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Introducing solid food is an exciting and important milestone for parents, however if your baby has a food allergy it can be extremely nerve-wracking.
Whether you know your baby has an allergy before you start weaning, or discover it during, it’s normal to feel stressed and anxious about the process. However, the right support and knowledge can help you feel prepared and confident and enjoy the fun (and messy!) weaning journey.
What is Cow’s Milk Protein Allergy (CMPA)?
CMPA is the most common food allergy to affect babies and young children in the UK, affecting 2-7% of children under the age of one. It is an allergic response which is triggered by your baby’s immune system (wrongly) thinking that proteins in cow’s milk are dangerous.
Symptoms can either be immediate (IgE mediated) and include hives, swelling, vomiting, wheezing, and a hoarse cry, or delayed (non-IgE mediated) and include a rash, itching, significant eczema, reflux, mucus and/or blood in stools, diarrhoea, constipation, weight loss/not putting on weight and colic.
It could be, like my two children, that symptoms show when the baby is breastfeeding (small traces of milk protein the mother is consuming reach her breast milk). Or, more commonly, a reaction presents when a baby directly ingests milk protein for the first time for example infant formula or a dairy product like yoghurt when weaning.
Always seek professional support
It’s really important if you suspect your child has CMPA to discuss it with a GP or healthcare professional. Your GP can hopefully refer you to an allergy clinic, and/or a dietitian who can help you with practical tips on nutrition, alternative milks and introducing other allergens.
In the UK, current guidance is to start weaning around six months of age, but not before 17 weeks. However, if your baby is considered ‘higher risk’ for food allergies you may be advised by a healthcare professional to start weaning earlier, from four months old.
Higher risk in this instance would be if they have an existing allergy (so if you already know they have CMPA) and/or have severe eczema. The reason for early weaning is that research indicates high-risk babies may benefit from early introduction to eggs and peanuts specifically to help prevent these allergies developing. However, the decision to wean early should always be guided by a dietitian or allergist and it’s important that your baby is showing the developmental readiness signs, being able to:
How to approach weaning
If weaning early, generally you’ll be advised to start with a purée approach, but if you’re starting at six months old you can decide whether to start with purées or finger food (baby-led weaning).
Personally, I spent a lot of time worrying about which approach was best before my eldest started weaning, but found that my two kids were totally different and soon showed me which route they preferred, which happened to be opposite to each other! You also don’t need to choose one or the other, a mix can work just as well.
To make purées, steam, boil or roast the ingredients until soft then add to a blender with enough milk (whatever they usually drink) or water and blend. Start with a smooth texture and aim to progress to lumpier textures over the coming weeks.
Make sure any finger foods are soft enough to be squished between finger and thumb and are cut long and wide, in the general size and shape of your finger.
Here’s 5 top tips on approaching weaning when dealing with food allergies;
Documenting which foods you have introduced each day can be really helpful to both track progress and also look back on if you suspect an allergic reaction. Unless you’ve been advised by a healthcare professional, there’s no need to wait three days between introducing each new food, unless it’s a common allergen. My children were offered a new food each day, and once introduced I’d mix foods together, for example sweet potato and broccoli.
Attending or watching a first aid course can help you feel prepared for how to deal with emergencies such as choking, and how to perform CPR. British Red Cross also have specific first aid resources on what to do if a baby or child has a severe allergic reaction (anaphylaxis).
It’s important to be extra cautious when preparing food to ensure that you limit the risk of cross-contamination of the allergens you’re avoiding. Make sure work surfaces are sanitised and that anyone who prepares food washes their hands thoroughly before and after. You can also consider getting separate, different coloured crockery and cutlery that only your baby uses.
The top 9 allergens (wheat, cow’s milk, crustaceans, eggs, fish, peanuts, sesame, soya, tree nuts) should be introduced carefully, and only when your baby is well, and any eczema is under control. If your baby is already dairy free, you won’t introduce cow’s milk, but will no doubt be feeling nervous about introducing the rest. I put together the SSS acronym as an easy way to remember how to approach introduction;
Single – Introduce one single allergen at a time and wait three days before introducing another one to give you time to spot any delayed reactions.
Small – Offer a very small amount the first time you introduce it (¼ tsp of the allergen) and introduce directly.
Slow – If there’s no reaction, slowly build up the amount offered and then keep it in their diet regularly to maintain tolerance.
Please be reassured that 998-999 babies out of 1,000 won’t have a severe reaction to a food that’s introduced but remain vigilant when it comes to looking for reactions. It’s especially important to be aware of the ABC signs of anaphylaxis and always immediately follow any emergency allergy plans in place and call 999 if you suspect this. For any other reactions, call 111 or speak to your GP for professional advice.
It’s completely possible for your child to get everything they need when following a cow’s milk-free diet, but it’s wise to learn about important nutrients when dairy free, so you can include them in their diet. Ones to pay particular attention to are calcium, iodine and iron. Choose fortified milk alternatives including cheese and yoghurt and get to know good natural sources of these to include regularly in their diet.
Recipe
Banana, Blueberry & Chia Seed Oat Bars
These delicious, healthy oat bars are suitable from 6 months due to their soft texture. Chia seeds are a great source of calcium and other important nutrients making them a fantastic addition to dairy free meals.
Makes 16 (Store in fridge for 2 days or freeze for up to 3 months)
Ingredients
Method
Kate Lancaster is the founder of the popular Instagram page @thedairyfreemum. Kate’s two young children have both had Cow’s Milk Protein Allergy (CMPA) and she is passionate about raising food allergy awareness; using her experiences to help fellow allergy parents with information, recipes and advice to support their own dairy free journeys. Her book ‘Feed Your Family Dairy Free’ was published in 2024 by Yellow Kite Books.
