Why does my child need to follow a cow’s milk and egg free diet?
A cow’s milk and egg free diet is necessary if your child has, or is suspected to have an allergy or intolerance to cow’s milk and egg.
Which foods does my child need to avoid?
The table below lists suitable and unsuitable foods on a cow’s milk and egg free diet.
Although there are obvious sources of cow’s milk and egg which should be avoided, derivatives of cow’s milk and egg are also found in manufactured foods.
Avoid any foods with the following ingredients:
Ingredients containing cow’s milk and cow’s milk derivatives:
- Cow’s milk/evaporated milk/condensed milk/milk drinks
- Cream, cheese, yoghurt, ice cream
- Butter/Margarine/ghee
- Butter oil/butterfat/buttermilk
- Lactose
- Casein/caseinates/milk protein/ hydrolysed casein
- Non-fat milk solids/milk sugar solids/milk solids
- Milk powder
- Whey/whey syrup sweetener
Ingredients containing egg and egg derivatives:
- Egg yolk
- Egg white
- Egg/ fresh egg (including all birds eggs)
- Egg proteins (albumin, ovalbumin, globulin, ovoglobulin, livetin, ovomucin, vitellin, ovovitellin)
- Dried egg
- Frozen egg
- Egg powder
- Pasteurised egg
- Egg albumin
- Egg lecithin E322
Pre-packed foods for sale within the UK containing milk are required by EU law to be highlighted in the ingredients list. This may be in bold, underlined or in italics. However please remember foods sold outside the EU do not have to comply with these laws.
Labels that say ‘may contain …’ are not covered by labelling laws. They are used to indicate that the food is produced in the same area as foods containing allergens and there may be a risk of cross contamination. It is very difficult to tell how much milk or egg is in these foods. Please talk to your dietitian about the safest approach to these foods.
Under EU food labelling regulations there must also be a list of product ingredients available for all foods that may not be labelled as they are sold loose such as those sold in a delicatessen or bakery. This may be written down or explained to you verbally.
|
Suitable foods |
Foods to check |
Unsuitable foods |
|---|---|---|
|
Suitable foods Milks Non-dairy alternative milks should not be given as your child’s main drink until they are two years old, unless advised otherwise by your dietitian. They can be used in cooking from six months. Choose calcium enriched types. Soya milk drink e.g. Alpro Soya 1+ or supermarket own brand · Oat milk drink e.g. Oatly, Alpro, Moma or supermarket own brand · Coconut milk drink e.g. Koko dairy free, Coconut dream + calcium. · Hazelnut milk drink e.g Alpro chilled hazelnut milk · Almond milk drink e.g. Alpro almond, Almond dream, Almond breeze · Rice milk drink for children over 4 ½ years e.g. Rice Dream or Provamel rice drink · Pea milk drink e.g. ‘Mighty Pea’, ‘Qwrkee M’lk’ · Hemp milk drink e.g. ‘Good Hemp’ |
Foods to check |
Unsuitable foods All animal milks - cow’s, goat’s and sheep’s milk (fresh/ dried/condensed/evaporated skimmed milk powder) All cow’s milk based or goat's milk based infant formula, including partially hydrolysed cow’s milk formula (‘comfort’ or ‘anti-reflux’ formulas) ‘Lactose-free’ cow’s milk |
|
Suitable foods Cheese and cream alternatives Soya, coconut, rice or oat based cream Soya or coconut based cheese alternative e.g. ‘Scheese’, ‘Vbites Cheezly range’, Violife vegan cheese range, supermarket’s own brand’ dairy free cheese |
Foods to check |
Unsuitable foods Single and double creams including those made from vegetable fat e.g. Elmlea Coffee whiteners All types of cheese and cheese spreads made from cows’ milk, sheep’s milk or goats milk. |
|
Suitable foods Fats/oils Dairy-free margarines e.g. ‘Pure’ or ‘Vitalite’, ‘Tomor’, ‘Flora Dairy Free’, ‘Koko Dairy Free’ |
Foods to check Hydrogenated vegetable oils may contain milk Suet |
Unsuitable foods Butter Spreadable butter and margarine spreads containing milk |
|
Suitable foods Desserts Soya desserts, soya rice pudding and Supermarket own brand ‘free from’ desserts Soya, coconut, almond, cashew, or oat-based yoghurt Soya or oat based custard Dairy-free ice cream Jelly made with water or a suitable milk |
Foods to check Custard powder Sorbet Pastry Other dairy free or ‘free from’ ice cream Sorbet |
Unsuitable foods Yoghurt, fromage frais, crème fraiche, dairy ice cream, crème caramel, milk chocolate desserts Dairy desserts e.g. custard, mousse, instant whips, trifle, Angel Delight Rice pudding or tapioca unless made with a suitable milk Instant custard powder Desserts containing milk or egg e.g. pancakes, bread and butter pudding, custard tarts, meringues, sweet waffles, sponge fingers, trifle, choux pastry, éclairs, soufflé, custard tarts, crème caramel, doughnuts, pies Royal icing, marzipan |
|
Suitable foods Cereals and flour Cornflakes, Crunchy Nut Corn Flakes, Frosties, Coco Pops, Rice Krispies, Weetabix, Shredded Wheat, Honey Loops Ready Brek (original), porridge oats All varieties of flour, cornflour, arrowroot, baking powder, egg free pasta (check ingredients lists), rice, sago, semolina, tapioca, spaghetti, rice noodles, cous cous, quinoa and polenta |
