What To Feed Your Baby Who Has CMA
Even small amounts of milk can cause a reaction in a baby who is allergic to milk. Parents need to make sure that their baby avoids all milk and foods that contain milk.
For breastfed babies
If mom consumes cow’s milk, her breast milk may contain enough of the protein to trigger a reaction.1 If that’s the case for you and your baby, your healthcare professional will likely advise you to eliminate cow’s milk from your diet.
For formula-fed babies
Your doctor will likely suggest a hypoallergenic formula, such as Similac® Alimentum®, in which the protein has been extensively hydrolyzed, or broken down. After baby's first birthday, your doctor may recommend milk-free alternative beverages.
Discuss with your healthcare professional if an extensively hydrolyzed formula may be right for your baby.
See the breakdown of protein in different Similac® formulas:
Milk allergies aren't just about what's in your baby's bottle. If your child has started eating solid food, you'll also need to make sure that she avoids all milk-containing foods, such as yogurt and cheese. Because milk can be in many foods, your baby's doctor may also refer you to a registered dietitian to help you learn to look for problem ingredients.
What To Avoid Feeding Your Baby Who Has CMA
If your child has CMA, it’s important to avoid milk in all forms. This includes2:
- All milk and dairy products
- Lactose-free versions of milk products
- Anything containing traces of milk ingredients
You may not be able to tell if a food contains milk from its name alone. For instance, galactose, ghee, and casein all contain milk. According to the US Food and Drug Administration food allergen label law, a food label is required to state if it contains a “top 8” allergen, such as milk. Not all foods and products are covered by the law, so it’s important to read labels.
Read the entire ingredient label to look for the names of milk2:
- Are milk ingredients within the list of the ingredients?
- Is milk listed in a “Contains: Milk” statement beneath the list of ingredients?
Avoid foods that contain milk or any of these more common ingredients:
- Butter, butter fat, butter oil, butter acid, butter ester(s)
- Casein/caseinates (in all forms)
- Cottage cheese
- Lactalbumin, lactalbumin phosphate
- Milk (in all forms)
- Milk protein hydrolysate
- Rennet casein
- Sour cream, sour cream solids
- Sour milk solids
- Whey (in all forms)
Reintroducing Milk: What To Consider
Most children eventually outgrow a milk allergy. Many infants transition to cow's milk after 12 months of age, but it’s not uncommon for children with milk allergies to need some formula up to 18 months.1
It’s important to work closely with your doctor to determine when this transition should begin and to identify an appropriate milk alternative beverage. Your healthcare professional may recommend that you continue a hypoallergenic formula, as a supplemental beverage, in your child's eating routine past the 1-year mark.1
Similac Alimentum is hypoallergenic and designed to give babies the complete nutrition they need for growth and development.
Do not introduce cow’s milk unless directed by your child’s doctor.
Find a formula that is the best fit for your baby.
Tummy Trouble Tool
Question 1:How old is your baby? My baby is:
Question 2:What do you feed your baby? In addition to solids (if applicable), I feed my baby:
Question 3:How often does your baby cry? My baby cries:Why babies cry Check the basics
Question 4:Does your baby have difficulty releasing gas? My baby:What causes gas? Signs of gas
Question 5:What are your baby's stools like? My baby’s stools are:What's normal? Signs/causes of constipation Signs/causes of diarrhea
Question 6:What color are your baby's stools? My baby's stools are:What's normal? What if the color changes?
Question 7:How often does your baby spit up? My baby:What's spit-up? What are reflux and GERD? What's vomit?
Question 8:Is there a family history of eczema, asthma, or any other allergy?What are the signs of a food allergy?
Crying is your baby’s only way of telling you something’s bothering her. It might mean there’s an issue, but it could be her way of asking to be held.
Your baby might cry to let you know she's hungry, has a wet diaper, or is hot or cold. Check to make sure all of her needs are taken care of, and make sure she's not wrapped or swaddled too tightly.
There are two likely causes of gas: 1) It's a natural part of digestion, occurring when food is broken down. 2) It occurs when your baby swallows air during feeding or crying. If this air isn't burped back up, it can get trapped in his digestive tract.
He might have gas if he:
Shows excessive fussiness during and after feedings
Pulls his legs toward his chest
Normal stool consistency ranges from runny applesauce to Play-Doh.
