It's been suggested that your baby has a Cow's Milk Protein Allergy - and you're breastfeeding. What do you do now? This post is for you the mama, not the bubba - I can do another one covering that. Also have a listen to my podcasts as they're just more chatty introductions to CMPA.
It's nearly a year since the revelatory day when we got our CMPA diagnosis and I started my exclusion diet. I was reading the CMPA support group this morning and thought I could have really done with an idiots guide at that time. So that's what I'm going to try and put together today. Not because you're an idiot, but because if you're stressed, tired, sleep deprived and anxious then sometimes it's easier when things are spelled out in black and white.
Time - It takes between 4-6 weeks for allergens to leave your system completely so your baby's symptoms might not improve immediately. That said, we saw reductions in vomitting day by day and by the second week had a weight gain of 11oz. Keep going, I know it's frustrating and hard work, but what if it works?
Alternative milks - Having tried a lot (to save you the pain) I've come to this conclusion. Unsweetened almond milk tastes most like skimmed milk, Oatly in the blue carton is most like whole milk. Making hot chocolate with hazelnut milk does not equal something akin to Nutella. Sad times people. Sad times. Almond milk works well on cereal, in porridge, and in baking. Make sure whatever milk substitute you use is fortified.
Tea, coffee and hot drinks - I haven't found any alternative milk that makes a cup of tea I can stomach, so in a decision that I'm surprised didn't make the 6 o'clock news I gave up tea. I now drink black coffee - mainly decaf (and I used this post from Helen to make cold brew coffee which was a revelation in the summer) as I'm still breastfeeding, but I do have the occasional mug of really yummy proper coffee. And love it. Rooibos tea is lovely, and I drink lots of the spicy flavours of Yogi teas. I have heard that Galaxy make a hot chocolate (oddly one of the make with milk ones) that's dairy and soya free - I fully intend to try that made with Chocolate Oatly.
Free From sections in the supermarket - If you want my honest opinion, they're not really developed with us in mind. They're heavily focused towards people with coeliac disease and gluten allergies, the products are very expensive, and once you get your head around obsessive label reading you can shop in the usual aisles fairly easily. Also... DON'T GO MAD ON SOYA! Not even the wonderful Alpro soya chocolate puddings *weeps* Soya proteins are really similar to cow's milk protein strands and lots of babies can't tolerate either.
Your calcium levels - this was raised with me by our dietician. As women of childbearing age we must be wary of reducing calcium levels if we're excluding dairy. There are lots of non dairy sources of calcium: dark leafy green veggies, tinned sardines, figs, oranges, and oily fish are all good sources of calcium. That said, I wasn't sure how much was 'enough' so our dietician gave me a copy of this document which showed me I needed 21 stars. You can get a supplement prescribed from your GP but do make sure it's compatible with any other allergies. As an aside, I like the Tropicana fortified orange juice.
Cheese, chocolate... what is it for you? A year ago I'd have said it was the chocolate, but it's the savouriness of a mozzarella panini I miss, or the luxury of a baked camembert spiked with garlic, the simplicity of going to the fridge and having strong cheddar sarnies with tomatoes from the garden. There will be something. Something that just occaisionaly makes you question your sanity for doing this, and then you look at your increasingly chubby bubba, smile and remember why. But it is there. Find a substitute you love. Not something you tolerate, but love. For me it's Ritter marzipan sport, Sainsbury's sell it for £1, and it hits the spot every time. I can't get on with Violife, (Harry loves it) so have filed cheese away for now. Bourbon biscuits are also a winner, only the cheap ones mind you - but for me, they're perfect with a coffee and an episode of Once Upon a Time on Netflix while Harry naps.
Take your glasses shopping - Read the labels, every time. This post on bread goes into in a bit more depth, but not every brand will publicise a change in recipe and the bread that was fine last week, can contain dairy or soya 7 days later. The aforementioned Bourbon biscuits are a case in point - some say on the label (Asda, I think) that they're 'not suitable for milk allergy sufferers' others will just list allergens. Now is also the time to learn about food labels. The top 14 allergens are now (by law) listed in bold if they're contained in a food. Oh and some wine contains milk - no I have no idea why either.
Get assertive - bolshy, confident... whatever you want to call it. You've been the person that will have seen your child at his or her worst, it's in your power to not let him get that way again. Don't shy away from going out for that cup of coffee, meal with your partner, or to that family party... but say - I need to be dairy free. I always offer to bring something for myself to people's houses - and my dairy free baking goes down well with everyone. In restaurants and cafes I've rarely ended up with nothing. In France the lovely waitress went and asked the chef to alter a dish so I could eat it. Be polite, friendly - ask to see the allergy folder (they should show you). Or if you're nervous like I am, contact people in advance, either by phone, email, twitter or Facebook and explain the situation. All the food at Harry's birthday party was safe for him - not one person questioned (or noticed) the lack of dairy, eggs, soya or strawberries).
Food wise - what does your family like to eat? Don't throw your family favourites out of the window... get familiar with some of my useful substitutions
Butter - Vitalite or Pure dairy free spreads
Milk - Almond, or Oatly
Cheese - Violife
Jus-Rol pastry (not the all butter version) is dairy free
If you'd previously have added cream or soft cheese to a sauce - try Oatly creamy oat instead.
If you're a lover of takeaways, again - don't be afraid to ask. Our local chip shop is amazing, I have given up on Chinese takeaway, but I know people who've had success with Indian food. So it is possible.
There's so much more I could write - but I wanted this post to be accessible and not dreary. If you have any non medical questions then just post in the comments and I'll do what I can to answer them. Also, if you've got any foodie hints or tips you've discovered since starting your ecvlusion diet, post those too and I'll include some in a future post.