The house at poo corner - tales of the food intolerant kind

Not that great a subject, is it? But, nevertheless, one which (like the yucky stuff) needs dealing with. I don't know about you, but I'm not good with wee, poo, sick or snot - one of the reasons why I decided against becoming an infant teacher. When you deal with small children, these bodily substances tend to come with the territory. Ironic then, that having a little one with a milk allergy, I've had to deal with what I consider more than my fair share of the yucky stuff! 

'Oh no! It's a dodgy poo!' 

Something my poor husband has heard all too frequently. He (preferring not to mention bodily functions aloud) almost winces whenever I yelp the above phrase. Unfortunately for him, if something distressing happens to me I tend to let it out - to get it off my chest. Now we have Baby, anything unpleasant that happens to her affects me quite deeply - the sight of a dodgy nappy gets me going like nothing else. This particular post has been inspired by another such nappy - just the other morning.

Why can't I just get on with it quietly?

It's just a dirty nappy, isn't it? All babies have them, don't they? Normally dirty nappies don't bother me, in fact I do most of the nappy changing in our household. However, the kind I'm talking about DO bother me, because they tend to involve diarrhoea (not to be confused with a slightly looser bowel movement - I know the difference). The ones that I'm talking about mean one of two things: either a tummy upset, or a reaction to something she's eaten. Either way, I have a miserable baby on my hands and it's going to mean a whole lot of washing for me to sort out - these nappies tend to leak!!

What if it's a tummy bug?

My least preferred option, because Baby's had a few of these (even though I try to be careful with hand washing and hygiene). It's horrid seeing her miserable and feel that there's nothing we can do about it. They last between 5-10 days and she doesn't usually want to eat anything. I hate the fact that I daren't go anywhere as I don't want to spread it around to others. In some ways I prefer to be at home because it's easier to change her nappies/clothing etc. (and wash my hands properly in hot soapy water afterwards) but the pair of us usually end up with a bad case of cabin fever as a result.

What if it's a reaction to food?

Having had a few of these, I think this scenario is easier to deal with - we now know we can do something about it. In the early days (before she was diagnosed and we cut the dairy out of my diet) it was harder because we had no clue as to what was causing Baby's discomfort, distress and diarrhoea. It was heart-breaking seeing her writhing in pain both before the nappy, because her tummy hurt, and then after, because her skin was so sore. We tried to keep her as clean as possible and be incredibly gentle, when cleaning up the mess, but otherwise the Hub and I just felt so powerless to do anything about the cause. 

Who needs more washing?

The episodes were pretty much constant and so therefore was the discomfort too. Added to this, many of her lovely early baby clothes were completely ruined by the yellowy brown tell-tale stains from leaky nappies - even when we used Napisan for extra stain-busting power. 


These days we don't get lots of nappies if there's a reaction to food. Usually there's one or two, several hours apart. They tend to come swiftly and unexpectedly - which is one reason why (although I know I can't leave it too long) I've held back from potty training. I know from my own experiences with food intolerance that when the body has decided to reject the food it doesn't want, you lose an element of control over your body which is distressing and can be embarrassing too, if you're caught out away from home.

However, the good thing about one of 'Baby's' reactions is that the symptoms don't seem to last longer than 24 hours (so long as we've eliminated the source from either her diet or mine) which means we're back to normal quite quickly. They're are usually because her strictly dairy free diet has been breached in some way. 

It's fairly easy to spot (now that we know what to look for) in that she is more clingy than usual (I'm guessing that's because her tummy is feeling uncomfortable). She may also pass an unusual amount of wind, from the gases which build up in her stomach. Also, 'Baby' will want her nappy to be changed (normally nappy changes result in a battle of wills) and her botty will be quite sore from the poo - it's like a burn. Thankfully, once we've cleaned her up with plain water, the soreness usually clears quite quickly, unless it's a bad reaction. If this is the case, once we've cleaned her up, we slather her botty with vaseline to protect her skin, from contact with the acid in any further unwanted episodes.

Once we've established it's likely to be a dietary breach, it's just a case of identifying the cause.

Identifying the cause

We've got pretty good at this by now, we just have to consider the following:

1. I've eaten something with dairy in it. 

As I'm still breastfeeding this is still possible. This possibility usually has me racking my brains; thinking back over the last 24 hours and re-examining labels on food packets, to see if I've unwittingly eaten something that may have contained milk. More recently, however (completely by accident) we've established that I've eaten a few things that would definitely have caused a reaction in the past, that haven't - such as a biscuit made with milk. This is a definite improvement on what used to be, but I just need to work out the limits, so I don't overstep the mark.