Foods to check Some brands of breakfast cereals, muesli and chocolate flavoured cereals |
Unsuitable foods Yoghurt coated cereals, instant porridge |
|
Suitable foods Homemade biscuits and puddings using milk and egg free ingredients (suitable egg replacers can be used – see later) |
Foods to check Gluten free bread and bread products often contain egg Some breads (white, brown and wholemeal), rice cakes and rye crispbreads, corn crackers Pastry |
Unsuitable foods Pasta dishes with sauces containing milk and or egg e.g. lasagne, some Bolognese and moussaka sauces, macaroni cheese, carbonara Egg noodles, egg pasta Milk loaf, croissants, brioche, buns, scotch pancakes, choux pastry Eggy bread, egg fried rice Biscuits, cakes, sponge, cake mixes and puddings made with milk and egg or milk and egg containing ingredients e.g. sponge, sponge fingers, malted milk biscuits Egg glazes on baked goods Yorkshire puddings |
|
Suitable foods Meat, fish, chicken and alternatives All varieties prepared and cooked without milk and egg Tofu Soya products e.g. mince, burgers, sausages, nuggets (check ingredients labels) Pulses e.g. red kidney beans, chickpeas, butter beans, cannelloni beans Lentils ‘Quorn’ Vegan Range – milk, soya and egg free quorn products (check ingredients label) |
Foods to check Pre-packed cooked meats such as ham or chicken slices Some meat, fish or poultry in batter, crumbs or sauce Sausages Vegetable burgers and vegetarian products Pate |
Unsuitable foods Quorn, (except the Quorn Vegan Range) Meat products that use egg as a binder (such as meatballs) |
|
Suitable foods Eggs Egg replacers – see below for details on both commercial and home-prepared egg replacers |
Foods to check |
Unsuitable foods All scrambled, boiled, poached, fried eggs Omelette, scotch egg, egg in batter Quiches |
|
Suitable foods Vegetables All fresh, frozen or tinned |
Foods to check Instant potato, potato waffles, potato shapes Oven chips |
Unsuitable foods Vegetables pre-packed in sauce containing milk or butter Potato salad, coleslaw containing yoghurt or mayonnaise |
|
Suitable foods Fruit All fruits (fresh/ frozen/ dried/ tinned in juice or syrup) Fruit in jelly Fruit juices |
Foods to check Smoothies |
Unsuitable foods Yoghurt coated fruit |
|
Suitable foods Nuts Fresh and plain salted nuts (not suitable for children under five years). Nut butters e.g. peanut/cashew/almond |
Foods to check Dry roasted and flavoured nuts |
Unsuitable foods Yoghurt coated nuts |
|
Suitable foods Snacks Homemade popcorn (without butter) Plain pretzels Homemade hummus, guacamole Pepperami Olives |
Foods to check Flavoured potato crisps and snacks Puffed wheat and corn snacks, oatcakes Plain potato crisps and snacks Prawn crackers Pre-packed popcorn Twiglets Cereal bars Dried fruit and nut bars |
Unsuitable foods Toffee popcorn Cheese flavoured snacks e.g. ‘Cheddars’, ‘Wotsits’, cheese straws, pretzels , crackers Manufactured dips e.g. hummus, guacamole, cheese and chive, sour cream Twiglets Yoghurt or chocolate coated cereal bars/snack bars |
|
Suitable foods Preserves and confectionary Sugar, glucose, jam, honey, syrup treacle, marmalade Dairy free chocolate Boiled sweets, lollies, pastilles, gums, jelly tots, peppermints, chewy fruit sweets |
Foods to check Plain chocolate and plain cooking chocolate Marshmallows |
Unsuitable foods Lemon curd Toffee, fudge, caramels, butterscotch. Some sweets e.g. ‘milk bottles’, mint humbugs, soft or fondant centred sweets e.g. Crème Egg, Milk Way, Snickers, peppermint creams. Milk and white chocolate and chocolate bars Chocolate spread Royal icing Marzipan |
|
Suitable foods Drinks Tea and coffee with milk alternative Nesquik powder, Crusha syrup Cocoa powder Squashes, fizzy drinks, fresh fruit juices |
Foods to check Fruit smoothies |
Unsuitable foods Instant coffee drinks with added milk e.g. cappuccino, lattes Babyccino Malted drinks e.g. Horlicks, Bournvita, Ovaltine, Instant hot chocolate Milkshakes, yoghurt drinks |
|
Suitable foods Soups, sauces and gravies Home-made soups, sauces and gravies made using milk-free and egg-free ingredients Tomato ketchups, brown sauces, pickles, chutney |
Foods to check Soups, sauces and gravy granules Bovril, Marmite, Vegemite |
Unsuitable foods Pesto Cream sauces Cream soups Mayonnaise, salad cream, horseradish sauce, tartare sauce, hollandaise sauce |
|
Suitable foods Miscellaneous Salt, pepper, herbs, spices, vinegar, mustard, mustard powder, bicarbonate of soda, cream of tartar, baking powder, yeast, colourings, essences, monosodium glutamate |
Foods to check Medications containing lactose – most children with milk allergy do not need to avoid medical grade lactose. Discuss this with your dietitian if you have concerns |
Unsuitable foods Low calorie sweeteners containing lactose Monosodium glutamate with lactose filler bought as a powder for Chinese cooking |
Please note: All branded products are cow’s milk and egg free at the time of printing, however ingredients may change over time therefore please continue to check the labels.