Grunting and straining during a bowel movement is normal. Changing the position of your baby during a bowel movement might help.
In some cases, holding her in a semireclining position might help. If she is lying flat, give her something to brace her feet against (your hands or a wall). Pushing against a surface might ease her efforts to have a bowel movement.
In breast-fed babies, the frequency of bowel movements can change dramatically over time. In the early weeks it is not unusual to see a bowel movement with every feeding. By about the sixth week, bowel movements just once or twice a week are considered normal, but most babies have stools every day.
If your baby is constipated, her stool will be hard and dry, and painful to pass. Grunting or straining doesn’t mean she’s constipated; she is simply learning to use her muscles correctly.
Hard stools occur when the colon absorbs most of the water in the stools.
When your baby's stool suddenly becomes more frequent and watery than what is normal for her, she might have diarrhea.
Diarrhea can signal an infection or your baby's inability to absorb nutrients in her food.
Normal stools for babies are yellow, green, or brown.
Changes in stool color are not necessarily a sign of problems. As long as the stool is yellow, green, or brown, it's normal.
During or after every feeding, most babies spit up a small amount of food. It is caused by immature muscles in the digestive tract that allow small amounts of food to escape painlessly back out of the mouth. A single episode can look like a lot, even when it's a little. Learn more about spit-up here.
When stomach contents reflux (back up) into the esophagus and sometimes into the mouth, it is called "GE reflux" (gastroesophageal reflux). In most cases it goes away as the baby matures.
GERD (gastroesophageal reflux disease) occurs when the upper digestive system is irritated by stomach acid reflux and symptoms develop. These can include irritability, vomiting, poor weight gain, and respiratory problems.
If spit-up becomes more forceful, with more volume, it is considered vomiting. It usually causes babies some discomfort.
The typical signs of a true food allergy are:
• Skin rash (eczema)
• Blood and/or mucus in the stool
• Excessive spit-up or vomiting
• Wheezing or runny nose
I’m afraid to give Alimentum to my baby because it says it has milk in it and my baby can’t tolerate milk.
Alimentum should only be used as directed by your physician or health care provider. Although the protein in Alimentum is derived from cow milk, the protein has been extensively broken down or hydrolyzed to make it hypoallergenic and safe for feeding virtually all infants with cow milk protein allergy.
On the Alimentum label, what does “derived from milk” mean?
“Derived from milk” on the Alimentum label means that the original source for the particular ingredient was milk. In this case, the casein ingredient has been significantly modified resulting in a hypoallergenic and safe formula for feeding to virtually all infants with cow milk protein allergy.
Why did my pediatrician suggest Alimentum if my baby has a milk allergy?
Alimentum is a hypoallergenic formula indicated for infants with cow’s milk protein allergy. Although the protein in Alimentum is derived from milk, the protein has been extensively broken down or hydrolyzed to make it hypoallergenic and safe for feeding to virtually all infants with cow milk protein allergy.
Why is milk not listed as an allergen in Alimentum after the ingredients on the label?
According to the Food Allergen Labelling and Consumer Protection Act of 2004, manufacturers are required to label products containing major potential food allergens, including milk. There are two acceptable labelling options. For most of our products, we have a capitalized, bolded statement about potential allergens following the ingredient list. For example, it might say, "CONTAINS MILK INGREDIENTS." The second way to identify the allergen is in parentheses immediately after the name of the ingredient.
Because Alimentum is often recommended for infants who are allergic to milk, we were concerned that our usual allergen statement might alarm or confuse the infant's caregivers. Therefore, our INGREDIENTS listing includes: "casein hydrolysate (derived from milk)". Additionally, in a blue box on the back of the label is the following statement: "It's hypoallergenic and contains a milk protein that is broken down into tiny pieces to virtually eliminate allergic reactions in most babies who are allergic to cow's milk protein." So, our intention is that the milk derivation of our ingredient is included in a way that will explain, rather than alarm, a caregiver about the use of this product.
- Milk allergies in children: a parent’s nutrition plan. Abbott website. http://www.nutritionnews.abbott/healthy-moms-babies/milk-allergies-in-children--a-parent-s-nutrition-plan.html.html. Accessed April 30, 2018.
- Milk allergy. Kids With Food Allergies website. http://www.kidswithfoodallergies.org/page/milk-allergy.aspx. Accessed April 30, 2018.