When 'Baby' was three months old, I ate a packet of salt and vinegar crisps - completely unaware that dried milk powder had been used in the flavouring. The result was a miserable baby and a disastrous nappy within the hour! It was only when I saw the nappy that I realised the cause of her distress and checked the labels on the packets of everything I had eaten. It was this incident that surprised the pediatrician - he decided that as the milk in the flavouring would have been minimal, her sensitivity must be quite strong and that there was no point in us returning to see him until she was at least one!

Once you suspect there may have been a breach of the diet, you have to be really vigilant and suspect anything - even Free From food stuffs are not immune. Once I couldn't pin the blame on anything but some Free From chocolate mints that came from one of the major supermarkets. I only knew this for sure, when I visited one of their stores and saw a sign recalling the product - within certain dates - which matched the packet I had at home.

One further possible source that may go under the radar is medication! I always ask the Doctor to check that there is no milk, whatsoever, in any medication that he prescribes for me (or baby). I also check the labels on vitamins, although these seem to be aware of dietary needs.

2. 'Baby' has eaten something with dairy in it. 

Now that 'Baby' has been weaned onto solid food (apart from the milk she has from me) this is a distinct possibility. Once we ate at a carvery and the dodgy nappy she had later that day confirmed my suspicions - they must have put butter on the veggies. Baby, being quite a bit older than before, and presumably more tolerant by this stage, didn't actually have the dodgy nappy until the evening. She had another the next morning, but it was less severe - possibly because I ate the same as her and it took a bit longer for the milk protein to pass through my milk and into her.

3. Either 'Baby' or myself have eaten something else to which she is sensitive. 

We were warned, when weaning 'Baby' that she may be sensitive to other foods also. This meant that we had to be exceptionally careful - adding one new thing to her diet at a time, for four/five days, before trying something new. This is because a reaction to a food may not become evident, until after you've eaten something several times. However, sometimes it can take even longer to cause a reaction, as we were to discover. 

It was 'Baby's' Vitamin D drops, which caused the problem. We had been advised to give her these from the age of six months (this is standard advice for mothers who continue to breastfeed beyond the first six months, as breast milk does not contains much Vitamin D). It wasn't until about six months later that we realised we had a problem, when 'Baby' came down with what I thought was a stomach bug. 


When the 'bug' didn't go away, I kept a strict food diary, and eliminated different foods from her diet (one at a time) to try and find a pattern. This took about three weeks. Eventually there was nothing else to eliminate but the vitamin drops. When I stopped them, hey presto, the dodgy nappies 'miraculously' stopped! When I reintroduced the drops, they began again, so there could be no doubt - the vitamin drops were the cause!

So back to her most recent nappy...

The nappy the other morning was not as bad as in the early days - so hopefully one day there will be no reaction whatsoever. She hasn't been writhing around in the day but was rather restless overnight.The poo wasn't runny, like it used to be - just a bit more yellowy and much softer than normal but the skin on her botty was an angry red colour. Unusually it has stayed that way for a few days. 


Thinking back over the last few days, I can't think that we have given her anything with cow's milk in it, so maybe it's something else that's causing the problem. Maybe it's because I've just started having coconut milk recently, and the proteins from that are coming through my milk and affecting her. Or, maybe it's because we've upped the amount of soya milk she's having and she's developing a sensitivity to that. Perhaps it's some ingredient in the new type of Free From biscuits she ate on Sunday. Who knows at this stage? We'll just have to take all the foods that are under suspicion out of her diet and then (once her skin has cleared up) add them all back in again, one by one, until we find the culprit!! 

For when you get the munchies...

Biscuits, Cakes & Other Yum Stuff

There's nothing like a good biscuit, or cake, when you've got what Winnie the Pooh might call a "rumbly" in your "tumbly". Following fairly (ahem) extensive research (my waistline will confirm this) I discovered that there's some good dairy free alternatives out there along with 'normal' biscuits that are already dairy free! I'm going to share with you some of my faves.

Free From

Let's look first at some Free From alternatives. There are some goodies out there but, as always, Free From means more expensive.

Jaffa Cakes - I've come across two versions: one from Tescos and the other is Kelkin's which are available at the moment from Sainbury's and The Co-op. Kelkin's are the best as far as I'm concerned. The version you can get in Tescos is inferior being smaller, drier and harder. Kelkin's, tastes so similar to the original that I can't fault the flavour at all. The only downsides are the size (smaller than 'normal' Jaffa Cakes) and the price.

Chocolate Chip Cookies - I can't decide whether I prefer Doves Organic or Waitrose Gluten Free (also dairy free but you have to read the back of the pack to find that out). Both are quite yummy - especially the Waitrose double chocolate version. The Doves version I have only found in an independent health food shop, so far - even though Waitrose stock two other types of Doves organic cookies. These other two types are nice enough but the chocolate version is far superior, in my opinion.

Sun Start Supreme Golden Crunch and Raspberry Golden Crunch - the nearest I have got to something like shortbread, that I like. Produced by an American company, they are available in Tescos and Holland & Barrett.

