When you’ve got a little one with food allergies like CMPA, it can be really nerve wracking making sure they are getting everything they need nutritionally whilst you’re eliminating food groups. And as a mother who gives up dairy to breastfeed their CMPA child, you may also worry about missing vital nutrients from your diet. It’s been drummed into us for a long time now that cow’s milk is our best/main/only source of calcium, and so lots of parents worry that their dairy free children aren’t getting enough. As well as calcium, dairy products also provide children with protein, fat and iodine, which are essential for healthy brain development, and some of these are hard to replace with the alternative milks on the market. Below are some ideas and recommendations on ensuring that you and your little one get enough of each of these.
Young children who are exclusively breastfed will get everything they need from breast milk, and even children who are down to 1-2 feeds a day will be receiving all the nutrients they need because breast milk adapts as the child grows.
As a breastfeeding mum you need to look after yourself nutritionally though, and as children get older and eat more food you may want to regularly offer some of the suggestions below to keep on top of their nutritional needs, as well as start some good habits. Eventually, once your child reaches 2, you may want to consider what milk you’ll offer them once they have weaned from breast milk, and before that you may be interested to know which alternative milk is the best choice for you. Or you may be happy to continue breastfeeding, but are wondering which is the best choice to offer on other occasions or to use in food. Read more on alternative milks and vitamin sources below, then check out some more CMPA FAQs. For a list of all my dairy free resources head over to the Breastfeeding With CMPA Directory.
Alternative Milks for CMPA
For children who are still breastfed (or given a suitable dairy free formula), they should be getting all the vitamins they need from this. That’s why it’s really important to remember that the current NICE guidelines recommend that CMPA children have breast milk or dairy free formula as their main drink until 2 years of age. The recommendations clearly state that alternative milks may be used after 2 years as a drink, with the exception of rice milk which should not be given to children under 4.5 years old. Alternative milks do not offer the same nutritional value (calcium, protein, fat and iodine) as breast milk or formula so shouldn’t replace those, but they can be used in food/cooking from 6 months of age.
Below is a comparison chart of the most popular current alternative milks suitable for CMPA. Please note that lacto-free milks are not suitable, as they still contain cow’s milk protein.
You can see that calcium wise they are all equal to cow’s milk which is reassuring (and many of these sources are easier for the body to absorb), but the level of protein, calories and fat differ greatly. If your little one can tolerate soya then Alpro Growing Up Drink is definitely the best choice – it’s the best replacement nutritionally for cow’s milk and it also contains extra iron and added iodine which most of the others do not. It is the only alternative milk that would be okay to give as a main drink before two, if you were hoping to stop breastfeeding before this point. If that’s the case you may also want to consider SMA Wysoy formula though, which will work out cheaper.
If soya isn’t suitable (remember around 30-50% of CMPA babies will also react to soya) then there are still lots of other choices. Your child will still be receiving most of the things he needs from breast milk, so this is just to compliment that and be used in food/cooking. I’ve ordered the current choices by protein content so you can see which come out best. Amounts listed are per 100ml, and all examples are the original long life versions (there are slight differences between long life/fresh and original/unsweetened).
UPDATED JAN 2019: I have added several new milks to the bottom of the chart below, including Koko Super, Oatly Whole/Semi and the M&S Oat Milk. Koko Super contains a great amount of additional nutrients, although much less iodine than the Alpro Growing Up milk. It does however have the most amount of calcium per 100ml, a good amount of protein, and is much lower in sugar than Oatly so I think it is actually now the best soya free choice on the market nutritionally, with Oatly Barista as a second choice.
Looking for an alternative milk as a breastfeeding mum, you might be more interested in how they taste or which ones work best in tea or coffee. It is a little bit of trial and error taste wise, but personally I would recommend Oatly Original/Barista or Provitamil Oat milk (my definite favourite). Both work well in hot drinks and taste okay in my opinion. And a top tip – Oatly chocolate heated in the microwave makes a very good hot chocolate and is also a great boost of calcium which means it definitely counts as something healthy and not a treat!
As a breastfeeding mother you will need to keep an eye on your own intake and ensure you are getting enough calcium – either from your diet or from supplementing. There are some excellent vegan sources of calcium you can include in your diet regularly, or your GP should be able to prescribe you a calcium supplement if you’d prefer. Make sure to check that your supplement is free from any allergens you’re avoiding.
