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Introduction

It is not uncommon for babies to be sensitive to cows’ milk.  Symptoms may include diarrhoea, vomiting, poor weight gain and skin rashes. You may have been advised to trial a milk free diet in view of your child’s symptoms. Your dietitian will advise you on the diet and provide on-going advice as required on how to manage and monitor your baby’s symptoms.

Lactose Intolerance

Sometimes after gastroenteritis, a baby can develop a temporary 
intolerance to lactose, the sugar found in milk. You should discuss with your doctor or dietitian how and when to re-introduce cows’ milk.

A Milk free Diet

This diet is completely free from cows’ milk and excludes both milk protein and milk sugar (lactose). It excludes:

  • Cows’ milk and cows’ milk formula
  • Foods made from cows’ milk such as cheese and yoghurt
  • Manufactured products containing cows’ milk

Following successful weaning, it is important that your baby is reviewed by their doctor or dietitian to see if the diet has helped and to discuss if it should be continued. Further information is available for toddlers and older children who need to follow a milk free diet.

Milks

When milk is excluded from the diet, a substitute is needed to provide the nutrition your baby needs for healthy growth and development. You may continue to breastfeed your baby, but you may need to follow a milk free diet yourself if you are breast feeding; ask your dietitian for more written advice to help with this.

Formula

If your baby is drinking infant formula, it will need to be changed to a cows’ milk free formula (sometimes called ‘hypoallergenic’ formula). These are available on prescription from your GP and are nutritionally complete.

Hypoallergenic formulas taste and smell different from ordinary baby milks.  Younger babies tend to accept them well, however older babies starting a milk free diet may be more reluctant.

Contact your dietitian if your baby refuses the feed. Be aware that your baby’s stools may change colour to dark green when taking a milk free feed; this is normal and not a cause for concern.

The amount of calcium varies slightly between formulas. Use the milk free formulas as a main drink and for mixing with solids e.g. cereal. Milk free formula can also be used in milk free sauces, custard and rice pudding.

‘Cartoned’ plant-based milk alternatives

Infant formula or breast milk should continue to be offered as a main drink until your baby is 12 months old. However, cartooned plant-based milk alternatives can be used for cooking and mixing in to food from 6 months unless advised by your Dietitian. There are a wide variety of these milks available to buy, both fresh and UHT, based on oat, coconut, soya, rice, nut and pea protein. Rice milk is not suitable for children under 4 and half years. Their nutritional value does vary. Unfortified or organic varieties do not contain any additional nutrients. Always look for the brand that contains additional calcium and ideally iodine.

The recommended milk for your baby is Alpro oat or soya growing up milks or Koko super.

Introducing Solids

Breast milk or infant formula can provide all the nourishment your baby needs for their first six months. You should start introducing solid food at around six months of age. However, all babies are different, so discuss this with your health visitor or dietitian. You should introduce solids by 6 months (26 weeks) at the latest. Do not introduce solids before four months (17 weeks).

Weaning a baby on a cows’ milk free diet is like weaning any other baby; nutritional requirements are the same. The only difference is that the diet does not contain any cows’ milk, cows’ milk products or products that contain these.

When is the Right Time to Introduce Solids?

Every baby is different so look for signs of readiness, these include:

  • Chewing fists
  • Showing interest in other people’s food
  • Able to hold their head 
  • Some hand to mouth coordination
  • Crying between feeds

Waking in the night when a baby has previously slept through on its own is not an indication to start solid food.

Tips and Hints for Successful Weaning

  • Start by offering one to two teaspoons of solids at one feed in the day
  • Try to choose a time when your baby is not too tired or too hungry
  • First foods should have a thick, soft, smooth consistency.  Suitable choices include:
    • milk free baby rice mixed with water or milk free formula
    • well mashed, cooked vegetables like carrots, parsnips and butternut squash
    • well mashed soft or cooked fruit such as pears, apples and peaches.  You can use fresh fruit or fruit canned in natural juice
  • Do not add sugar, honey or salt to your baby’s food
  • Gradually increase both the quantity and number of times your baby has solids in the day. Do not worry if the baby refuses new foods you offer - try the same food again on another day
  • Introduce a cup/beaker with a spout from 6 months of age for formula or water. Tap water can be used from 6 months onwards

I am Worried About Other Food Allergies-Which Food Should I Give First?

There are a number of foods that people can be allergic to such as milk, egg, soya, nuts and wheat. There is no evidence that delaying the introduction of other foods into your baby’s diet beyond 6 months will reduce the risk of developing other food allergies.