Chocolate Muffins - Tescos & Sainsburys both produce a pack of two chocolate muffins. They're not huge but they are soft, moist and taste yummy.

Chocolate Cake Bars - Tescos Free From taste very nice indeed.

Chocolate Brownies - various versions around. OK Foods Free From Chocolate Brownies from The Co-op seem quite yummy.

Madeira Cake - Asda's seemed quite nice. You could serve slices of this with dairy free custard, for a quick and easy pud.

9 Bar ...Original - I know they definitely sell these in Waitrose. They are both delicious and nutritious but sadly a bit strong on my stomach, these days. I think it's all those seeds!!

Cherry Bakewells - Tescos and Sainsbury's both do a decent Free From version. If I' picky, I don't like the pastry all that much, but I think all shop bought pastry is a bit inferior.

Bramley Apple Pies - Tescos and Saunbury's must use the same suppliers! Tasty. These might make a quick handy pud when served with some dairy free custard or dairy free ice cream.

Scones - Tescos and Sainbury's both do a decent Free From version with dried fruit. No cheese ones unfortunately, for obvious reasons!

'Normal' Fare

There is a fair bit of 'normal' food which is dairy free. Often it is the cheaper version of a classic, which has been made with vegetable oil because it's cheaper than using milk! However, you must always check the label, as manufacturers may well change the recipe without warning! Also the products in this category may well contain traces of milk (as they are made on a normal production line) so if you are really sensitive to dairy, they may not be suitable for you.

Digestives - Free From digestives are nothing like a good Mc Vities. The nearest I got to the McVities was Doves Organic Digestives, which can be found alongside all the other 'normal' biscuits in Waitrose, even though they're dairy free. I got to the point where I preferred them to McVities, until I had to go wheat free.

Rich Tea - a classic biscuit, good when you need something bland! Waitrose essentials version is or was dairy free, when I was still eating wheat.

Hobnobs - joy oh joy! I was ecstatic when I discovered these were dairy free, as I so love flap jacks - that syrupy oatey taste! Hobnobs were the nearest I got to replicating what I was missing, until I discovered...

Nature Valley Crunchy Granola Bars (Oats & Honey) - absolutely delicious! I loved these before I had to go dairy free and was overjoyed when I realised they were still OK for me to eat. They're a bit pricey though!

Doves Organic Flapjacks - I've a feeling these were produced with Vegans in mind. I love the version with apple and sultana! They also produce muesli bars but I prefer the flapjack above all.

Fox's Party Rings - a recent revelation! My daughter loves these! Ideal for when your dairy free child goes to parties!

Date and Walnut Cake - Waitrose are the stars here. I liked it, when I could still eat wheat.

Sesame Snaps - these are yummy. They're a bit hard on your teeth - literally but also because they're so sweet and sticky. Sesame is meant to be a good natural source of calcium, so these could be useful if you're trying to consume enough calcium!

Crumpets - the last time I tried Free From Crumpets from Tescos I couldn't eat them they tasted so disgusting! However, Tescos own cheaper 'normal' version of crumpets are dairy free and taste fine! Perfect with dairy free chocolate grated over the top, or with honey!

Check the Ingredients on the back of the popcorn - just to be sure!

Popcorn - yes if you find the right type, you can still eat popcorn. Salty should be dairy free and sweet can be too, but make sure you check the labels carefully. I have fallen in love with Tyrells Sweet & Salty version. It's not just me - hubby and baby loves it too. Tescos and Sainsbury's have their own versions but they're not quite as nice!

Baby & Toddler Fare

A lot of baby food is dairy free because milk is not meant to be used in their diet to begin with. The following are some that we have come across:

Farley Original Rusks - dairy free but high in sugar and not very satisfying in my opinion. Baby didn't get them much and didn't seem that impressed, when she did.

Plum Spelt Fingers - baby kind of liked these until she came across real biscuits! Then she wouldn't touch them. They are quite hard. Wrapped in packs of two, they're useful for taking out and about in your bag.

Organix Goodies Organic Oaty Bites - kind of like flapjacks, they come in bars (like a muesli bar) or in packs with individually wrapped bite size pieces (useful again for your bag or pocket). They're not as yummy as flap jacks (they're sweetened with natural fruit juices) but if baby has never had the real thing she'll never know, will she? 

Orgran Gluten Free Mini Outback Animals Chocolate Cookies - Only found in Sainsbury's so far. The animal pieces are quite small and come in mini packs. Dry and yet somehow slightly chewy; they have a chocolatey taste that is also a bit syrupy. Baby didn't enjoy these.

Summing up

Looking back at the list I've made here, there's quite a lot of choice out there, after all. So there's no need for anyone's 'tumbly' to be too 'rumbly'! However, I'm sure there's more that I've missed or don't know about yet, so if you have any hot tips... please let me/us know and share the joy!!

