Breastfeeding provides the best source of nutrition for babies. Occasionally breastfed babies can react to cow's milk in breastmilk from the mother's diet. This is usually for those babies that have delayed symptoms such as reflux, being unsettled, abnormal stools or severe eczema. For babies that have immediate symptoms to dairy products the maternal diet does not need to change. This dietary advice sheet gives some general information to help you make the recommended changes to your diet and should only be followed for 4 weeks.

If you have any other allergies or medical conditions, please seek further advice.

It is important for you to have a milk free diet, and to avoid major sources of soya. This is because many babies who have delayed reactions to cow's milk also react to soya proteins. Soya can often be tried later to see if your baby reacts to it or not, but it is best not to include it for the first 4-6 weeks. However, do not worry about "soya lecithin" or "soya flour" in products such as bread and sausages.

You will need to avoid cow's milk, soya milk, dairy and soya yogurts, dairy and soya custard, cheese and any products that contain these. Other mammal milks such as goat and sheep are not suitable alternatives as your baby is likely to react to these.

Suitable alternatives to cow's milk and soya milk are: Calcium enriched oat milk, calcium enriched hemp milk, calcium enriched coconut/almond/hazelnut/cashew milks.

 

  Milk and soya free foods Foods to avoid / check labels
Fruit & vegetables All plain fruit vegetables
Fresh, dried, frozen or tinned
Vegetables mixed with sauces made from cow's milk
Fruit mixed with ordinary yogurt, custard, cream, ice-cream or soya alternatives
Meat, fish, eggs, quorn, pulses Plain meat, fish, eggs, nuts and pulses
Plain quorn products (but check labels)
Meat, fish, eggs, and pulses in a sauce made from cow's milk
Processed/prepared meat/fish (check labels)
Tofu
Dairy products Calcium enriched milk alternatives can be used in cooking as well as in cereals
E.g. Oat milk, nut milks, coconut based yogurts
Cows', goats' and sheep's, soya milk and all products made from these
All cheeses, including cheese spreads, cream cheese, soya cheese
Dairy or soya ice cream, cream and desserts
Starchy food and cereals Bread/rolls/wraps/bagels/pitta/crackers
if no milk in ingredients (soya in the ingredients is fine)
Flour, plain pasta and rice
Plain potatoes
Plain breakfast cereals (oats, cornflakes, Weetabix, shredded wheat (check labels)
Bread/rolls/wraps/bagels/pitta/crackers with milk in ingredients list.
Filled pasta/ravioli or rice in cows' milk based sauces
Processed potato products (check labels)
Breakfast cereals which contain milk
Other foods Any oils, lard, suet, dripping
Dairy-free margarine e.g. Pure, Vitalite, Tomor, Flora fairy-free, supermarket own dairy-free brand, Kosher and some vegan spreads
Milk free chocolate and spread
Standard butter, ordinary margarine or spread
Biscuits and cakes that contain milk
Milk chocolate, most chocolate spread
Large quantity of soya spreads

Ingredients to watch out for on labels:

Milk and milk products will be indicated and 'Milk' in bold on the ingredient list, so check the labels. Most supermarkets will provide a list of their milk-free foods on request. There's no need to avoid all products with 'soya' in the ingredients. Only avoid the main source of soya such as soya milk and yogurts, soya desserts and cream, soya cheese and tofu.

 

When eating out, check with the restaurant or food outlets as they have to provide allergen information by law. As a breastfeeding mum your daily calcium requirements are 1250mg. If this is not met from your diet, then you should take a supplement that provides 1000mg of calcium per day.

Use the following chart to check your calcium intake:

 

Food Average Portion Calcium (mg)
Alternative milk (calcium enriched) 100ml 120mg
Sardines
Pilchards
Salmon (tinned with bones)
Prawns
Whitebait
Lentils, boiled
Cooked chickpeas
Peanuts
Tahini
Quorn mince
60g (1/2 small tin)
60g
52g (1/2 tin)
60g
50g
100g
50g
20g
15g (1 tbs)
100g
550
300
47
90
130
19
25
18
100
30
White bread
Wholemeal bread
Calcium fortified bread
Pitta bread/chapatti
Calcium fortified cereals
Calcium fortified hot oat cereals
100g (2 large slices)
100g (2 large slices)
40g (1 slice)
65g (1)
30g
15g (1tbs dry cereals)
100
54
191
60
137
200
Broccoli, boiled
Spring greens
Curly kale
85g (2 spears)
75g (1 serving)
67g
34
56
100
Medium orange
Dried apricot
120g (1 medium)
5 apricots
75
20

If your baby requires a cows' milk free diet then you should be referred to a Paediatrician Dietitian or a trained Health Professional for advice on introducing solids and to ensure you are achieving a nutritionally adequate diet.

What about Vitamin D?

Vitamin D is needed by the body to absorb calcium and the best source is from the action of sunlight on the skin. Vitamin D is only found in a few foods so a supplement is recommended for everyone.

Note: micrograms (mcg) can also be written as µg. IU stands for International Unit.

Target groupRecommended supplement (SACN 2016)Do not exceed
Breastfeeding mothersEquivalent 10 micrograms/day or 400IU100 micrograms/day