Calcium! Are you getting enough...?

"Did you know that not getting enough could actually kill you? Well according to the Daily Mail..." The Hub (who sounded mildly interested when I began making my point) harrumphs loudly at this point, makes despairing noises about me reading that particular newspaper again and returns to whatever he was doing on his laptop. I, however, am quite perturbed. It seems that getting my calcium intake correct is more important than I thought. I mean, I know I didn't want my bones to go all crumbly, but die? Really?

Do I really need Calcium?

It turns out that Calcium (number twenty on the periodic table) is not just important for preventing crumbly bones (osteoporosis). It is essential for the following reasons:

• strong bones and teeth
• clotting blood
• sending signals between the brain and nerves
• muscles - squeezing and relaxing
• the release of hormones and other chemicals
• regulating your heartbeat                          (US National Library of Medicine)

And apparently, this isn't just another 'women's thing' - it's something that we all need to watch out for. Well I never! Best pay attention to this one then!

How much?

So let's start at the beginning with this one - hands up who knows how much you should be getting (sorry no prizes for getting it right). Well if you said 700mg a day (UK Food Standards Authority) you wouldn't be wrong, but actually not necessarily right either! (That is the without taking into account the fact that it varies according to age/sex etc.) 

In fact, where you live might make some difference to your answer, because different countries seem to make vastly different recommendations! Sweden recommends 800mg a day, the US 1,000mg and Australia as much as 1,300mg a day! So it seems sensible, to me, take the view of Dr Virginia Warren of Bupa and aim for between 700mg-1,200mg of calcium a day.

Of course that was just for the adults! How about everyone else? Well the SNDRi (I couldn't find a UK reference online, so I used a booklet by this organisation which I think is Scottish, so that means British - for now) recommends the following:

1-3 years                        350mg

4-6 years                        450mg

7-10 years                       550mg

11-18 years                     900mg

adults                             700mg

breastfeeding women     1250mg

post-menopausal women 1000mg                                        (SNDRi - 'milk-free zone')

If you prefer to follow US Government recommendations, you can refer to the NIH. 

Where?

Available as a dietary supplement

Well, although you can get dietary supplements, the best way to get calcium (which it turns out is actually a metal) is, of course, through what you eat and the richest source is... wait for it... dairy!! Apparently about a pint of milk would give you enough for one day (good old pint, eh?). Hmm!! Not much good for dairy free baby and me then, is it? 

Where else?

Well there are other places, but don't be fooled, it's not all that easy! You may need to eat an awful lot of apricots and nuts!

Milk substitutes can provide calcium

Thankfully, these days, with good calcium enriched milk substitutes available, you can usually get around a third of your daily recommended amount, just by having one glass (200ml). However, you need to check each carton, as they are not all necessarily the same - the amount of calcium may vary according to brand. 

If you don't fancy drinking dairy free milk straight, well, there are other ways of adding it to your diet- with a bowl of cereal or porridge in the morning, or perhaps a pancake? You could also squeeze it in by making a dairy free lasagna, or fish pie. Then there's always desserts, such as custard, rice pudding, bread pudding - anything in which you'd usually use milk. A mug of hot chocolate or a cold milk shake (Nesquik Strawberry for me) could also add to your daily intake - although you might want to watch your sugar levels here!

Also, Tropicana make an orange juice that is enriched with calcium - 35% of my daily allowance. So that's almost two-thirds, what about the rest? Well, bread is fortified with calcium, but a slice of white bread  will only provide 64mg. Still got a way to go to get my recommended daily allowance, then. 

The top dairy free source of Calcium is sadly... not chocolate! It is, apparently (if only I could  get myself to like it)  Whitebait - a 3oz. serving could provide me with a whopping 774mg of calcium!! However, I needn't despair, there are other places to look too - here's the list I was given:


Fish
Sardines in oil                                                                   75g                      375mg
Sardines in tomato sauce                                                    75g                      323mg
Tinned Salmon (flesh & bones)                                           100g                      300mg
Pilchards in tomato sauce                                                  115g                      288mg
Tinned Salmon (flesh, no bones)                                         100g                       91mg

Veggies
Boiled Spinach                                                               90g                      144mg
(I'm not sure that Spinach is considered a great source of calcium, because the body doesn't absorb the calcium in spinach very well, this is because spinach also contains oxalate)
Boiled Curly Kale                                                             90g                      135mg
Stir-fried Okra                                                                50g                      110mg
Boiled Spring Greens                                                        90g                        68mg
Raw Watercress                                                              20g                        34mg


Pulses, Beans & Seeds
Steamed Tofu                                                                100g                      275mg
Tahini (sesame paste)                                                       25g                      170mg
Sesame Seeds                                                                 25g                       168mg 
(I believe the best way to get at the calcium in sesame seeds is to grind them)
Baked Beans                                                                  200g                       106mg
Canned Red Kidney Beans                                                  70g                        50mg