Update! Bah! My little one has turned out to be more sensitive than first thought - she now reacts to 'may contain'. She is more likely to react than not. So do watch out! 

Shopping Around... Dairy Free

When we first started shopping dairy free, I must admit I was a bit daunted. I mean, I knew that I was safe with plain meat and fruit and veg but there had to be more to food than that!! Would I have to give up cakes, biscuits and chocolate? It's all very well being born with a milk allergy - you never know what you're missing, but when it is suddenly thrust upon you (and until now you've been able to eat whatever you like) you know exactly what you're missing! 

Fortunately, as I was to discover, there is food that you can still enjoy out there... somewhere, it's just finding it! 



First, know your 'enemy'!

So you've got the list? You know the one that goes like this...


Check labels for: 
milk (including skimmed, semi skimmed, evaporated, condensed, dried, longlife, sterilised)
buttermilk
butter
cheese
quark
cream
yoghurt
fromage frais
casein
caseinates
hydrolysed casein
whey
whey solids
whey syrup sweetener
milk solids
non fat milk solids
lactose*


Yes? Well, now you have it, anyway!

This'll be the list that you'll need to assist you in your shopping! The list looks a bit long long to remember off by heart, but of course most of these do not need to be learned off by heart as they are pretty much common sense. It's the unusual words, that you never realised had anything to do with milk (for me it was 'casein') that really need to be taken in. By the way, watch out for 'lactose free' - this does not mean 'milk free' or 'dairy free'!

Update 2019: You no longer need to carry around this list in the EU, because of statutory requirements that mean that all food products have to clearly denote the presence of the top fourteen allergens (one of which is milk). However, it is still worth knowing your enemy, as other products such as shower gels etc. do not have to declare the presence of the top 14 allergens. I have recently found a really comprehensive list of allergens via a US Allergy Charity which is really comprehensive. Please click here.


Checking the labels

Dairy free shopping means checking the food labels on every food product you purchase (even if you have bought the product before, as recipes and ingredients can change) and being aware of all the ways that milk might be referred to on these labels. It can be a bit of a chore. 

Once upon a time, it was much more difficult to source suitable products, I believe health food stores were pretty much the only option (I shudder to think what people did before these came along). Now the big supermarkets have got in on the act; they've cottoned on to the 'need' or 'market' and made things slightly easier for us - in that they not only stock specific 'Free From' products but helpfully group them together in one section. The big stores also have lists of dairy free products which can be obtained from them, if you ask.

A supermarket Free From aisle

Helpful as this is, the frustrating thing is,that they often major on 'Gluten Free' products some of which (by no means all) are also dairy free, so again you need to check labels. Conversely and confusingly, sometimes products labelled 'Gluten Free' are sometimes also dairy free but do not state it openly. Waitrose gluten free chocolate chip cookies are just one example of this and it's a shame they don't make more of the dairy free labelling, because in my opinion, they're quite scrummy. 


Recently I met a mother whose child, like mine, was dairy free and who expressed her frustration at the restrictions of her child's diet. She just wanted to buy her daughter 'ordinary food'. If you are or have family members who are dairy free, you have probably shared this frustration at some point. The good news is, that there are products out there on the shelves of the supermarkets**. The bad news is that it is a bit like looking for a needle in haystack unless you get some hot tips from someone you know (I can still remember the huge sense of joy I felt, when told by the curate's wife, that Hobnobs were dairy free). 



Use modern technology

The next bit of good news is, that you can get an app for that!! Called 'Food Maestro,' its been made in conjunction with Health Care Professionals, who work with allergies. It doesn't work in all stores yet, but is getting there!


My husband has been my lifeline - he often finds food products, when doing the weekly shop (which, to make life easier, we now do online at Ocado). He originally started doing this to avoid the weekend scrum at the supermarkets and soon discovered he liked the way they laid out their product information. It was through investigating Ocado's website that he discovered my gluten free pasta, which I'm only mentioning here because it is made with chickpeas and is therefore quite handy if you are trying to top up your daily calcium (it's also available from Waitrose, in the fresh pasta section). Of course other stores do similar things with online shopping, you just need to find the one that suits you. 


You can also shop online by using Internet food stores devoted to allergies. I haven't used these personally but have looked at a few and found them quite interesting. They have a wider range than you might find at a supermarket and provide accurate information.  The only thing you might find with these is that delivery charges add to the price of already pricey items - Free From food is already expensive enough as it is! 


You may decide online shopping is not for you and may not have a smartphone on with which to use fancy apps but you can still find product information online, and browse for ideas before you hit the shops. In the past we have used Sainsburys site which seemed to be fairly helpful but I don't generally spend much time browsing for products, unless I'm looking for something specific. Also I get frustrated if I can see something online but not in my local store! 



