Which milks and formulas are suitable for children with cow’s milk allergy?

Now that your baby has been given a proper diagnosis of cow’s milk allergy you may be feeling relieved but a bit overwhelmed. It is important to understand why your doctor has recommended a specific formula for managing your little one’s cow’s milk allergy and why particular milks or formulas may or may not be suitable for them. Read on to get clued up on what options there are, but always follow your child’s doctor’s advice and speak to them if you are worried about anything.

Breast milk

As well as providing your baby with all the nutrients they need, breast milk can reduce the risk of your baby getting certain infections. That’s one of the reasons why the World Health Organisation recommends exclusive breastfeeding for the first 6 months of a baby’s life and continued breastfeeding up to 2 years of age or beyond alongside the introduction of nutritionally adequate and complementary solid foods.

To avoid the cow’s milk proteins that trigger allergic reactions being passed to your baby within breast milk, your doctor may ask you to eliminate all dairy products from your diet. Find out more about what diet changes are needed when breastfeeding babies with cow’s milk allergy.

Hypoallergenic formulas for cow’s milk allergy

Some hypoallergenic formulas are suitable for babies with cow’s milk allergy. In these formulas, the cow’s milk proteins are either broken down (as in extensively hydrolysed formulas; eHFs) or aren’t present at all (as in amino acid-based formulas; AAFs). eHFs are suitable for most cases of cow’s milk allergy (mild to moderate cow’s milk allergy) and AAFs are usually recommended for more severe cases. Hypoallergenic formulas must only be used under the supervision of your doctor. Your doctor will have advised you on the most suitable hypoallergenic formula for your baby.

Other milks and formulas may sound tempting, but they are not always recommended or suitable as the first choice for babies with cow’s milk allergy

Standard infant formulas and follow-on formulas

Infant formulas and follow-on formulas are usually made from cow’s milk and contain intact cow’s milk proteins. Therefore, infant and follow-on formulas are not recommended for infants with cow’s milk allergy as they may trigger an allergic reaction.

Some infant formulas and follow-on formulas are partially hydrolysed. Even though the cow’s milk protein chains in these formulas are partially broken down (or hydrolysed), they’re still big enough to cause allergic reactions in babies with cow’s milk allergy. As a result, they are not hypoallergenic and are therefore unsuitable for infants with cow’s milk allergy.

Cow, goat and sheep milks

Cow’s milk is not recommended for children with cow’s milk allergy as it contains the proteins that trigger an allergic reaction. Goat, sheep and other unmodified animal milks are also not recommended for infants with cow’s milk allergy because the protein in these milks is very similar to the protein found in cow's milk. This means they may trigger an allergic reaction in infants with cow’s milk allergy.

Soya formulas

Guidelines do not generally recommend the use of soya formulas for babies with cow’s milk allergy. However, they may be suitable in certain situations. You should always follow the advice of your doctor. Your doctor will advise you when and how to test whether your child has started to grow out of their allergy and can return to a normal diet.