This is the second part of a post covering what to do if you suspect that cow’s milk may be the reason your baby is so unsettled. As Part 1 states, you should have a good read of Is It Cow’s Milk Allergy to get informed. But what next? In this second part I’d like to share the advice I wish we’d had. It may not all be relevant to your situation but hopefully some of it will make your journey a lot easier and a lot quicker than ours! The only piece of advice you MUST follow is that you should see your doctor before you try eliminating cow’s milk from your baby’s (and your) diet. Don’t mess with your baby’s nutritional intake on your own!
Firstly, make a really detailed food and symptoms diary for 3 days before you change anything about your diet. This needs to include what you ate and when, including ingredients of foods, breastfeeds, and your baby’s symptoms – crying, sleeping (or lack of), nappy contents, rashes, etc. The more detailed the better as this is going to form the baseline to provide concrete evidence as to whether being cow’s milk free has made a difference or not. Use a page of A4 per day with the time down the side and 3 columns for ‘you’, ‘breastfeeds’ and ‘symptoms’ as you’ll find it’s a lot of information to record.
Once you’ve completed your food/symptoms diary take it to your doctor and discuss it with them. Be open to discussing all the causes and management options for excessive crying as hopefully your doctor will have more experience on dealing with unsettled babies than you and there may be another reason for your baby being unsettled that you haven’t considered. If you think it will help in guiding your joint decisions you could take a copy of the “Map of Medicine: Infantile Colic” that I included in a previous post. Even though it’s written for NHS doctors your doctor may not be familiar with it and and it may help to guide management decisions.
If your doctor decides you should trial a cow’s milk free diet then you have a big change ahead of you, which may be daunting in your sleep-deprived state! I’ll try to keep it simple…
Some babies react to soya and other animal milk products as well as cow’s milk as the protein structure is so similar. We learned this the hard way as I was determined to go strictly cow’s milk free and bought all soya alternatives instead. Over the first few days I tried them all out – the soya milk, soya yogurts, soya custard, even a large starbucks decaf soya latte, and we were gutted when our little girl got worse rather than better! Then we read about the soya issue and I dropped soya from my diet too, which is when we started to see dramatic improvements. You need to decide whether you want to avoid just cow’s milk initially or cow’s milk and soya from the start. If you just avoid cow’s milk you may see only a partial improvement initially and the process may take longer. If you avoid both you will hopefully see dramatic improvements like we did but you may be avoiding soya unnecessarily which makes your diet a lot harder to stick to.
Once you’ve decided whether you’re going to avoid cow’s milk or cow’s milk and soya you need to learn the names of the ingredients that you need to avoid. Below are two factsheets which you may want to print out to take with you when you go shopping.
Next, go through your cupboards to check the ingredients of your staples. Stock cubes, salad dressings, flavoured crisps, sweets, bread, and tinned soup are just some of the places that cow’s milk and soya hide so be thorough in your checking.
Now it’s time to head to the grocery store to buy the following…..(I live in the UK so I’m afraid the product information will be less helpful in other countries).
- A calcium and vitamin D supplement for yourself
- In you’re only avoiding cow’s milk buy soya milk from the long life milk section and other soya products such as yogurts from the Free From section.
- If you are also avoiding soya try oat milk from the long life milk section. It is one of the best tasting for cereal and baking but almond milk is nice in tea and coffee so buy that too.
- ‘Pure’ sunflower margarine or ‘Vitalite’ sunflower spread – many others still contain cow’s milk so always read the packaging.
- Bread – this is hard if you’re avoiding soya as well. Aldi stock one in their Village Bakery range and a few in the Tesco Finest range are soya free. Pittas and crumpets are a safer choice but still read the packaging.
- Lunch options – bread, ham, tuna, eggs, some soups, ready salted crisps (most flavours contain cows milk derivatives), fruit, salad.
- Dinner options – endless! Tomato based pasta sauces, tomato or coconut based curries, homemade white sauce dishes using oat milk, meat and two veg, etc
- Sweet options – hobnobs, digestives, the cheaper bakery items, dark chocolate, nougat, Mrs Crimbles coconut macaroons in the Free From section and other “Free From” treats.
Keep it very simple initially with only a few options for breakfast, lunch and dinner so that you establish a few ‘staples’ and don’t overwhelm yourself with the change in diet. Also, make sure you have plenty of high calorie snack options as it is very easy to accidentally lose weight when you go onto a cow’s milk free diet! The coconut macaroons, nougat and ready salted crisps were my ‘go to’ options! You should start to see an improvement in 24-48 hours and once your baby is more settled you will have the time and energy to invest in expanding your food options and getting to grips with being cow’s milk free so don’t stress about it all when you start out.
It will take 2 weeks to clear your system of cow’s milk and then a further 2 weeks to clear your baby’s system so don’t expect to see the full effects of your new diet for around 4 weeks. Remember to continue with your food and symptom diary so that you have concrete evidence of the improvements, both for yourself and also the healthcare professionals. An ongoing food/symptom diary is also helpful as there is a chance that your baby may be allergic to additional foods and a diary will highlight this and help to pinpoint the culprit.
Once you’ve completed the cow’s milk free trial you should head back to the doctor with your diary and your hopefully much happier baby. If there has been an improvement you should ask for a referral to see a paediatric dietician and possibly an allergist if your doctor feels it appropriate. This is because most babies grow out of cow’s milk allergy fairly quickly but the reintroduction of cow’s milk should only be carried out with the support and guidance of an appropriate healthcare professional, plus you will need support when it comes to weaning your baby.
I really hope this information is helpful. Please don’t be overwhelmed by it! Just keep it simple initially and once you’ve found your staples you’ll find that it’s actually quite an easy diet to adhere to. I have more posts planned on eating and weaning on a cow’s milk and soya free diet so please pop back another time. And if you have any additional tips or product recommendations for other readers please add them in the comments section below. I’ll leave you with a recommendation for the dairy-free cookbook I used (available here).