It's worth shopping around 

Someone made me laugh the other week by pointing out that my husband*** works for one major supermarket, but that we shop elsewhere - at Ocado and Waitrose. This is not entirely true - living in an area where I have quite good access to a number of different supermarkets, I hop around the different shops according to where I happen to be that day or according to which Free From products I want, as the supermarkets all vary slightly in what they have to offer. Prices can vary too, as I found out last week, when I visited the Co-op and found that my favourite brand of Free From bread and my Free From Jaffa cakes are currently cheaper at the Co-op than at either Sainsburys or Tescos! 


I also still pop in to independent health food shops from time to time. They might be a bit pricier than the supermarkets but they quite often have products that you can't find elsewhere (except maybe the allergy food shops online). Where else can you find a dairy substitute made from pea protein? And they tend to offer their customer a bit more of a personal touch than supermarkets too. Who else might offer to order in something that they don't have in stock, but will offer to order it anyway, because they can get hold of it and they know you want it - like those Free From ice cream cones I wanted, last summer? Yes! These days you can get dairy free ice cream! Mmm! Sounds like a cue for another blog!




*Watch out for 'lactose free' on labels - this does not necessarily mean 'dairy free'!

**The bad news is that if you are really sensitive to milk, a lot of these products may not be suitable for you. Even if they do not contain milk in the ingredients, they may still contain 'traces of milk'. This is because they have other products made on the same production line that are made with dairy - in which case they cannot guarantee 100% that a tiny amount of dairy might not enter the one you're after. 


NB Something else to look out for - if something is suitable for Vegans then it may also be dairy free. Although some products that say they are Vegan still say 'may contain milk'. The only way to be sure is to (yep, you've got it) check the label carefully everytime.

*** The Hub no longer works for any supermarket - just in case you're wondering!

There are dairy free alternatives, but it's certainly not butter!

You may be familiar with the advertising slogan for a current alternative to butter: 'I can't believe it's not butter'. Unfortunately, I don't think there's a true alternative to butter in dairy free land. It's very difficult to replicate the true flavour of dairy products. However, I have found a spread that replaces margarine quite nicely. The one I use is produced by Pure dairy free. They have produced three different versions: Soya, Sunflower and Olive, all of which are are associated with certain health benefits. Their website provides more information and some helpful recipes to try, but here are a few of my personal thoughts about their products:

Soya

The soya version isn't any use to me, due to my problems with soya. I did try a bit, to see if my body would cope with it (it didn't), and it seemed to taste OK. It is the spread of choice for supermarkets - if they only have room for one dairy free margarine, they seem to stock this version, by default - which is rather annoying for those of us who need to avoid soya!

Olive

The Olive version is alright, but I thought it produced slightly greasier results, when baking. 

Sunflower

My favourite version is sunflower, which I have found to be very versatile - good on bread and toast, I've also used it for making scrambled egg and cakes, with excellent results. I have to admit, I thought that it might have some unpleasant after taste, but I haven't noticed any. The other good thing about sunflower is that it contains vitamin D, which your body needs to absorb calcium.

Update
Since I wrote this post other dairy free margarines (usually made with sunflower) have seemingly sprung out of the woodwork! Vitalite's version is available in many places, Sainsbury's also sell one called 'Tomor' in the Kosher section of their chiller cabinets and most supermarkets now seem to be producing their own dairy free brand - from M&S to Aldi! Now we have choice!!

Update 2015:
Look out also for Koko's new margarine, which is coconut based. It is currently sold via Waitrose.

Here's what to look out for!

Update 2016:

Now Flora have entered the dairy free fray by bringing out their own dairy free version. Watch out though, as the packaging is very similar to it's Original margarine! I also hear that its made on the same lines as other products containing milk, so if you're really sensitive to dairy, it may be best to avoid!

There are alternatives - dairy free milk substitutes

So you can't have milk, but you might still want your morning breakfast cereal or something with your cuppa. Well there's no need for complete despair, there are alternatives! 

One of the main things to consider is the age of the individual involved. Some milk substitutes aren't suitable before the age of six months, two, three or even four years, so you need to read your labels carefully. 

Baby's choice:1+ by Alpro

You might also want to bear in mind whether your milk substitute needs to be enriched with certain vitamins. If, for example, you want your milk substitute to perform the same kind of role that normal milk would previously have carried out for you (by providing a considerable amount of your daily calcium allowance) you need to check the label. Most do, but organic versions won't, because they cannot call themselves organic, if they have added anything into the mix. 

Some also have vitamin D added. It is vital for your body to get enough vitamin D, in order to absorb calcium, so it could be worthwhile to make sure your milk substitute contains vitamin D as well. Some also have B vitamins, and so it goes on...


