from foods eaten. It is recommended that breastfeeding women take a supplement containing 10µg of Vitamin D every day (400IU). These can be bought from chemists, health food shops or supermarkets.

Dairy products are an important source of iodine for UK diets. Other good sources of iodine include fish, eggs and some fortified milk substitutes. If your diet is low in these foods you
could take an iodine containing multivitamin. Often breastfeeding multivitamins contain 10µg Vitamin D, up to 800mg of calcium and up to 200µg of Iodine.

Sources of milk
Many foods can contain cow’s milk. You should avoid all milk, cheese, cream including ice cream, yogurt, butter and ghee. Lots of processed foods may also contain milk such as gravies, some meat products, bread and breakfast cereals. Manufacturers MUST declare in ingredient lists if a product contains any milk or milk derived ingredients. They usually do this by putting the ingredient in bold type in the ingredient list, but sometimes it is in italics, underlined or a different colour. You should also avoid milk and milk products sourced from other animals such as sheep and goat. You do not need to avoid eggs if you are only avoiding milk products.

Tips for a milk free diet
1. Remember to always check the labels for packaged foods very carefully.
2. Remember to re-check ingredients lists EVERY TIME you buy as manufacturers can change their recipes and production lines.
3. ALWAYS check that any plant based milk substitutes are fortified with calcium. ‘Organic’ varieties are not fortified.
4. If you are eating out remember to ask about the ingredients. Laws state that a restaurant MUST be able to provide a list of allergens in their foods when required.
5. Some cow’s milk substitutes contain lots of added sugar. Choose sugar free or unsweetened options where you can and brush your teeth at least twice a day to maintain good dental health.
6. ‘Lactose free’ foods can contain cow’s milk and are not suitable for a milk free diet.
7. Supermarket own brand “free from” foods and milk substitutes can sometimes be cheaper than other brands and are often still fortified with calcium and iodine.