Here are some tips on introducing new foods:

  • Start with low allergenic food like fruit and veg
  • Try a cooked version of the food first
  • Ensure your child is well before introducing a new food
  • Introduce foods singly, early in the day so any symptoms are noticed
  • Try a new food for 2-3 days, then move on to other foods
  • Make sure you know how to deal with an allergic reaction if it happens—ask your GP or hospital doctor
  • If you have a plan for an allergic reaction, make sure it is to hand

Homemade Food

These can take time to prepare but are cheaper than buying readymade baby food. You can cook a batch in advance and freeze in ice cube trays or small pots. Make sure you thoroughly defrost and re-heat well before feeding to your child.  

Ready Made Food

Jars, tins, pouches and packets of baby food that are milk free are suitable for your baby. Always check the labels carefully.

Weaning Guide

Starting Off

(around 6 months)

Moving On

(around 7 months)

Family Meals

(9-12 months)
  • Mashed, cooked and soft foods with a smooth consistency
  • Some babies may require a smoother consistency if starting solid food before 6 months
  • At first offer once a day during or
  • after a feed (breast or formula)
  • Gradually increase the amount and number of times the food is offered
  • Gradually move onto mashed and lumpier foods to encourage your child to chew
  • Offer soft finger foods
  • If using readymade baby food move
  • onto the 7 month jars
  • Before a breast/formula feed, aiming for 3 meals per day
  • Work towards 3 meals and 3–4 formula feeds per day
  • Move onto chopped up finger foods
  • Try to have a
  • routine - 3 meals a day with small snacks in between, if needed

How Much?

How Much?

How Much?
  • Begin with 1-2 teaspoons. 
  • Gradually increase this as your baby is ready to eat more
  • Start with fruit and vegetables then introduce soft meat, fish or lentils
  • Use gluten free cereals (e.g. baby rice) before 6 months
  • Servings might still be small
  • Include meat, fish, eggs or lentils in at least 1 meal per day
  • Try to offer 2-3 servings of starchy foods and 2 servings of fruit and vegetables a day
  • 2 small servings of meat, fish, eggs or lentils
  • 3-4 small servings of starchy foods
  • 3-4 servings of fruit and vegetables

Suggested Meal Pattern

Starting Off

(around 6 months)

Moving On

(around 7 months)

Family Meals

(around 9-12 months)
  • Breast milk, milk free formula substitute,  water (cooled boiled water before 6 months)
  • Introduce drinks from a cup or beaker
  • Breast milk, milk free formula, tap water
  • Offer drinks from a cup or beaker
  • Breast milk, milk free formula, tap water
  • Offer drinks from a cup or beaker

Amount of Milk Free Formula
  • Aim for around 600ml (~20-floz) per day, either as a drink or in puddings or on cereals

On Waking
  • Breast milk or milk free formula
  • Breast milk or milk free formula
  • Breast milk or milk free formula

Breakfast
  • Milk free baby rice and mashed fruit
  • Breast milk or milk free formula
  • Cereals such as porridge, instant oat cereal or whole-wheat biscuit cereals and milk free formula or alternative milk  (e.g. soya, oat, coconut)
  • Cereals with milk free formula or alternative milk
  • Toast with milk free margarine
  • Pancakes made with milk free substitute

Lunch and Supper
  • Soft meat, fish or lentils with mashed vegetables
  • Mashed fruit with milk free custard or milk free ground rice pudding
  • Minced meat, flaked fish or cooked lentils with mashed vegetables and potatoes
  • Mashed fruit with milk free custard, milk free rice pudding, soya desserts or soya yoghurt
  • Chopped meat or fish with soft, cooked potatoes or pasta and vegetables; or cooked lentils with rice and chapatti
  • Pasta with milk free white sauce (made with milk free cheese) or tomato sauce
  • Milk free sandwiches, made with milk free spread and ham/houmous/jam/cold meat/egg (if allowed)
  • Fruit with milk free cream

Bedtime
  • Breast milk or milk free formula
  • Breast milk or milk free formula
  • Breast milk or milk free formula

From first introducing your baby to food, to around one year of age, gradually change the type, amount and texture of the food that you offer your baby.

Baby led weaning is an approach where you let your child feed themselves. This can be done from the start of weaning by allowing your baby to choose their own food and eat at their pace. There are many pros and cons to this approach in the short term - speak to your dietitian or health visitor for more information.

Checking Food Labels

Checking and understanding food labelling is very important when you are managing a food sensitivity. The Food Information for Consumers Regulation (EU FIC) 2014, aims to bring general and nutritional labelling together to simplify practices. Always check the ingredients list to make sure products do not contain any milk. For more information visit www.food.gov.uk/allergy

Ingredients List

If milk is present, it must be included in the ingredients list. Food labels will use bold, italics, underlined or highlighted text to emphasise any of 14 common food allergens, including milk. Always check the ingredients list to find out if/what allergens are in the products. Some manufacturers may change their recipes so always check labels.

