You can begin to introduce solid foods into your baby’s diet at around 4 to 6 months, or when your baby is showing the signs of being ready (but never before 17 weeks).1
Introducing new food to a baby may make any parent feel understandably cautious, but weaning a baby with cow’s milk allergy (CMA) is very similar to weaning a baby without CMA. The main difference is that you have to be vigilant with avoiding cow’s milk-containing products in the foods you introduce, as you would expect.
The British Society for Allergy & Clinical Immunology (BSACI) has developed an excellent summary for parents on how to prevent allergic reactions to food.
You can begin to introduce solid foods into your baby’s diet at around 4 to 6 months, or when your baby is showing the signs of being ready (but never before 17 weeks).1
If your baby can do the following things, then they could be ready to start weaning:2
Solid foods are often introduced in stages, although the ages are approximate. Every baby is different and will develop at their own pace. The following table gives you an idea of which foods you can feed your baby at these different stages.3
First foods
(4–6 months)
Foods to offer
Consistency
Puréed or mashed consistency, soft finger foods can also be introduced at this stage
How much?
Start with small amounts (1–2 teaspoons) twice a day and gradually increase
Building on weaning
(7–9 months)
Foods to offer
Consistency
Mashed, chopped, minced consistency; more finger foods
How much?
2-3 meals plus snacks
Established weaning
(10 months and older)
Foods to offer
Consistency
Mashed, chopped family foods and a variety of finger foods
How much?
3 meals plus snacks
*Whole or chopped nuts should not be given to children under 5 years of age due to the risk of choking.
When weaning your baby, it is best to plan and to keep track of their diet using both a meal planner and a weaning diary. Doing so will help you pinpoint any potential food allergies if your baby displays any allergic reactions.
You may find the following resources helpful.
A printable 7-day calendar for parents to plan and track their baby’s food intake
Courtesy of Allergy UK
A food diary to help parents keep track of new foods and allergic symptoms displayed by their baby
Courtesy of Allergy UK
Even with the best preparation possible, your baby may still present with symptoms of CMA. See the list of common symptoms that your baby may experience
Learn moreIf you think your baby is experiencing an immediate allergic reaction to a food, please contact your healthcare professional.
Most allergic reactions are mild, but in very severe cases, a reaction called anaphylaxis or anaphylactic shock can occur (symptoms may include breathing difficulties, increased heart rate and losing consciousness). This is a medical emergency and needs urgent treatment (call 999 for an ambulance immediately).4,5
There are many alternatives to products that contain cow’s milk. Here are some common substitutions you can make:1,6,7
Cow’s milk
Hypoallergenic infant formula if breastfeeding is not possible (e.g. Alimentum or EleCare)*, oat, soya, rice†, pea, coconut, quinoa, hemp and nut‡ (e.g. almond, hazelnut, cashew).
Plant-based milks should not be offered as main milk source for infants under the age of 1.6
Always try to choose a brand of milk that is fortified with calcium where possible (organic products do not always have added calcium). If the product is not fortified with calcium, it is likely that a calcium supplement will be required.7
If you are unable to get your child to take any of the above milk substitutes, it is important to seek advice from a dietitian as it may be necessary to start a vitamin or mineral supplement.7
*Hypoallergenic formula should be continued until two years of age, however, your dietitian may recommend an alternative milk (e.g. soya [if appropriate]) after the age of one if your baby’s dietary intake is adequate. Ready-made alternative milks may be used as a main drink after two years of age.7
†The Food Standards Agency does not recommend giving commercially available rice drink to children before the age of five years old.8
‡Avoid nut-based milk alternatives if you have/are at risk of a nut allergy.
Butter
Vegetable, sunflower, olive and avocado spreads*
*Check the ingredient list on labels for traces of allergens.
Cheese
Soya (if appropriate) and coconut cheese
Dairy-free alternatives to cream, crème fraîche and yoghurt are also readily available in most supermarkets. Vegan products are good alternatives to products that contain cow’s milk, however, it is best to check the label for any allergen traces.1
Recipes for incorporating Alimentum or EleCare into solid food
Download recipes and resources
When you are weaning your baby, it is important to know how allergen information is presented on store-bought foods.
In the UK, pre-packed foods are required by law to present information regarding the top 14 allergens on the label. These allergens are:1,9
Celery
Lupin
Sesame seeds
Cereals containing gluten
Milk
Soya
Crustaceans
Molluscs
Sulphites
Eggs
Mustard
Tree nuts
Fish
Peanuts
Please note that different packaging will present allergen information in different ways.
Some food packaging will include a precautionary allergy warning. These messages, which often begin with ‘May contain…’, ‘Not suitable for…’ or ‘Made in a factory that handles…’, are used to indicate potential cross-contamination in foods that have been made in a factory that also handles allergen foods.1
The British Dietetic Association (BDA) also provide some helpful advice on checking food labels.
BDA: British Dietetic Association; BSACI: British Society for Allergy & Clinical Immunology; CMA: cow’s milk allergy.
UK-SIMILAC-2000018 November 2020
References
1. Allergy UK. Weaning your food allergic baby. Available at: https://www.allergyuk.org/assets/000/003/032/DesignConcept_A5_Info_Book_v1.5_original.pdf?1589795676 (accessed January 2021).
2. NHS. Weaning. Ready or not? Available at: https://www.nhs.uk/start4life/weaning/ready-or-not/ (accessed January 2021).
3. NHS. Your baby's first solid foods. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/solid-foods-weaning/ (accessed January 2021).
4. NHS. Anaphylaxis. 2019. Available at: https://www.nhs.uk/conditions/anaphylaxis/ (accessed January 2021).
5. NHS. Food allergy. 2019. Available at: https://www.nhs.uk/conditions/food-allergy/ (accessed January 2021).
6. BDA. Milk allergy: Food Fact Sheet. 2018. Available at: https://www.bda.uk.com/resource/milk-allergy.html (accessed January 2021).
7. BDA. Suitable milks for children with cow’s milk allergy: Food Fact Sheet. 2020. Available at: https://www.bda.uk.com/resource/children-with-cows-milk-allergy.html (accessed January 2021).
8. FSA. Arsenic in rice. Available at: https://www.food.gov.uk/safety-hygiene/arsenic-in-rice (accessed January 2021).
9. FSA. 14 Allergens. Available at: https://www.food.gov.uk/sites/default/files/media/document/top-allergy-types.pdf (accessed January 2021).