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My child has a cows milk protein allergy, which milk alternative do I choose?


Has your child been diagnosed with Cow’s Milk Protein Allergy and now you are unsure what milk to give them?

The good news is there are now many cow’s milk alternatives on the market, but this in itself can make it hard to decide what is best for both you and your child. This blog will help you navigate the world of cow’s milk alternatives showing you what to look for when choosing a milk alternative for your child. When your child reaches 1 year of age, you can transition them onto a milk alternative. Lets discuss further...


Firstly, what is Cow’s Milk Protein Allergy?

CMPA is a reaction to the proteins found in cow’s milk. Children with IgE allergies experience symptoms such as itchy skin, shortness of breath, and hives up to 2hours after drinking cow’s milk or eating cow’s milk products. This is the result of the immune system identifying the protein and immediately reacting to what it sees as dangerous proteins. In contrast, some children have non-IgE allergy which is associated with a delayed reaction. They show symptoms such as vomiting, constipation, diarrhoea, eczema, and poor weight gain. Non-IgE allergies can be more challenging to identify due to the length of time between exposure and symptom onset.


Will my child have a cows milk protein allergy forever?

It is likely that your child will not have to avoid cow’s milk for life with up to 80% of infants with CMPA growing out of the allergy by age 3years. This occurs due to maturation of the gut. However, you and the parents of the 7% of children under 1 in the UK may need to provide their child with milk alternatives until they grow out of CMPA.


What should you look out for when choosing a milk alternative?

Ideally when choosing a food alternative, you should find a food that has a nutritional profile similar to the food being avoided. This ensures that with the absence of the food you are still meeting all nutritional requirements. This is particularly important for cow’s milk due to its rich nutritional profile. 100ml of cow’s milk provides 63kcal, 3.4g protein, and 3.6g fat. This is the most energy dense milk available as you can see from the table below. It also is quite high in protein which is not always the case with milk alternatives. Providing your child with sufficient energy and protein is essential to support both growth and development.


Additionally, cow’s milk is often the main calcium source in the diet. 100ml cow’s milk provides 120mg calcium. This calcium content is significantly higher than the natural occurring calcium composition of milk alternatives. This means that choosing milk alternative brands which are fortified in calcium is best to provide your child with the calcium they require for bone and teeth health. Many brands will fortify milk alternatives to ensure that the calcium content is the same as that of cow’s milk. However, often organic products are not fortified and this is something to watch out for.


Another important consideration when it comes to milk alternatives is their sugar content.

Choosing unsweetened versions are best to reduce your child’s free sugar intake to protect their teeth. This is also important so that your child does not develop a preference to sweet tasting drinks leading to potential dislike of cow’s milk and an increased consumption of fruit juice and sugar sweetened beverages in the future.


With all of this in mind, the table below provides a summary of some milk alternatives that are available along with their nutritional composition. While this provides a guide to the nutritional value of these products, it can vary between brands and so may not always be the same as the nutritional composition detailed at the back of the milk bottle.



In summary, there are many different milk alternatives on the market but finding a milk alternative which your child enjoys but which also replicates the nutritional profile of cow’s milk is important.


This can be difficult to do on your own and so attending Nutrition and Co's cows milk protein allergy group sessions can help you to gain more information and provide you with additional support in navigating the milk alternative market.


Alternatively, if you are looking for more tailored advice you could book an appointment for a 1:1 consultation with our specialist paediatric dietitian at Nutrition and Co.


Click on the button below to DOWNLOAD OUR FREE dairy free recipes for children


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