If the food contains any of the following ingredients, you should avoid it:

  • Milk
  • Fromage frais
  • Modified milk
  • Buttermilk
  • Milk solids
  • Butter
  • Non-fat milk solids
  • Margarine
  • Skimmed milk powder
  • Ghee
  • Cream
  • Whey, whey solids
  • Artificial cream
  • Hydrolysed whey protein
  • Crème fraiche
  • Hydrolysed whey sugar
  • Condensed milk
  • Whey syrup sweetener
  • Evaporated milk
  • Casein (curds)
  • Cheese
  • Caseinate
  • Cream cheese
  • Hydrolysed casein
  • Yoghurt
  • Lactose

Foods Without Packaging and Eating Out

All allergen information for foods sold without packaging or wrapped on site must be provided. However, information on potential cross contamination is not needed.

Do not take risks - ask for more information from staff in the food setting and if you have any doubts, avoid the foods.

Always check labels to make sure food is milk free.

Allergy Advice

Allergy advice statements on the front of packages are not compulsory, therefore, always check the ingredients list of products to ensure that there is no milk in them.

Despite great care from food manufactures, small amounts of allergens may get into a product following cross contamination in production or packaging.  Always take these warnings seriously. Manufacturers may label these foods as ‘may contain milk’.

Dairy and Alternatives

Safe Choices - always check labels

Avoid foods likely

to contain milk

Milk

  • Milk alternative as recommended by your dietitian
  • Soya formulas (if recommended) from 7-8 months
  • Calcium enriched almond, hemp, cashew, hazelnut, coconut or oat milk (under one year for mixing or cooking, not as a main drink)
     

 

 

  • Cows’ milk based infant and follow on formulas, for example SMA, Cow & Gate, Farley’s and Aptamil ranges
  • Cows’ milk specialised formula, for example Cow & Gate, Comfort 1 & 2 and SMA High Energy
  • Lactose-free formulas like
  • SMA LF, Enfamil IF
  • Cows’ milk - all kinds, for example full-fat, skimmed, lactose-free, evaporated, dried, condensed, sterilised, long-life UHT
  • Goats’ and sheep’s milk
  • Milkshakes, including milk-based smoothies
  • Cream, crème fraiche and synthetic cream toppings

Yoghurts

  • ·Soya yoghurts and desserts (if allowed, from 7-8 months)

 

  • Natural, fruit, baby and Greek yoghurts and fromage frais
  • Yoghurt drinks, including yoghurt-based smoothies

Cheese (from 7-8 months)

  • Soya based cheeses, Violife (pea and coconut based hard/spreadable cheese)

 

  • Cheese, cheese spread, cheese slices, cottage cheese, vegetarian cheese, goats/cream cheese.
  • Sauces containing cheese
  • Quark

Potatoes, Bread, Rice, Pasta and Starchy Foods

Safe Choices - always check labels

Avoid foods likely

to contain milk

Cereals

  • Breakfast cereals, for example Weetabix or Rice Krispies.  Remember to serve with milk substitute

 

  • Baby cereals, baby biscuits and rusks containing milk powder

Bread

  • Wholemeal, 50:50 and white bread/rolls/pitta/bread sticks

 

  • Croissants, pancakes and most bakery items

Potatoes

  • Boiled, baked, chips and roasted

 

  • Remember to use milk

substitute and milk free
margarine if you are
mashing potatoes
  •  
  • Mashed potatoes with milk, margarine or butter
  • Potato products such as ready-made/instant mash, croquettes and potato Smiles
  • Flavoured potato crisps
  •  

Pasta

  • All plain pasta, for example pasta shapes and macaroni

 

  • Pasta with cream or cheese based sauces, for example

macaroni cheese

Rice and noodles

  • Plain boiled rice and rice cakes
  • Plain wheat, rice and egg noodles

 

Fruit and Vegetables

Safe Choices - always check labels

Avoid foods likely

to contain milk

Fruit

  • All fresh, frozen, canned and dried, for example stewed apples, mashed banana, pears canned in their own juice, fruit based baby jars

 

  • Chocolate yoghurt covered dried fruit
  • Fruit served with or coated in yoghurt, cream, caramel/chocolate sauce or custard

 

Vegetables

  • All fresh and frozen vegetables, for example home cooked, pureed and mashed vegetables and vegetable-based jars

 

  • Vegetables with butter, white sauce or cheese sauce

Protein Foods

Safe Choices - always check labels

Avoid foods likely

to contain milk

Meat

  • All plain beef, chicken, lamb, port and turkey

 

 

  • All beef, chicken, lamb, pork and turkey cooked with milk, cream, cheese or butter
  • Any battered beef, chicken, lamb, pork and turkey
  • Fish
  • All fresh and frozen plain fish
  • Canned tuna and salmon
  • Shop bought fish fingers (home or freshly made varieties may contain milk)

