Saturday, 20 September 2014

Finding the perfect formula for the dairy free baby

Breast is best, right? 

Well, I am a big fan of breastfeeding, BUT sometimes our boobs don't work, or we have to go back to work, or we don't produce enough milk, or... well for a hundred and one reasons, there are times when for some reason or another, with the best will in the world, we need a formula to feed our little ones.

In my case, it was because I had such painfully cracked nipples, that for a while, I needed to ease up a bit on breast feeding and top up with formula.

If you've just discovered your baby is allergic to cow's milk, you might wonder what on earth you can feed your little one - after all the only alternative to breast milk is cow's milk formula, right??

Well, not quite!!

There are formulas that are suitable for a dairy free baby

There are some options out there, that might be suitable for your little one!

Before we explore them, though, let me make it quite clear that contrary to what some might say, you do NOT have to give up breast feeding if you discover your little one is allergic to milk. You may have to remove dairy from your diet whilst you're still breastfeeding - as the proteins from cow's milk can pass through your breast milk (although this is not necessarily true of everyone, as your body breaks down the proteins to some extent), but it can be done. I know, because I have done it! Check out these posts, by following this link, if that's what you wish to do. 

What's out there:

Soya Formula

There are formulas that are completely dairy free, such as SMA's Wysoy, which is made from soya. Soya has been a popular non-dairy choice for years, because the proteins are so similar. However, because they are so similar, a large percentage of children with an allergy to cow's milk, might also be allergic to soya.  

The other problem with soya, is that concern has been expressed about phytoestrogens - naturally occurring oestrogen contained within soya. Because of this, soya formula is not recommended by the BDA for any babies under 6 months of age, or any boys under the age of one. The concerns are that the plant oestrogen could affect boys' future fertility or prolong girls' future menstruation.

Also soya milk contains glucose, which can cause tooth decay. Lactose (the sugar contained in mammalian milk) does not.

Extensively Hydrolysed Milk Formula

If your baby has been diagnosed with a cow's milk allergy they may be prescribed what is known as an 'extensively hydrolyzed milk formula' of EHF, such as Nutramigen 1 or Aptamil Pepti. These milk formulas are made with cow's milk, but the proteins in the milk have been broken down into tiny pieces, to enable children with milk allergy to cope with them. They come in two kinds - either whey-based (which also contains lactose) or casein-based. A dietitian or allergy specialist should be able to work out which is best for your little one. 

Most babies with cows milk protein allergy (around 90%) will be fine with formulas such as these, but sometimes babies with a milk allergy are so sensitive, that they cannot even cope with a hydrolysed formula - in which case they may be prescribed an AAF - amino acid formula.

Hypoallergenic Amino Acid Formula

An amino acid formula, such as the one prescribed our baby (Nutramigen AA) does not contain cow's milk protein at all, but amino acids - the bits (often referred to as the 'building blocks') that make up protein. Because this formula does not contain milk protein it is also lactose free. If you want to know exactly what is in a formula such as Puramino (formerly known as Nutramigen AA), see here. It makes for interesting reading!!

The other formula you are likely to come across in the UK is by Neocate - LCP.

These formulas are the first line of medication only for severe cases of milk allergy. If your GP informs you he/she cannot prescribe it, until it has been recommended by a specialist, this could be because their local prescribing guidelines dictate that they are only to be prescribed in secondary care.

Plant-based Milks

So-called 'Plant-based Milks,' such as almond or coconut, are not considered suitable as a main milk drink before the age of 2. This is because they do not provide enough calories, protein, or the desirable balance of vitamins and minerals required by the very young. They may however be used in small amounts, in food, once you have started weaning, providing your children is not allergic to any of the ingredients.

Points to note:

1. The first formula that you are prescribed may not be the right one for your baby. So if it does not seem to work for your little one, keep talking to your Doctor/Dietitian, they can probably try your baby with another. However, bear in mind, also, that it may take days or even weeks for the effects of the cow's milk protein to disappear. Another thing to note is that these formulas may cause your baby's poo to be a bit loose and appear a bit green!

2. Around six months a baby's bitter taste buds develop. It can be harder to introduce a formula at this stage, as breast milk is naturally sweeter. 'Baby' went off her formula around this time. Although our dietitian tried to help by introducing another formula, she didn't take to it. Unfortunately, I wasn't aware (at that stage) of how it was possible to gradually introduce a new milk, or that it is possible to try and disguise the taste with flavouring such as a non-alcohol based vanilla extract (apparently breast milk tastes like vanilla - see here).

3. Plant-based milks, such as Koko, Oatly or similar, are not suitable as a main milk drink for babies. This is because milk is the means by which babies gain all (pre-weaning) or most (up to the age of one) of their nutrition. Plant-based milks do not contain enough calories, or other essential nutrients. You will need a prescribed milk formula for children under the age of one, who are not being breast fed. 

4. Goat milk formula, such as 'Nanny Care,' is not considered suitable for children with a cow's milk protein allergy, because the proteins are so similar. In one study, 94% of children who were allergic to cow's milk, were also allergic to goat's milk.

5. Some other potential drawbacks with hypoallergenic formulas are outlined here.

Related post:

Further Reading: 

Suitable Milks for Children with Cow's Milk Allergy - BDA Fact Sheet

Living with cow's milk allergy - what do I feed my baby?

Suitable infant formula for babies allergic to cow's milk 

NHS Choices - Can I give my baby soya-based milk formula? 

Find a formula that's right for your baby - Baby Centre

1 comment:

  1. Good thing there are posts like this, a great help for those mums that were unable to produce breast milk. checked your notes also and they are very helpful too!