Breads/Cereals
Ready Brek (made with water)*                                          40g                       480mg
Porridge (made with whole milk)                                      160g                       205mg

White Bread (medium)                                           1 slice  36g                         64mg

Swiss Style Museli                                                             50g                         55mg

Wholemeal Bread (medium)                                    1 slice  38g                         38mg

Fruit

Medium Orange (peeled)                                                 160g                        75mg

Dried Figs                                                                       20g                        50mg

Currants                                                                         25g                        23mg

Dried Apricots                                                                 25g                        18mg

Other similar lists, listing some other alternative sources have been produced by The National Osteoporosis Foundation and The Vegan Society, among others. Another list that I've come across in a couple of places, (it might be American - it refers to molasses) may also prove useful, although some of the units of measurement seem to be missing! Another list for the Americans (produced by the US Government) also seems quite useful, but you need to scroll down to find the calcium!


Anything else you need to know?
Well, yes, actually - don't overdo it! It seems that taking too much calcium can give you tummy pains, diarrhea, kidney stones and now heart problems (Daily Mail)!! 

Also, you need to make sure that you are  also getting enough vitamin D to help your body absorb all that calcium, but more on that one another day!! 

Another thing to consider is the big E - exercise! Apparently 'weight bearing' exercise (walking, running etc.) helps to keep your bones strong.

And last of all, watch how much cola you drink - well caffeine actually! Apparently it makes your body excrete all that lovely calcium. Oh dear!! Now for me... that could be a bit of a problem - I do love my coffee... and chocolate...!!

Updates January 2015:

*Please note: Ready Brek used to be listed as a good source of calcium, indeed it is, but it now carries a milk warning - 'not suitable for milk allergy sufferers'!

Thanks to Sarah (@Sugarpuffish, via Twitter), I've just come across this new list suggesting good sources of calcium. I must admit, I really like the star ratings, which makes everything so much easier to understand! However, the reference to the calcium level in 'Wot no dairy?' yogurts is wrong - it's 60mg in 100g! The Hovis 'Best of Both' calculation also seems to be out - I cross-referenced it with this list from the BDA.

And there's more... Milk substitutes

Look what I found!

Lookee here!  Not content with soya, and almond, it seems like Alpro is going all out to become the milk substitute of choice! Alpro has now brought out a 'hazelnut drink' (spotted in the chiller cabinet at Tescos the other day and also on the shelf at Waitrose). 

Although I think choice is a good thing, I'm not sure that bringing out more nut based milk substitutes is a good idea. It makes me wonder what Alpro's rationale is - especially as nut allergies are so common these days. 

I haven't tried it yet, I wonder if anyone else has given it a go...

Personally, what I'd like them to do, is to expand their dessert and yoghurt ranges  - making them with something else other than soya (as many people who are intolerant of dairy also cannot tolerate soya). Now there's an idea!

An Addendum to Winter Warmers

The new kid  on the block!

Stop Press! Excitement of excitements - another update! You may have read my post, the other week, on dairy free hot chocolate. Well it seems that I no longer have to make mine the old-fashioned way, using cocoa powder - as I found out in my most recent trip to my local Tesco Extra. 

Not to be outdone by Oatley, Alpro and the like, Kara, (who make coconut milk) have now brought out a chocolate version! And yes! I have not wasted any time - I have already purchased some and tried it! 

To my mind, it tastes very similar to the kind of hot chocolate instants you can buy (if you are able to tolerate dairy) like the one produced by Galaxy. It's very sweet, kind of syrupy in flavour. However, having become recently reacquainted with my old-fashioned version (made with Green and Blacks) I'm not sure how ready I am to like this new version. Still you never know, I've got most of the carton left and it may yet grow on me! 

Hmm! Now, I wonder how it might taste cooked with some pudding rice for a few hours? It could be good, or... well I've never claimed to be a Nigella now, have I?

Update: Kara, has since been renamed 'Koko'

So how do you like yours? - Pancakes!!

So it's Shrove Tuesday soon and this year I'm getting excited. For one thing, we've got a new frying pan, but for another, it is of course the tradition of making and eating pancakes. Traditionally Shrove Tuesday was designated for using up the goodies in the cupboard, so they didn't go off during the fast season of Lent. I'm afraid I'm not giving up anything - my excuse being that I've not much else left to give up. 

New Pan!

I am taking up something this year, though. Well kind of taking it up again really. Having got dairy free omelettes cracked (using water instead of milk) I'm going to make pancakes. Two years ago, having just received news of Baby's problem with milk, we were barely getting to grips with anything and so Pancake Day passed us by. 


Last year Baby was still too young to appreciate the fun and I was trying to get to grips with something else - being unable to tolerate wheat. This year, I'm going for it - but dairy and wheat free, with the help of my new cooking friend (Doves  Gluten  Free Flour) and my choice of milk substitute.  I'm still debating which one though - Baby is alright with soya but I'm still not sure whether she's OK with coconut. I could perhaps use almond, as it's just a little in cooking... Hmm! Some further thought required!

