Simplifying Dairy Free Diets for Breastfeeding Mothers
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What is a cow’s milk allergy?
Also known as a dairy allergy, or incorrectly referred to as a lactose intolerance, a cow’s milk protein allergy is a condition that causes injury to the gastro-intestinal system1. Often seen in infants, cow’s milk protein can reveal itself similarly to other food allergies, but is hard to identify in infants. If you think your baby may have a cows’ milk allergy, ask your healthcare provider. Infants may ingest cow’s milk proteins from either drinking formula that contains in-tact proteins, or from proteins ingested by the mother and then found in breastmilk. For breastfeeding mothers, discontinuing cow dairy and also soy may be a solution to a fussy baby2. However, removing a food group from daily intake can create gaps in nutrients that are crucial to both mom and baby.
Then what is a “lactose intolerance?”
A food intolerance is different from a food allergy. With a food intolerance individuals can eat small amounts of a food without symptoms; in contrast, small amounts of a food allergen can cause an immune response and may become life threatening3. Lactose intolerance refers to the difficulty digesting lactose sugar found in cow’s milk. Lactose is an abundant sugar found in milk from all mammals4. Both humans and cows produce milk that contains lactose. We break down lactose with an intestinal enzyme called lactase. As we age our lactase enzyme in our intestines along with our ability to digest lactose may decline due to illness or genetic factors4. This is why lactose intolerance is often seen in adults. However this is less frequently the case with infants who have a higher concentration of the lactase enzyme with the goal of milk digestion4.
Possible Milk Substitutes
As a new mom making dinner can be a challenge, but incorporating a new diet can be especially difficult. If attempting to cut out cow’s milk, it is important to remember that calcium intake is still necessary for baby’s teeth and bone development as well as mom’s bone maintenance and heart function. Luckily there are many fortified milks available that can serve as a substitute in recipes or by themselves. Almond, cashew, rice, oat, flax and coconut are just a few plant-based milks that are available in many grocery stores. Oat milk is going to be a thicker consistency and the closest option to whole milk. Each plant-based milk has its own unique texture and flavor. Plant-based substitutes are trending in forms of desserts, yogurts and even cheeses. So, if you are worried about going dairy free, there are many new products to try. If you are not a fan of milk there are several vegetables that contain calcium as well. These include white beans, edamame beans, broccoli, chickpeas, cabbage and tomatoes5. The recommended amount of calcium for breastfeeding is 1000mg per day or about 3 cups of dairy or milk substitute6.
Read your labels!
Navigating a dairy free diet is more difficult that just avoiding milk. Many products contain butter or cream, which are both made from cow’s milk. As mentioned before soy may also be an allergen for infants with a cow’s milk allergy2. Foods that contain soy are items like soy sauce, tofu, edamame beans and miso soup. Reading labels can take away the burden of having to remember which foods contain which allergens. Milk is one of the major 9 allergens and by law must be listed on packaged foods. Food ingredients must state if the food contains soy, milk, tree nuts, peanuts, shellfish, fish, wheat or eggs and more recently, sesame7.
Unsure of what to cook for dinner tonight? Give this dairy free recipe a try available from NCEFNEP EFNEP 15 Minute Soup
15 Minute Soup
Makes 4 servings; Serving size 1½ cups
- 1 ½ cups pre-soaked beans or 1 (16-ounce) can beans, drained
- 1 (14-ounce) can low-sodium chicken broth
- 1 (16-ounce) can chopped or diced tomatoes, undrained
- 1 small onion, chopped
- ½ teaspoon garlic powder
- 1 (10-ounce) package frozen, chopped spinach
- ½ Cup macaroni
- In a 2-quart pot, combine all ingredients except spinach and macaroni.
- Heat until the liquid comes to a boil.
- Stir in and break up spinach; bring to a boil again.
- Stir in macaroni and simmer until pasta is tender, about 6-8 minutes.
Nutrition information per serving
145 calories, Total Fat .5g, Saturated Fat 0g, Protein 7g, Total Carbohydrate 28g, Dietary Fiber 7g, Sodium 135mg. Excellent source of vitamins A and C. Good source of iron and calcium.
- Cow’s milk protein intolerance. Cow’s Milk Protein Intolerance – Conditions – Gastroenterology, Hepatology & Nutrition – Golisano Children’s Hospital – University of Rochester Medical Center. Accessed February 16, 2023.
- Kattan JD, Cocco RR, Järvinen KM. Milk and soy allergy. Pediatric clinics of North America. Published April 1, 2011. Accessed February 16, 2023.
- Pongdee T. Food allergy versus food intolerance. American Academy of Allergy Asthma and Immunology. February 2011.
- Anderson J. Lactose intolerance and the breastfed baby. Lactose intolerance and the breastfed baby | Australian Breastfeeding Association. Published May 2022. Accessed February 16, 2023.
- Mangels, R. Calcium in the vegan diet. Simply Vegan. 5th Published August 2018.
- National Library of Medicine. Dietary reference intake for calcium and vitamin D. Published July 8th, 2010.
- Major allergens: The big nine. School Nutrition Association. Accessed February 16, 2023.