It wasn’t easy going dairy-free when my first son was diagnosed with CMPA. The options back then were far more limited than they are now and I was surprised at the number of times I was accidentally given dairy whilst trying to remain dairy-free.
In one restaurant, I remember tasting a distinctively buttery taste in the rice. The waiter assured me that it didn’t contain dairy as he had checked prior to the meal being ordered, but agreed to go back and check again with the chef.
He returned, apologising, saying that unfortunately there had been some confusion and the chef had thought that “butter oil” was ok.
For me, it may mean an unhappy baby with reflux, rash, and change in stools. For others, the same mistake could be fatal.
After going dairy-free for the third time, I actually developed a preference for non-dairy milks myself.
I previously used Oatly Barista for my lattes, but Oatly Semi has become my milk of choice now for my hot drinks. It heats up just as beautifully but has less calories than Oatly Barista. I have tried various other “barista” blends but this is still by far my favourite.
My favourite non-dairy milks for cereals, porridge, and smoothies are Plenish Almond Milk, Plenish Cashew Milk, and Koko Coconut Milk.
Oatly makes a great single-cream alternative and creme-fraiche alternative. I use coconut cream from time to time, but you don’t always want to create meals with a coconut taste to it.
When introducing solids to a baby with CMPA, you need to ensure that the food is dairy-free. Other than that, the schedule (e.g. starting with a particular food such as vegetables, or method you choose to introduce solids) would be the same as it would be for a baby that did not have CMPA.
Some babies may require a more individualised plan under the guidance of a medical professional which may affect how you introduce solids. For example, it may be advised that a baby is started on solids at 4-6 months rather than 6 months. A medical professional may advise introducing allergens before 6 months after skin-prick testing (see post “Introducing Solids”). A baby with slow weight gain may be advised to follow a plan that includes higher calorie foods.
5 tips for feeding a baby with CMPA
1. Some hypoallergenic formula milks taste better than others
Hypoallergenic milk formulas (e.g. Extensively Hydrolysed Formulas (EHF) and Amino Acid Formulas (AAF) have a different taste to regular infant formula milks. Some babies may reject the taste of a hypoallergenic formula, particularly if they have become used to the taste of breast milk or regular infant formula. Even the smell may be different.
I found it helped to combine expressed breast milk with the formula and offer it to my baby as a combination at first. Over time, I reduced the amount of breast milk until he was able to tolerate drinking the formula better on it’s own. Later on, we found another Amino Acid Formula that was more readily accepted without any issues. It’s worth trying a different brand of hypoallergenic formula if a baby is still really struggling with the taste of a particular one.
2. Utilise pharmacy prescription services at the airport when travelling
When travelling abroad and leaving from a London airport, I requested that the prescription for my baby’s hypoallergenic formula was electronically sent to the Boots pharmacy at the airport located in departures after security. I called to confirm that the formula had arrived to ensure that there weren’t any issues. This meant that I could take his formula as hand luggage and not worry about what to do if my hold luggage got lost in transit or the hassle of taking formula through security. You then just need to collect the formula and board your flight once your gate is ready.
3. Carry a couple of dairy-free snacks when out and about
There have been more dairy-free options available in recent times, but there were a number of times where I had been out somewhere and unable to eat anything on offer. It’s useful to having something in your bag as a back-up for those situations.
4. Vegan trademarked food doesn’t guarantee that it is dairy-free
Vegan trademarked products may also have a warning that it “may contain milk”. This is to ensure that people with a milk allergy are aware that the product may have come from an environment or production-line that is not completely milk-free, highlighting the potential for accidental cross-contamination.
5. Some babies with CMPA also have slow weight gain, work with your dietitian to aim for a calorie-rich feeding plan
My third baby had CMPA and slow weight gain. I ensured that her diet included servings of high-calorie foods, e.g. bananas, avocados, rice, and pasta. The second way I increased the calorie content of her food was to add a high-calorie ingredient if I was serving a typically less calorie-rich food. This was especially important in the early stages when starting solids, when her portion sizes were small.
- Adding a small drizzle of olive oil / rapeseed oil to pasta, rice, and vegetables
- Adding a little coconut oil / a teaspoon of ground almonds / or nut butter to porridge (making sure that it was well-mixed with no sticky lumps that may become a choking hazard)
- Baked apple with butter on top, then mashing (without the skin)
- Adding Oatly single cream alternative / Oatly crème fraiche alternative / coconut cream
Whenever I prepared food for her, I thought about ways in which I could make it a higher-calorie food. She gained weight steadily and I was able to stop the high-calorie additions. As she enjoyed food, ate well, and outgrew her CMPA/reflux, she continued to grow as expected. She still enjoys the addition of nut butters in her porridge.
What have been your experiences of feeding a baby with CMPA?
Amal is a paediatrician and mum/step-mum to four wonderful children. She started MedicMum101 to share tips and experiences on all things motherhood. She enjoys writing about parenting, health, and wellness, as well as other life musings from time to time. When she is not working, writing, or running after the kids, you can often find her working on a new piece of art.