This is also not an exhaustive list and products can change frequently so please do look in your local supermarkets for additional suitable products.
Detailed information on manufactured products can be obtained from the customer services department of most supermarkets.
Which milk substitutes can I give my child?
Infants and children under two years of age should be given a suitable cow’s milk free formula to ensure adequate intakes 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 cow’s milk substitutes can be used such as almond milk, soya milk or oat milk. Alpro Soya Growing up Milk Drink for 1-3+ years, is available for children aged over one year. Rice milk is a suitable cow’s milk substitute for children over the age of 4½ years. It is recommended that you choose a cow’s milk substitute which is calcium and vitamin enriched.
Can I use egg replacers?
Egg replacers are made from raising agents such as corn starch, potato starch or tapioca starch. They have no nutritional value, but they can be useful for baking, such as cakes/pancakes. Both commercial whole egg replacers and egg white replacers are available and they can generally be obtained from health food stores, large supermarkets, pharmacies or directly from the manufacturer. Some are available on prescription but only at your GPs discretion.
- Orgran No-egg (whole) replacer (available from Asda, Tesco, Holland and Barrett and online retailers)
- Orgran Vegan Easy Egg (available from Ocado, Asda or online retailers), can be used for scrambled eggs, quiches, omelettes and frittata (available from Asda, Tesco, Holland and Barrett and online retailers)
- Follow Your Heart – VeganEgg, (available from online retailers), can be used for scrambled eggs and omelettes as well as cookies, muffins and cakes
- Free and Easy Egg replacer (available from Ocado, Asda or online retailers)
- Loprofin egg white replacer (by SHS/Nutricia) – GP prescribable or available online
- Low protein (whole) egg replacer (by PK foods) – GP prescribable or available online
- Ener-G (whole) egg replacer (by General Dietary) – GP prescribable or available online
Other home-prepared egg replacement ideas for baking:
- Use ¼ cup of unsweetened apple sauce/puree in place of 1 egg (suitable for most baking recipes)
- Use ¼ cup of mashed banana (from approximately ½ banana) instead of 1 egg when baking cakes/pancakes
- Combine 1 tablespoon of ground flaxseeds with 3 tablespoons of water – use in place of 1 egg
- Whisk together 2 tablespoons of water, 1 teaspoon of oil (e.g. vegetable oil) and 2 teaspoon of baking powder. Use in place of 1 egg; works well for baked goods/cookies
Does my child need a vitamin and mineral supplement?
If a calcium and/or vitamin supplement is required your Dietitian will advise you on an appropriate product and dose for your child.
The Department of Health recommend that all children under the age of five take a supplement containing vitamin D (8.5-10mcg vitamin D for babies under one year; 10mcg vitamin D for children aged one to four years). Many suitable preparations are available over the counter at pharmacies and supermarkets.
However, if your child is taking more than 500ml of formula milk per day, then they will not require a vitamin D supplement as the formula milk provides enough vitamin D. Please ask your dietitian or local pharmacist if you have any questions.
Who can I contact for further information?
Dietitian:
Contact number:
We are smoke-free
Smoking is not allowed anywhere on the hospital campus. For advice and support in quitting, contact your GP or the free NHS stop smoking helpline on 0800 169 0 169.
Other formats
Help accessing this information in other formats is available. To find out more about the services we provide, please visit our patient information help page (see link below) or telephone 01223 256998. www.cuh.nhs.uk/contact-us/accessible-information/
Contact us
Cambridge University Hospitals
NHS Foundation Trust
Hills Road, Cambridge
CB2 0QQ
Telephone +44 (0)1223 245151
https://www.cuh.nhs.uk/contact-us/contact-enquiries/