Why would I need to follow a milk-free diet while I’m breastfeeding?
Some babies (breastfed or formula-fed) develop a cow’s milk protein sensitivity or allergy. This means that your baby’s body thinks the proteins in cow’s milk (called casein and whey) are allergens. When he drinks or eats anything containing cow’s milk protein, he develops signs of an allergic reaction.
What are the signs of a cow’s milk protein allergy?
Allergy testing is unreliable in babies. If your doctor suspects your baby has a cow’s milk protein allergy, they will look at your baby’s symptoms instead. Common symptoms of a cow’s milk protein allergy are:
- Vomiting
- Rashes
- Blood in your baby’s poop
- Runny nose and wheezing that are unrelated to a cold
- Excessive fussiness
- Colic
Why does my breast milk contain cow’s milk protein?
After your body digests and absorbs food you eat, the nutrients – including proteins from cow’s milk – pass from your blood into your breast milk. Food you eat containing casein or whey could lead to an allergic reaction in your baby. If you follow a milk-free diet, your breastfeeding baby won’t be exposed to any cow’s milk protein. This may improve his allergic signs and symptoms. It can take up to three weeks on a milk-free diet for cow’s milk protein to completely leave your breast milk and your baby’s body. You should follow a milk-free diet for three weeks before you evaluate whether or not your baby’s symptoms are improving.
How do I remove cow’s milk protein from my diet?
You need to avoid ALL foods which contain cow’s milk, casein, and whey (including yogurt, cheese, butter, baked goods containing milk, etc.). Since casein and whey are often added to processed foods like crackers and chips, it’s important to read ingredient labels to see whether ALL of the foods you eat contain casein or whey. Food containing cow’s milk protein must be labeled in one of two ways:
- By having the word “milk” in the ingredient list, such as “Ingredients: Wheat, canola oil, whey (milk)”, OR
- By having an allergy statement at the end of the ingredient list, for example “Contains milk”
Sneaky Food Sources of Milk Protein (ingredient lists can change any time, so it’s important to read labels EVERY time you shop!)
- Pirate’s Booty
- Smartfood
- Some salad dressings
- Some granola bars
- Some margarines
- Lactose-free foods are not necessarily milk-free!
What about goat’s milk and soy?
The protein in goat’s milk is very similar to cow’s milk protein. We recommend you avoid goat’s milk when you’re following a cow’s milk-free diet. Occasionally, babies who are allergic to cow’s milk protein are also allergic to soy. We recommend you start with a milk-free diet and if that doesn’t clear up your baby’s symptoms after three weeks, start a soy-free diet as well.
Will my breast milk have enough protein?
If you eliminate all cow’s milk protein from your diet, your breast milk will still contain enough protein for your baby. The proteins from other foods you eat will go into your breast milk.
How do I make sure my diet is well-balanced?
Eliminating a food group (in this case, dairy) means there’s a chance you won’t be getting enough calories. Make sure you’re eating substitutes to replace the foods you’re avoiding (check out the table below). Because you won’t be eating any dairy products on a milk-free diet, it’s possible you may not be getting enough calcium and vitamin D. Your body will draw calcium out of your bones to make healthy breast milk, and this can weaken your bones. We recommend either making sure you get enough calcium from food (800 mg/day) or by taking a supplement that contains both calcium and vitamin D (we recommend at least 600 IU vitamin D daily). Below, we list some milk-free substitutes for some of your fave foods.
| Instead of… | Choose… |
| Milk | Non-dairy milk (soy milk, almond milk, cashew milk, etc.). Read the label to make sure it’s fortified with calcium and vitamin D. |
| Yogurt | Non-dairy yogurt alternatives like soy yogurt, cultured almond milk, or cultured coconut milk. |
| Cheese | Look for vegan “cheese” like daiya brand. Some melt better than others. Many people actually enjoy pizza without cheese (with lots of other toppings!) Nutritional yeast adds a cheesy taste to foods like soup. |
| Butter | Margarine is made from vegetable oils but may not be completely dairy-free. Some brands contain casein or whey, so you should read labels carefully. Vegan “butter” is dairy-free. Many people like the flavor of coconut oil in baking and cooking. |
| Ice Cream | Brands like So Delicious and Tofutti make great dairy-free ice creams. You can also make your own using almond milk and coconut milk or making vegan “nice” cream using bananas as the base. |
In summary, make sure you read labels every time you shop to ensure the foods you eat are milk-free. Take a supplement with calcium and vitamin D and eat calcium-rich foods every day to maintain your healthy bones! The benefits of breastfeeding are worth this short-lived diet; many babies outgrow their milk allergy by 12-18 months of age. Do you have more questions about adopting a milk-free diet while breastfeeding? Leave a comment below or drop us a line through our Contact page.