A child aged 1 – 3 needs 350 mg of calcium per day. A breastfeeding mother needs 1250 mg.
Dairy Free Calcium Sources
There are loads and loads of vegan or dairy free calcium sources out there, and some are much easier for the body to absorb – meaning you take more calcium from it than you would a glass of cow’s milk. Here are some examples of dairy free calcium sources to eat yourself and offer your little one:
- Fortified alternative milks (see above)
- Fortified breads and cereals, or a juice like Tropicana Calcium
- Green leafy veg like kale, broccoli and pak choi
- Sesame or chia seeds
- Fish like sardines or anchovies, where you eat the bones
- Dried fruit – raisins, figs, apricots
- Baked beans, kidney beans and chickpeas
- Soya beans and tofu, if you’re little one tolerates these
Check out this helpful information from the Vegan Society and NHS, or google ‘vegan calcium sources’ for more ideas. The British Dietetic Association has a really great fact sheet on calcium foods too.
It’s important to understand the relationship between calcium and vitamin D. If you’re keeping an eye on calcium intake then it’s a good idea to also be mindful of vitamin D. Vitamin D aids the absorption of calcium from the foods we eat, so helps to make sure we are getting as much of the goodness from our diets as possible.
We get most of our Vitamin D from sunlight, so during the Spring and Summer make sure everyone gets regular exposure to sunlight (no sunscreen, short sleeves, for at least 15 minutes around 3 times a week) to get a vit D boost. Obviously during the winter sunlight is limited (sometimes in this country it’s limited in Summer too!) so you may find that you need a daily supplement. Although some food likes fortified cereals, egg yolk and oily fish contain vitamin D it’s not likely that you’ll get enough from your diet. Those who are at an increased risk of vitamin D deficiency include babies, young children and pregnant or breastfeeding women so chat to your GP or dietitian about supplementing.
Read more on the BDA’s vitamin D fact sheet.
Iodine is an important mineral for adults and young children, as it helps produce the thyroid hormones which are essential for things like growth, metabolism and brain development. Breast milk contains iodine, but the level depends on how much the mother is consuming herself. Anyone who avoids eating fish or dairy is at risk of iodine deficiency. Lots of breastfeeding vitamins contain a certain level of iodine so you may already be partially supplementing. Alternative milks don’t contain iodine (with the exception of Alpro Growing Up Milk) which is why the NICE guidelines of CMPA children being breastfed or on formula until two are really really important.
A child aged 0-5 needs 90 mcg of iodine, and a breastfeeding mother needs 200 mcg.
Dairy Free Iodine Sources
- Fish, haddock and cod especially
For more information check out this iodine factsheet from the BDA.
Something else that’s important to include in young children’s diets is good, or healthy, fats – by that I mean monounsaturated or polyunsaturated fats. This will be especially important if you have a little one who may have slow weight gain as a symptom of their CMPA. Remember again that breast milk is a great calorie source for children, if you’re little one is struggling with slow weight gain its breast feeds that should be increased first. Here are some sources of good fats to offer your little one regularly:
- Peanut or other nut butter
- Olive or coconut oil (use in cooking, add to mash potatoes etc)
- Nuts like walnuts and almonds
- Oily fish like salmon and tuna
- Seeds like sunflower or chia
So for example you could try cooking with more oil, serving peanut butter on toast or with apple as a healthy snack, or making your own fruit and nut bars or balls with chopped nuts/seeds and dried fruit.
The other nutrient that dairy usually provides in your diet is protein, which is essential to maintain good health. It also keeps you feeling fuller for longer, so it’s really important for hungry breastfeeding mums to get plenty. Here are some ideas for protein sources:
- Meat – eg. chicken, turkey and pork
- Fish and seafood
- Soya yoghurts, tofu and tempeh (if not soya free)
- Nuts and seeds, including peanut butter
- Pulses like lentils, beans or chickpeas
Hopefully that gives you a good idea of what kind of vitamins and nutrients your child might be getting less of on a dairy free diet, and what you can offer to replace them. Above all remember that breast milk is a pretty incredible substance, and will change with the needs of your child to provide them with everything that they need so whilst your feeding you don’t need to worry about any of this too much. It is important to maintain your own health though, and as a breastfeeding mother lots of these things are really important for your diet to, so this should help guide you to make sure you’re getting all you need too and make the best possible choices.
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