The Batter

My recipe works!

Meanwhile, I've been studying a few recipes but, let's face it, I'm no domestic goddess so I'm not going to be giving Nigella a run for her money. No, but (as far as I can tell anyway) most pancake recipes are pretty much the same: plain flour, one egg, milk (in my case possibly coconut milk) and some melted butter. Aghh - melted butter!! Thankfully, my recipe of choice (a good old favourite from my old book by Marguerite Patten) has come to my rescue - it is full of extra useful hints and tips and says that you can use olive oil instead (phew, panic over). 

The Topping

Now that's the basic Pancake Batter sorted, what about the topping? Well TV chef James Martin was faffing around with Grand Marnier and orange on Saturday Kitchen (slightly disappointed he didn't toss his pancakes - calls himself a chef) but me, I like things simple. Saying that, I do remember having a Pancake Party one year, where we experimented with toppings like Nutella and Marshmallow Fluff among others (please note, all available out of a jar, no skill whatsoever required). However, it's all about satisfying your personal taste really. 

Update: By the way, if you're okay with hazelnuts and 'may contain milk,' you might like to give Anthony Worrall Thompson's gluten free chocolate spread a go (Free From aisle at Sainsbury's). I've tried it, it's really very nice!!

For me, though, no Pancake Day Pancake is complete without the routine I remember from childhood: caster sugar sprinkled over the waiting plate, onto which the pancake is delivered straight from the pan. The pancake is topped with further sprinklings of caster sugar; a generous dollop of Golden Syrup and a healthy dash of freshly squeezed lemon juice. Maybe this will become Baby's method of choice (when she's older) too or maybe, if she overcomes her intolerance, it'll be the Hub's choice of topping... caster sugar, on its own!!

So back to my original question: how do you like yours? If you're after something more adventurous, I came across this dairy free recipe, yesterday. Although I'll be sticking to my tried and tested favourite this year, this recipe does look scrummy, so maybe next year...

Another update: Meanwhile those of you who can't have egg, may be interested in this recipe, by 'Pig in the Kitchen.'

Winter Warmers

Brr! It's been so chilly this week! I don't know if you've woken up to snow at all, but we certainly have. I love snow - watching it fall; walking in it; playing in it. When I come back in from the snowy cold, I don't know about you, but I really need a hot drink to warm me back up again. As I watched my husband put on the kettle and reach for his instant hot chocolate sachet, the other day, I felt rather envious - thinking how much I would like to do the same (last year, before my other intolerances became apparent, I used to heat up some chocolate Oatly instead). 

It brought back to mind those times as a child, when we'd been out to play in the snow. When we came back in again, our fingers all numb and tingly, my mum would make us hot chocolate (the old-fashioned way) by warming up a pan of hot milk and stirring in some cocoa powder. Then it hit me - surely I had a tin of cocoa* somewhere in the back of my cupboard? And I knew I had a carton of coconut milk on hand, just in case of an 'emergency'. 

Well probably most of you will have got there before me and already made your hot chocolate this way, but I've got so used to living without milk that I don't think of using even the available substitutes that often. I gave up eating cereal, when I became intolerant to wheat and corn and gave up trying anything in my tea or coffee fairly early on as I didn't like rice milk (was advised against it anyway, as I was breastfeeding) and couldn't have soya. At that time I hadn't discovered coconut milk or any of the others, so just got used to living without it. Not being the most adventurous cook in the world, mostly my milk substitutes just sit in the cupboard... waiting. Now at last I had found something to try with my milk substitutes... Hot Chocolate!!

Of course when you're dairy free it's not instant, but that doesn't mean you have to miss out altogether!! If you've not tried it before, it's fairly simple...

Step 1 Grab yourself a pan from the cupboard, and put it on the stove. Measure out a cup of your preferred milk substitute (mine'll be coconut) and pour it in the pan. Get a gentle heat going under your pan, whilst you...


Step 2 Dig that good old-fashioned drinking cocoa out of the back of the cupboard and measure the required amount of teaspoonfuls into your favourite mug (mine already has sugar added in, but you might need to add sugar to yours).


Step 3 Some cocoa powders advise you to mix your cocoa powder with some cold milk first. Once the rest of the milk is heated up, pour it carefully into your mug and stir like fury! Baby, being just about old enough now, I make some for her too.


Step 4 Now where did I put those mini marshmallows?  Can't find them anywhere! Bother! Oh well! Best put those on my shopping list for next time!


Step 5 Sit back and enjoy!


Now I've started, with the milk substitutes, there's a few more winter warmers I'll be giving a go. Porridge is definitely on my list and (having been to someone's for dinner the other week) the next thing I'm feeling inspired to try is rice pudding. Both of these will be just right for keeping me warm - what with all this cold weather we've been having! Then, of course, there's always custard (you can get cartons of ready-made custard if you can tolerate soya)) and Pancake Day is coming up soon...


* Always check the ingredients of course! It should be cocoa, but some 'may contain traces of...'

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