The good news is that there are all kinds of milk substitutes these days. The problem is that the choice could be bewildering, so let's take a look at the options:

Soya Milk

Perhaps most widely known and available - often offered in coffee shops etc. no good, however, if, like me, you have an intolerance to soya milk. Many people who can't have milk also have problems with soya. There is also some question mark over the use of soya by those who are pregnant or infants - soya contains a plant form of oestrogen, which it is thought might cause some kind of hormonal effect. More worrying for boys than girls apparently, but there nonetheless.

There are other associated risks, but reading around, it's tricky sorting out the fact from (quite frankly) the fanciful. The following article, from the BDA, is quite a helpful read.

One thing that does seem to be agreed upon, is that soya is not deemed suitable for children under the age of six months. Alpro produce a junior version (suitable from one year) that we now use for 'Baby'. This is the medical profession's preferred option for young children under the age of two, unless they are intolerant/allergic to soya. This is because it has the right amount of calories and additional vitamins, that are needed by very young children.

One of the major advantages of soya, however, has to be, that (as it has been around so long, as a useful milk substitute) manufacturers have found ways of developing yoghurts, cheeses etc. made with soya. You can also get it in various flavours and in smaller cartons, which are good for carrying around. So if you can tolerate soya, and don't depend too much on it, it could be a good option.

Rice Milk

Personally I think rice milk has a nasty after taste. It is a popular alternative but not considered suitable for children below the age of four and a half (and therefore not suitable for those who are breastfeeding either). This is due to the fact that rice contains a certain level of arsenic!! The arsenic comes from the soil in which the rice is grown. Yet somehow rice is generally widely consumed and is still considered safe as a first food for babies!! Read this article by the Food Standards Agency, for official advice. And then the following article, by Foodsmatter, for a more interesting read!

For those who can have rice milk, as well as the larger cartons, it also comes in handy smaller lunchbox-sized versions, which are good for travelling. They also come in variety of flavours.

Almond Milk

One alternative that is becoming more and more popular, is almond milk. I really like almond milk. Almond is a good natural source of calcium, so it makes good sense. It's also an excellent source of vitamin E. The good news, for nut allergy sufferers, is that almonds are not nuts - they're drupes and are related to the peach!

Ecomil, Blue Diamond, Alpro, Dairy Free Dream, and Rude Health all make their own versions of almond milk, but Ecomil's, being organic will not have any extra vitamins beyond those which are naturally present in the almond itself because you can't add vitamins to an organic drink - it immediately invalidates its organic nature). Rude Health's version will not be suitable for anyone avoiding rice milk (see section below), as it contains 14% rice milk. This isn't a huge amount, so you might regard it as okay, but that's entirely up to you!

Alpro's advice (aimed at those of us who have young 'uns) is that Almond milk is not suitable as a main milk drink for children under three, but can be used in cooking etc. Additionally, they state (unless they're organic, of course), that all Alpro milks contain vitamins B2, B12, and D as well as calcium.

Hazelnut Milk
Hazelnut milk has quite a distinctive nutty flavour. I like it in porridge, as it adds a kind of creaminess, which is missing in almond milk. Alpro is the brand leader in this one. Rice Dream also make a hazelnut milk, but it's unsuitable for anyone avoiding rice milk as rice milk is blended in with the hazelnut milk. As with almond milk, Alpro state that it is not suitable as a main milk drink for children under three, but can be used in cooking etc. 

Coconut Milk

Chocolate Kara

Made by Kara, it's OK, but I thought it left a slightly powdery taste on my tongue (but maybe that's just me). Kara's coconut milk is quite good used in custard and rice pudding. It's very popular with parents whose children are unable to have rice or soya milk. Kara's coconut milk contains calcium (250ml = 375% of RDA) and now vitamin D as well (it didn't used to). It is apparently cholesterol free. 

Handily, it comes in smaller cartons now, and in three flavours: Original, Chocolate and Strawberry, although the strawberry only comes in the smaller size. The chocolate version makes a very good hot chocolate once warmed!

Hemp Milk

Called 'Good Hemp' and made by Braham and Murray. I know it has lots of fans, but I tried this one once and am not a fan - it has a very distinctive taste. I'm guessing they've successfully removed the narcotic effects of the Hemp, though, as otherwise things could get a wee bit interesting! It's main selling point seems to be that, not only does it apparently contain calcium and vitamin D, it also contains omegas 3 and 6!

Quinoa Milk

Quinoa (keen-wah) is a type of grain. It was used by the Incas to strengthen their warriors, I believe. It's quite a good source of protein and is regarded by some as a sort of 'super food'. Made by Ecomil, we've only used this in making bread, so far!

Oat Milk

Oatly, are the brand leaders with this one, although there are now more oat drinks on the market. It was my personal favourite before my intolerance problems really began. Now that I can't tolerate gluten, this one is out for me - as it's not made with gluten free oats, which is a shame. 

