Some babies temporarily do not tolerate the natural milk sugar 'lactose' which is found in breastmilk and ordinary infant formula (made from cow's milk, and also in goat's and sheep's milk). Lactose intolerance in infants is usually a short-term problem. It occurs most often following a bad bout of gastroenteritis (stomach bug) and can last for up to 2-4 months. Lactose should only be avoided if the symptoms cause significant distress to the baby (e.g. crying, pain, nappy rash etc.)
Lactose-free infant formulas are available such as SMA LF, Aptamil Lactose Free or Enfamil 0-Lac. These taste similar to ordinary formulas and are available from pharmacies to buy. Until the age of 1, it is important your baby drinks at least 600ml (20 ounces) a day of a lactose-free formula to receive sufficient nutrients, especially calcium.
General advice for introducing solids (although this will not be dairy free specific, more detailed information is available at: (https://www.nhs.uk/start4life/baby/first-foods/)
Can I give other drinks?
The main drink for your baby needs to be breastmilk and/or lactose-free formula. If other drinks are needed, cooled boiled water is the best drink to give. Baby juices are not necessary and they would encourage your baby to have a sweet tooth. Tea should not be given to babies and small children as it reduces iron absorption from your child's diet.
Milk substitutes to be used in cooking
If your baby is having a Lactose Free Formula, these can be used in cooking. The lacto-free brand milk and products can also be used. Alternatively soya, oat, hemp or nut milks can be used in cooking (as long as they are calcium enriched and not used as main drink until 1 year of age). Please note rice milk is not recommended for babies and children under 5 years.
Lactose and cheese
Lactose is found in soft cheeses, e.g. cream cheese and cheese spreads, mozzarella, feta, etc. However, due to the maturing process of hard cheese, most of the lactose has been removed. Therefore, hard cheeses such as cheddar and Edam are usually tolerated on a lactose-free diet.
Check labels - all milk-containing products must now clearly state 'milk' in the ingredient panel on the label. Most supermarkets will provide a list of milk free foods.
*consistency given appropriate to age
Lactose free foods | Foods to avoid or check labels for 'milk' in the ingredient list | |
Fruit and vegetables | All plain vegetables and fruit - puréed, mashed and finger foods Fruit mixed with dairy-free alternative to custard, cream | Vegetables mixed with sauces made from cow's ilk Fruit mixed with ordinary yogurt/custard/cream/ice-cream |
Meat/fish/eggs/pulses/nuts* | Plain meat/fish/eggs/pulses/nuts/quorn/tofu | Processed meat/fish/eggs/pulses/nut products Or in sauces made from cow's milk Some meat alternative (vegetarian) products |
Dairy products | Lactose-free infant formula Lacto-free brand products (can be used in cooking from 6 months) Dairy-free yogurts and desserts Hard cheese e.g. Cheddar, Edam | Cow's, goat's, sheep's milk and all products made from these Ordinary yogurts Soft cheese e.g. cheese spreads, cream cheese, mozzarella, feta |
Starchy foods | Bread and flour Potatoes, sweet potatoes Pasta, rice Breakfast cereals (check label) | Milk breads, brioche Pasts in cow's milk based sauces Breakfast cereals which contain milk/chocolate |
Others | Any oils, lard, dripping Dairy-free margarine e.g. Pure, Vitalite, Tomor, Flora dairy-free supermarket own dairy-free brand Biscuits/cakes if milk-free | Butter, ordinary margarine Ice-cream, cream Milk chocolate, chocolate spread Biscuits/cakes that contain milk |
Baby jars/packets | All baby jars/packets/rusks which do not have 'milk' in the ingredient list | All baby jars/packets/rusks which have 'milk' in the ingredient list |
How long does my baby need a lactose-free diet?
Most babies grow out of lactose intolerance once their gut has recovered. To test this, try giving small amounts of dairy products e.g. ordinary yogurt or food made from cow's milk. If your baby has loose nappies and is unsettled, stop lactose-containing foods and try again in 1-2 weeks. It will take a bit of time for your baby to regain his/her ability to digest lactose, so increase the amount gradually.
If your child is still lactose intolerant at 1 year of age, please ask your Health Visitor/GP to refer her/him to a registered Dietitian.
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, however young children should not be exposed to the sun for long. 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.
Target group | Recommended supplement (SACN 2016) | Do not exceed |
Breastfeeding mothers | Equivalent to 10 micrograms/day or 400IU | 100 micrograms/day |
Breastfed babies up to 12 months | Equivalent to 8.5-10 micrograms or 350-400IU | 25 micrograms/day |
Formula fed babies up 12 months | Only if taking less than 500mls or formula/day | 25 micrograms/day |
Ages 1-4 years | Equivalent to 10 micrograms/day or 400IU | 50 micrograms/day |