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Breastfeeding a baby with cow's milk protein allergy - nutritional needs of mothers.

Updated: May 15

Occasionally, babies with cow's milk protein allergy (CMPA) will react to traces of cow's milk protein in mum's milk. A maternal dairy free diet is required, and consideration needs to be given to mum's nutritional needs, with particular attention paid to energy, protein, vitamin D and iodine. Most mothers I see for advice on managing their babies cmpa, haven't considered their own nutritional needs. I tend to find that many women excluding dairy from their diet don't eat sufficient calories and protein. They typically exclude dairy products but struggle to find suitable alternatives.

Breastfeeding with cow's milk protein allergy

Breastfeeding with cow's milk protein allergy

Supplementation recommendations for breastfeeding women on dairy free diets.

The newborn stage is a demanding time for mothers, it is exhausting, especially if your nutritional needs are not met. There are 3 key nutrients for which supplementation is recommended.

  • Calcium requirements increase significantly during lactation, from 700mg/d to 1250mg/d. Supplementation (100mg/d) is recommended as it is difficult to achieve the recommended intake from diet alone, especially when you are excluding dairy. Many calcium supplements provide 400-500mg a day, so two tablets are usually required.

  • Vitamin D supplementation is also recommended for mum and baby, 10mcg/d for mum and 8.5 mcg - 10mcg/d for baby during the first year, (after 1 year of age, 10mcg/d is recommended).

  • Iodine is a nutrient which is often forgotten about when excluding dairy, as dairy is a key source of iodine. Iodine is important for brain development, growth and thyroid function. It is important that mum meets her iodine requirements when breastfeeding, so that baby gets enough at a stage when the brain is developing. Individual iodine supplements are not readily available. For mother's eating fish a couple of times a week, or replacing table salt with iodised salt, then additional iodine supplementation is not required. In which case a calcium and vitamin D supplement (or one which provides both together) will be sufficient.

There are multivitamin and mineral supplement preparations available for purchase. It is so important to check the label to see what they provide. I spend a lot of time looking at vitamin and mineral supplements available for purchase over the counter, and most do not meet the needs of the particular population they are marketed for. For breastfeeding women wanting to take a multivitamin and mineral supplement, it is important to choose a formulation specifically for breastfeeding women, as these are less likely to contain excessive amounts of vitamin A. You need a preparation which will provide 10mcg vitamin D, as close to 1000mgs of calcium as possible, and 150mcg iodine. Pregnacare Breastfeeding is a supplement I have recommended as it provides the recommended amount of vitamin D and iodine, it provides 700mg calcium; inclusion of fortified dairy alternatives can be used to meet the remaining requirement for calcium. I am often looking for other preparations to recommend so that women have a choice, however, I am yet to find another supplement with adequate amounts of key nutrients. Please comment below if you have found an alternative supplement.

Breastfeeding with cow's milk protein allergy

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