It's not suitable for children under the age of two, as a main milk drink (unless advised otherwise by your dietitian), but can be used in cooking. I didn't get any nasty after-taste from it, but you do need to shake the carton really well before use as the mixture can separate. You can get a chocolate version (which isn't too bad) and they also do an Oatley cream substitute which is not unpleasant either (it's fairly thick, but thins somewhat, when it comes into contact with warm food).

In case you're wondering...
Goats milk and sheep milk are two substitutes to cow's milk that we've not tried - although people often bring these up in conversation, once they realise you have a problem with cow's milk! The reason that we haven't is because both of these contain proteins that are very similar to those found in cow's milk, so we're not going there! 

I have a friend who did rear her children on goat's milk (you can get it as a powdered formula in a tin from some supermarkets and good health food shops, it's called 'Nanny Care'), but I'm not prepared to take the risk of a bad reaction. Camel's milk and mare's milk are apparently much less allergenic, but I don't know about you, I've certainly not seen them on sale in any supermarket, just yet!


If you're from the States...
For the Americans among us, a comprehensive breakdown of milk substitutes available in the US, has been produced by the American nutritionist, Heather Bauer.


At the end of the day (having considered the options) whichever milk substitutes you end up trying, I hope you find one that you can enjoy with your cuppa and/or cereal!! 


And please... let me know how you get on!

More posts about milk substitutes can be found on our blog, under the heading 'Dairy Substitutes' which also covers yoghurt, cream and cheese!

Breastfeeding a baby with cow's milk allergy means no more milk for me!

So, decision made! 

A bit daunted, I decided to breastfeed baby. 

Knowing what I do now, I sometimes wonder whether (faced with the same situation) I would do it all again, but knowing me, I probably would. I don't always make things easy for myself, but if I believe in something then I follow it through - to the extent that two years down the line, I'm still breastfeeding my rather bigger 'Baby'!* 

Excluding milk

The paediatrician, whose interest just happened to be in food allergies, was a bit sketchy about what I should do but did advise excluding absolutely ALL forms of cow's milk from my diet - which meant reading ALL labels on ALL food products and medication ( I remind my GP, each time I'm offered a prescription). He also recommended (as I was  unable to have soya milk) using Oatley as a milk substitute but warned against using rice milk - more of which another time.

Fortunately for me, my mother happens to be acquainted with a retired dietician who used to work with a Doctor who specialised in allergies. This acquaintance passed on some important information - chief of which, was was that milk is an important source of calcium in our diets, so if I was going to go dairy free, it was essential to take a good calcium supplement along with vitamin D (vitamin D helps your body absorb the calcium). 

The other key information related to the different guises that milk comes in on food labelling - milk powder, cream, yoghurt, butter, fromage frais, buttermilk and cheese are perhaps pretty obvious, whey and curds, yeah I remember learning about cheese at school, lactose also made sense, but casein? That was a new one on me! 


The practicalities

There was so much to absorb about this new dairy free existence and it hasn't been easy. Life is a lot less spontaneous! I soon became acutely aware of how much eating is a core activity in the day - my days have had to be planned around what, when and where we will eat. 

So I have had to cook a lot more - ready meals are not so easily available. This is a good thing (I tell myself) because it is a lot more healthy, BUT it is a lot more time-consuming! It has certainly meant brushing-up my cooking skills. I've also had to adjust the way I cook - so many recipes use milk and sometimes there are no easy substitutes - especially, if, like me, you can't have soya.

We have found that although it's getting better, many cafes and restaurants have no idea about how to provide for even the most common food allergies, such as dairy (and now gluten, with me, too) even if they say they do, so, going out always means taking food with you - just in case. 

Because eating out in restaurants can be tricky, it has affected days out, social occasions, family get-togethers and even where we go on holiday. 

Shopping is not so easy these days, either. Most supermarkets have 'Free From' sections, but you can't buy all your food there, so all food labels need to be examined very carefully. Particularly as with our baby we've discovered we need to check for the slightest traces of milk. 

This is a particularly good Free From aisle. Unfortunately many stores don't stock this much choice.

One thing I have discovered is that 'may contain traces of milk' can depend on how the product is manufactured and even what batch. Others with cow's milk allergy might not be so sensitive, BUT following the occasions where this has caused problems, we no longer like to take the chance. As baby has a delayed reaction, it's not life-threatening, but it causes her a great deal of pain - not something we like to inflict on our little one, unnecessarily!

And, as I'm now milk and soya free, I find myself going on shopping expeditions in all kinds of different places, just to track down milk and soya free substitutes that can't commonly be found in supermarkets. These are often more expensive!! And tracking these products down can be very time-consuming!! Thank goodness for the Internet and online shopping is all I can say!!

If you can have soya, lucky you!! Soya substitutes are pretty good - most forms of dairy can be substituted pretty well, with soya and soya substitutes can be found everywhere - including many restaurants and cafes!