 

  • All fish products or products cooked with butter, milk or cream
  • Any battered fish

Protein Foods

Safe Choices - always check labels

Avoid foods likely

to contain milk

Beans, pulses, eggs* and other protein

  • All plain cooked eggs, for example boiled, poached, scrambled, omelette
  • Peas, beans, lentils and dhal
  • Tofu (if soya is allowed)


 

  • Scrambled egg made with cow’s milk

Other Foods, Desserts, Snacks

Safe Choices - always check labels

Avoid foods likely

to contain milk

Fat

  • Dairy-free margarines and spreads
  • Vegetable oils and solid fats

 

  • Butter and margarines
  • Low-fat olive oil and sunflower spreads

Desserts

  • Desserts made with milk substitutes such as custard, sago and rice pudding

 

 

  • Those containing milk or milk products, for example yoghurts, mousses, milk puddings, ice cream
  • Baby deserts based on milk or yoghurt

Biscuits

  • Milk free biscuits, oatcakes and crackers

 

  • Those containing milk or milk products, for example baby biscuits, shortbread, chocolate biscuits


*  Some children who are sensitive to cow’s milk also react to egg. Ask your dietitian for advice.

Beverages and Miscellaneous

Safe Choices - always check labels

Drinks

  • Water - give your child boiled and cooled tap until they are 6 months old, after this water does not need to be boiled
  • Baby fruit juices and flavoured waters can be given at mealtimes only
  • Pure fruit juices - only give these from 6 months using a cup and diluted 1 part juice to 10 parts water

However, babies only need water or breast/formula milk as a drink

Sugars and Sweeteners

  • Sugar, jam
  • Honey (only for children over 12 months)

Recipes

Milk free Custard (2 servings)

Milk substitutes taste quite sweet, so you will not need to add sugar. Serve with fruit such as mashed bananas, stewed apple or baby fruit puree in jars and cans.

2 rounded teaspoons of custard powder*
200ml (7 FL oz) of milk substitute to the bowl

  • Mix the custard powder with a few teaspoons of milk substitute in a bowl, making sure there are no lumps
  • Add the milk substitute to the bowl
  • Pour into a small pan and stir or whisk over a medium heat until the custard thickens and just comes to the boil
  • Pour into a small pan and stir or whisk over a medium heat until the custard thickens and just comes to the boil

Choose original, not instant powders - instant powders contain dried milk and are made up using water, so much be avoided when excluding milk

Variation - Chocolate Custard
Make as recipe above, add ½ level teaspoon cocoa powder and one level teaspoon sugar to the custard mix

Milk free Rice Pudding (2 servings)

2 rounded tablespoons (or 25g) flaked rice
200ml (10 FL oz) of milk substitute

  • Place all the ingredients in a saucepan and bring to the boil.
  • Simmer for approximately 10 minutes, stirring occasionally until thickened. If it is too thick, add a little more milk substitute

Milk free White Sauce (Useful recipe when moving to stage 2 - lumpy foods)
 
300ml (10 FL oz) milk substitute
2 rounded teaspoons cornflour

  • Method as for milk free custard above
  • Season with a little pepper
  • Serve with mashed pasta or vegetables such as carrot and potato, cauliflower and peas

Variations
Flavour with a squeeze of lemon juice and a sprinkle of chopped parsley or add extra calories by mixing in a teaspoon of vegetable oil or milk free margarine.

Ways to add extra nutrients to your baby’s food

  • Make all solids up with prescribed formula or plant-based milk if over 6months rather than water
  • Add oil to purees, vegetables or any savoury dish.
  • Add some milk free spread to solids to increase the energy content.
  • If your baby can tolerate nuts, add smooth nut butters to cereal, milk free yoghurt or into sauces. Nuts can also be ground to a powder to use in baking. 
  • Add milk free cheese, either hard or cream cheese type to mashed potato or pasta dishes to add extra protein and energy.
  • Mix blended or mashed fruit with milk free cream or custard.
  • Mashed avocado is high in energy and can be mixed with mashed banana or used as a finger food.
  • Offer milk free yoghurt as a dessert.
  • Spread toast fingers or bread with milk free spread. (if your baby can manage these textures) on both sides.
  • Offer fruit mashed up with a little milk free cream as a dessert.
  • Offer oily fish at mealtimes or tinned fish in oil.
  • If your child can tolerate coconut, this can be used in curries and Thai food and is a great energy booster. 

 

Contact us

If you have any queries relating to this information, please contact the Dietetics service.

About this information

Service:
Dietetics

Reference:
DT/090

Approval date:
22 May 2026

Review date:
1 May 2029

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