Milk and soya avoidance

A cow’s milk and soya free diet involves the complete avoidance of cow’s milk and soya milk. This will be necessary if your child has, or is suspected to have, a cow’s milk and soya intolerance or allergy.

Infant formula derived from goat’s milk is not suitable for infants under 12 months of age. Milk from goats and sheep has a similar protein to cow’s milk and in most cases may cause the same symptoms, and so is best avoided.

The diet excludes obvious and hidden sources of cow’s milk and soya (for example butter, cheese, cream, yoghurt, soya desserts and soya margarine). The following are terms for cow’s milk or soya, and foods containing them should be avoided.

Milk

Easily recognisable source of cow’s milk:

• butter
• cheese
• cow’s milk
• cream

Cow’s milk ingredients to be avoided:

• butter fat
• lactose
• buttermilk
• milk solids
• casein or caseinates
• non-fat milk solids
• hydrolysed caseinates
• skimmed milk powder
• sodium caseinate
• whey
• curd
• ghee
• lactoglobulin
• whey powder
• whey powder or sugar
• whey powder or sweetener

Soya

Easily recognisable source of Soya:

• soy or soyabean
• soya milk or formula
• soya yoghurts
• soya desserts
• soya flour
• soya protein
• soy sauce
• tofu

Soya ingredients to be avoided:

• miso
• tempeh
• edamame
• textured vegetable -protein (tvp)
• vegetable gum (soya)
• vegetable starch (soya)
• thickener (soya)
• emulsifier (soya)
• bulking agent (soya)
• soya protein isolate
• soya protein concentrate
• hydrolysed vegetable -protein
• soya lecithin
• soyabean oil*

*Soya bean oil and soy(a) lecithin are usually tolerated by children with soya allergies. Check with your dietitian if you are not sure about products containing these ingredients.

Food manufacturers must state the presence of cow’s milk and soya in a product. Carefully check the labels of any foods that you buy every time for the presence of cow’s milk and soya in the ingredients list, even if you have bought that product before. The term ‘natural flavourings’ on a food label can mean that they are milk or soya based flavourings, this should be declared on the label for example ‘natural flavouring (milk and soya)’.

Food items that do not have food labels, or foods sold loose may contain milk, soya, milk, soya derivatives, or may have come into contact with milk, soya products and so should be avoided. Such examples include bakery items, deli items and butchers products.

Milk substitutes

Cow’s milk and soya milk provide protein, calcium and energy in the diet. If your child is unable to take cow’s milk, soya milk or cows milk or soya based formula they will need a milk substitute. There are several cow’s milk and soya free formulas available on prescription for children under two years of age.

You can use the milk substitutes in cereal and in cooking. If your child will not drink enough of the milk substitute they may need a calcium supplement. Discuss this with your Dietitian.

Rice milk, oat milk and some other milk alternatives are low in energy, protein, and nutrients, and not all substitute milks have added calcium. These should not be used for young children unless advised by your Doctor/Dietitian.

Make sure you arrange regular follow up with your doctor and dietitian. As your child gets older, your doctor will let you know when it is safe to challenge your child with cow’s milk and soya. Food challenges are important to check if the diet is still needed, however do not challenge foods until directed by your doctor.

Meat, fish and alternatives

Bread and cereal products

Fruits and vegetables

Snacks

Fats and oils

Miscellaneous

Drinks

Please note: All branded products are milk and soya free at the time of printing. Detailed information on manufactured products can be obtained from the customer services department of most supermarkets.

Sample meal plan

Breakfast

• Cereal with milk substitute
• Toast and milk or Soya free spread
• Drink of juice or milk substitute

Lunch

• Sandwich with milk soya free spread or
• Beans on toast or
• Egg on toast
• Fruit
• Drink

Evening Meal

• Meat or fish or lentils
• With rice or pasta or potatoes
• Vegetables

Desserts

• Milk pudding or custard made with milk substitute
• Fruit with Oatily Cream

Snacks

• If your child is hungry between meals. Suitable snacks to offer include fresh fruit, crackers, a slice of bread or breadsticks.

Eating out

If your child has a food allergy there is no reason why you should not enjoy eating out. If your child needs emergency medication (such as an Epipen) they should not eat out unless they have their medication with them.

Order simple dishes such as grilled meats, steamed vegetables and potato, steer away from soups, sauces and dressings where ingredients are easily hidden. Fresh fruit is a good option for dessert.

Always check with the staff about the ingredients in the dish you want to order. If you are not sure do not order the food.