Soya substitutes, like these, are quite common

The sacrifices

It hasn't been easy having to sacrifice things that I loved. I've missed my lattes, cheese, cakes, puddings etc. etc. especially in the early days. There are times when I have felt quite jealous of everyone else eating 'normally' and even a little bit... well... angry? But then I remind myself that it was my decision to carry on breastfeeding my baby, no-one made me, and there is still so much more food that, thankfully, I can still enjoy or could - until I had a tummy bug and became intolerant to wheat (among other things) but that's a whole different story.


The joys

Along with the sacrifice there are some joys that should be mentioned. No claims that I feel healthier or have lost weight on a dairy free diet, however, my baby is healthier and thriving. That to me, is priceless, and on a more practical note although we initially had problems with breastfeeding and it has meant an awful lot of sitting down, it's quite handy and convenient! No more washing and sterilising etc. etc. (anything for less work, me) and it's with you wherever you go and isn't another thing to shove in your already overburdened change bag!!


Summing up

Time on, I must admit, I still miss those leisurely lattes I envisaged myself having once baby was born, but not so much these days - I now enjoy my black coffee and I can still have chocolate - there's a lot more dairy free chocolate out there, these days! All I know is that I did what I felt I had to do, and my baby is a healthy, happy and thriving little girl - which makes it all worthwhile.


*This is by no means what I originally intended - it came about partly because she still can't tolerate cow's milk protein but still needs calcium in her diet. The other reason is that I have an intolerance to soya milk - a common cow's milk substitute. Some people with cow's milk protein allergy have been known to also be unable to tolerate soya, so I have hung back a bit from introducing her to soya, until fairly recently. 

Further Reading:

Cow's Milk Free Diet for Breastfeeding Mums (Norfolk NHS)

After the diagnosis... breast or bottle?

Choices, choices...

Following the diagnosis, it became clear that I had two choices: continue breastfeeding and completely exclude dairy from my diet or switch to bottle feeding my baby, using a special formula. 

Formula?

The definite advantage of using formula is that as the cow's milk protein passes through the mother's milk, the baby's mother doesn't have to give up dairy herself. The formula which we were prescribed, Nutramigen, comes in small tubs and needs to be prescribed by a doctor. At roughly £25 a tub, it's just as well that it comes on prescription as it's not a cheap option by any means! I had one (locum) doctor ask me roughly how many tubs I needed, as it was so expensive!! 

One disadvantage of Nutramigen is the nasty smell, which emanates both from the formula and baby. Another disadvantage is the rather distinctive taste. I haven't tried it myself but it apparently doesn't taste that nice. I used it to make baby rice and baby cereal (having used it as a top-up when my baby was tiny) however, after a short while, my baby refused to eat it any more. When I discussed this with the dietician, she said it was because babies are predisposed to like sweet things (it's a survival instinct, because poisonous things tend to taste bitter) and the formula was a bit bitter. This tends to kick in around six months and might explain why one mother I spoke to said that she had quite a battle to get her child accustomed to the formula, when she tried weaning her onto it.

Breastfeeding?

The advantages of breastfeeding are spelled out everywhere these days, but the obvious disadvantage of breastfeeding a cow's milk protein allergic infant is that the baby's mother has to exclude milk completely from her diet - not an easy option, if like me you love lattes, cheese and cakes. Although actually when you look really carefully at food labels, there's an awful lot more ordinary everyday things that you used to take for granted that you can't eat, like chicken gravy.

My Personal Choice...

Let me stress that this bit of my blog is completely biased - it's about my choice.  It's not something I would push on another person - each to his/her own. I think I would have found this option a lot more tricky, if I had a bigger family to consider or if I had gone back to work. Fortunately for me, there are just the three of us and my husband was happy to go with whichever path I chose.

It soon became clear that breastfeeding was not going to be an easy option, but it was the right one for me, because although I loved milk and would have to cut it out, I saw this as having a short term impact on my life - according to the paediatrician most children grow out of the intolerance by the age of two and I wasn't intending to breast feed my baby that long! Meanwhile, I would be feeding my baby all the nutrients she needed through my milk and providing her with vital immunity. Also, breastfeeding is meant to help prevent food allergies and I certainly didn't want any more to deal with! 

In the end I actually chose a third way - I  combined breastfeeding and formula for a while, as although I wanted to breast feed I was very sore, so I opted to breastfeed from the least sore side, express from the other and top up with formula, until I had healed up enough (my aim was to drop bottle feeding and drive my milk supply back up, once I was better). Thankfully this didn't take too long and I was glad to drop the formula, at least until weaning time, as it was manufactured and therefore (in my humble opinion) second best! 

Actually, knowing what I do now, maybe if I had my time again I might choose differently and be less hard on myself, but who knows?

An article that might be helpful, if you choose to use formula, is this one by Nutramigen:
From diagnosis to weaning