Patient Information Department of Nutrition and Dietetics

Cows milk and soya free diet

Introduction
A cows milk and soya free diet involves the complete avoidance of cows (goats, sheeps) and soya milk. This will be necessary if your child has, or is suspected to have, a cows milk intolerance or allergy. Soya protein should also be eliminated from the diet as many children are sensitive to this protein as well as cows milk. This may be due to an immune reaction, or due to a gastro-intestinal infection. The diet excludes obvious and hidden sources of cows milk (for example butter, cheese, cream and yoghurt) and soya milk and soya products, for example, soya yogurt or desserts and soya margarines. Milk and soya products are also found in manufactured foods. The following are alternative terms for cows milk or soya and food containing them should be avoided:

Milk

Casein/caseinates/milk protein Skimmed milk/evaporated milk/ condensed milk Non-fat milk solids/ milk powder/milk solids Whey/whey solids/whey syrup sweetener Butter/Margarine Cream/Cheese/Yoghurt Lactose

Soy and soy derivatives

Hydrolysed vegetable protein Soya Lecithin E322 Soya protein products, for example, miso, tofu, edamame, tamari, Worcestershire sauce, oyster sauce, vegetable broth, vegetable starch

Please note: A product labelled free from soya or soya derivatives may contain soya oil and/or soya shortening. Soya oil, as used in manufactured products, is refined and contains no protein and is considered soya free. Cold pressed soya oil, available from health food shops, may contain soya protein and should be avoided.

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Milk substitutes
Infants and children under two years of age should be given a suitable milk/soya free formula to ensure adequate supplies of vitamins and calcium. Your dietitian will advise you as to the most suitable formula for your child. In instances where a specialist formula is not indicated, or where a child is more than two years of age, other milk substitutes can be used, such as rice milk and oat milk. These milk substitutes are not nutritionally complete and require supplementation with calcium and/or vitamins.

Calcium/vitamin supplementation
Your dietitian will advise you on an appropriate product and dose for your child.

Suitable foods
Other milks Coconut milk, oat milk, rice milks, for example Rice Dream (also available are calcium-enriched and in original or vanilla flavour), Provamel rice drink.

Unsuitable foods
All cows, soya, goats and sheeps milk, fresh, dried, condensed, evaporated, skimmed milk. Coffee whiteners, such as Coffeemate, Coffee Compliment. Single and double creams including those made from vegetable fat, for example Elmlea. All cheese, cheese spreads, soya cheese, From soya, Scheese, Plamil Veeze. Butter, margarine and spreads containing milk. Soya margarines such as Tomor, Vitaquell, Vitasieg, Granose. Hydrogenated vegetable oils may contain milk or soya. Yoghurt, fromage frais, crme fraiche, ice cream, milk chocolate desserts. Dairy desserts, for example custard, mousse, instant whips, trifle, angel delight, rice pudding Soya yoghurt, yofu, soya Desserts. Soya rice pudding Soya milk desserts, for example Provamel. Egg custard.

Cheese None. Fats/oils Lard, suet, dripping, vegetable oils, pure margarine, dairy-free and soya-free margarines.

Desserts Dairy-free ice cream, for example Berrydales, Oat Supreme.

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Suitable foods
Breakfast cereals Cornflakes, Crunchy Nut Corn Flakes, Corn pops, Frosties, Rice Krispies, Weetabix, Shredded Wheat, Honey Loops, porridge oats. Cereals, flour and products All varieties of flour, corn flour, arrowroot, baking powder, custard powder, pasta, rice, sago, semolina, tapioca, spaghetti, noodles etc. Bread (white, brown and wholemeal), breadsticks, rice cakes, crackers (check labels), Ryvita, pitta bread. Home-made biscuits and puddings using milk and soya-free ingredients. Meat, fish, chicken All varieties prepared and cooked without milk and soya.

Unsuitable foods
Special K, some brands of muesli (check labels), instant porridge, yoghurt coated cereals, chocolate cereals. Instant desserts, tinned spaghetti, rice pudding, macaroni cheese, pastry (check labels), Milk loaf, croissants, brioche, buns, cakes, biscuits and puddings made with milk or milk products (check labels). Butter icing. Some breads contain soya (check labels, cakes and biscuits). Pasta dishes with sauces containing milk and/or egg, for example lasagne, some bolognese and moussaka sauces. Meat products may contain milk derivatives, for example pre-packed ham, chicken. Fish, chicken or meat in batter, crumbs or sauce. Certain brands of sausages, fish fingers, chicken nuggets and tinned meat.

