Cow's milk allergy: Which dairy-free milks are suitable for children?

Cow's milk is a natural source of protein and calcium, which are important for children's development. It also contains vitamin A, which helps the body fight infections and is needed for healthy skin and eyes. However, children with a cow's milk allergy - otherwise known as a cow's milk protein allergy - can't tolerate dairy products such as milk, yoghurts or cheese.

From birth to around six months of age, babies should only have breastmilk or formula. Once you introduce solid foods, they can eat foods that use milk or non-dairy milk as an ingredient. For example, in porridge.

Luckily, there are a number of dairy-free or plant-based alternatives to choose from. It’s important to choose a milk that is unflavoured and unsweetened. You should also check to see if the milk contains added salt, as babies' kidneys are not fully developed to process it.

You should look for milks that are fortified with vitamins, minerals and calcium. Check the packaging for the nutritional value of dairy-free milks, as different brands may contain different added nutrients.

Some supermarkets sell dairy-free milks with added nutrients aimed at children aged over one, which are often called 'growing up' milks.

Breastmilk or formula

If your baby has been diagnosed as having a cow's milk allergy and is being breastfed, you may be advised to exclude cow's milk from your own diet. However, this should only be done after discussion with a dietitian or doctor, as it is important that mums who breastfeed have a balanced diet.

Babies who can't have dairy may also be prescribed a specialist formula by their doctor. This can be used instead of breast milk and can also be used in recipes during weaning.

What dairy-free milks are available?

Oat milk

Once a baby is being weaned onto solids, you can use dairy-free milks in place of cow's milk in recipes. Oat milk is a good choice because it is naturally free of lactose, nuts and soy. If made from certified gluten-free oats, it can be suitable for those with gluten-related disorders.

Often, oat milks are enriched with vitamins D and B12 and calcium. Oat milk generally has more calories, carbohydrates, and fibre than almond, soy and cow's milk. It provides less protein than soy milk. Additionally, it has a relatively neutral taste compared to other milks, which can make it easier to include in recipes for children.

Dr Krishna Vakharia, a GP and clinical director at Patient.info, says: "Some children find themselves more bloated and gassy with oat milk. However, they do tend to be ok with small amounts mixed into meals."

Soy milk

Research has shown children who are allergic to cow's milk can also be allergic to soy, so it's best to avoid - or be careful when introducing - soy milk¹. If you're unsure, speak to your doctor before giving it to your child.

"Some children - but not all - with a cow's milk allergy can react to soy" says Vakharia. "Soy can cross-react so you may get children displaying symptoms that they have with cow’s milk."

Coconut milk

"Unless children have a true allergy to coconut, most do very well with coconut milk, with little-to-no side effects," says Vakharia.

There are also lots of coconut-based yoghurts in supermarkets which can be good alternatives to dairy. Some shops also offer coconut or oat-based creams, which can be used in recipes like soups, pasta sauces or curries.

Nut milks

There is a wide variety of different nut milks, including almond, macadamia, hazelnut and cashew. Many of these milks contain added vitamins, minerals and calcium. However, some of these contain more fat - such as macadamia - and less protein, such as almond.

Hemp milk

Hemp milk is made from hemp seeds that are soaked and ground in water. It can be a good alternative to cow's milk as it’s free from dairy, nuts and gluten - and contains omega 3 and 6.

Pea milk

Pea milk is made from yellow split-peas rather than green garden peas. It's a plant-based alternative to dairy and contains several nutrients such as vitamins D and A and potassium.

Other animal milks

Other animal milks - such as goat or sheep - are not suitable because children who are unable to tolerate cow's milk are at high risk of allergic reactions to other animal milks. If you are concerned about your child’s allergies and whether to introduce certain foods, speak to your doctor or dietitian before doing so.

When introducing new foods to your child, monitor them for any symptoms that could indicate an allergic reaction, such as skin swellings, rashes, breathing problems and digestive issues such as blood in the poo.

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Further reading

1. Kattan et al: Milk and Soy Allergy.

2. Menon et al: Do arsenic levels in rice pose a health risk to the UK population?