Eggs All forms of egg. Vegetables All fresh, frozen or tinned without butter. Oven chips (check labels). Vegetables canned in sauce containing milk or pre-packed in butter. Instant potato, waffles, Alpha Bites, Smiley Faces, some flavoured potato crisps, fancy crisps (often contain milk powder). Potato salad, vegetable salad, coleslaw (check labels). Fruit yoghurt, fruit tarts or flans.

Fruit Fresh, frozen, dried, tinned in juice or syrup, fruit in jelly, fruit juices. Nuts Fresh and plain salted (not suitable for children under five years).

Dry roasted with lactose containing flavouring. Yoghurt coated nuts.

Suitable foods
Snacks Potato crisps such as Walkers, Hulahoops, plain or salted popcorn, olives, pretzels, puffed wheat or
Cows milk and soya free diet

Unsuitable foods
Twiglets, cheese straws, toffee popcorn, puffed wheat or corn snacks containing milk, cheese, soya etc. Avoid all cheese
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cornsnacks, prawn crackers (check labels). Home-made humous, guacamole (check all manufactured products). Pepperami. Jordans Frusli bars. Preserves and Confectionary Sugar, glucose, jam, honey, syrup treacle, marmalade. Some brands of plain chocolate and carob bars. Boiled sweets, lollies, pastilles, gums, jelly tots, peppermints, softmints, fruitella, marshmallows. Beverages Nesquick powder (except chocolate), Crusha syrup, cocoa powder, Bovril, Marmite, Vegemite. Squashes, fizzy drinks, fresh fruit juices flavoured snacks.

Lemon curd (check label). Toffee, fudge, caramels, butterscotch, Chewits, Starburst. Milk and white chocolate, most brands of plain chocolate, most confectionary bars.

Malted drinks, such as Horlicks, Bournvita, Ovaltine, Milo, Options, Drinking chocolate (check label), milkshakes, yoghurt drinks, soya milks, for example Granovita, Provamel. Soups, sauces, mayonnaise, gravies made with milk products or soya derivatives, such as pesto, cook in sauces, curry sauces, marinades, cream sauces, gravy granules (check labels). Ingredients listed simply as flavourings or natural flavourings may contain milk or soya. Contact the manufacturer for information about specific products.

Soups, sauces, gravies Homemade using milk-free ingredients. Certain brands of soups, sauces, gravies. Mayonnaise and salad cream (check labels). Heinz Tomato ketchup, HP sauce mustard, Branston pickle. Miscellaneous suitable foods Salt, pepper, herbs, spices, vinegar, mustard, mustard powder, bicarbonate of soda, cream of tartar, baking powder, yeast, colourings, essences, gelatine, and monosodium glutamate.

Please note: All branded products are milk and soya free at the time of printing. Detailed information on manufactured products can be obtained from the customer services department of most supermarkets.

Useful addresses
National Dairy Council 5-7 John Princes Street London W1M OAP www.milk.co.uk The National Eczema Society 163 Eversholt Street London NW1 1BU Telephone: 0171 388 4097 www.eczema.org

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Provamel UK Ashley House 86-94 High Street Hounslow TW3 1NH Telephone: 0181 577 2727 www.provamel.co.uk Allergy UK 3 White Oak Square London Road Swanley, Kent BR8 7AG Telephone: 01322 619898 www.allergyuk.org The British Nutrition Foundation High Holborn House 52-54 High Holborn London WC1V 6RQ Telephone: 0171 404 6504 www.nutrition.org.uk Customer Services J Sainsbury Plc. Stamford House Stamford Street London SE1 9LL Telephone:0171 921 5/6000 www.sainsburys.com Lists available for milk and soya free foods. The Nutrition Advice Service, Tesco House, PO Box 18, Delamare Road, Chestnut, Waltham Cross, EN8 9SL Tel: 01922 632222 www.tesco.com Lists available for milk and soya free foods.

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Bengali Document History

Authors Department Contact number Published Review date Supersedes which leaflet? File name Version no: Reference no: Paediatric Dietitians Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ www.addenbrookes.org.uk 01223 216655 October 2008 (minor amendment made December 2008) October 2010 Version 1, October 2008 Cows_milk_and_soya_free_diet.doc 2 PIN 2243

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