A It’s common for parents to be concerned about a child’s nutrition with an allergy to cow’s milk, since it’s a source of calcium, vitamin D and fat. These are important nutrients for growth and development, and to keep bones strong. However, many children thrive without consuming cow’s milk.

If you are breastfeeding your 18-month-old, you may continue to do so. In some cases, mothers who consume milk can pass allergenic proteins through their breast milk. If this is suspected, you may need to avoid milk products. In other cases, cow’s milk proteins are not passed through. Always consult your doctor or a dietitian before altering your diet while breastfeeding. Removing milk from your diet won’t be recommended unless absolutely necessary.

If you are not breastfeeding your daughter, she should drink soy formula until the age of 2. Soy formula is a complete source of nutrition and will provide enough calcium, fat and protein. Your doctor or dietitian can advise you on how much formula to give based on your child’s age, height and weight.

Some children don’t tolerate soy formula and require a hypoallergenic formula that contains extensively hydrolyzed proteins. Since the proteins are broken down, the body no longer recognizes them as allergenic. This formula should only be used on the advice of a doctor or dietitian.

While soy formula is a good alternative at your daughter’s age, soy, rice and other dairy-free beverages should not be used in place of an infant formula as a main source of liquid nutrition. These beverages do not contain the amount of protein, fat or iron needed and may lead to poor weight gain and brain development.
Young children who cannot eat or drink cow’s milk products must continue on soy formula or extensively hydrolyzed formula until age 2. (Children without milk allergy are able to drink homogenized milk starting at the age of 1.) Goat’s milk is also not a suitable alternative for a child allergic to cow’s milk, as those with this allergy may also react to goat’s milk.

By 2, your daughter can be reassessed to determine if she is ready to transition to a fortified soy beverage with vitamins and minerals, such as vitamin A, vitamin D, vitamin B12, riboflavin, calcium, zinc and others. Children allergic to cow’s milk should eat non-dairy, calcium-rich foods as well as foods with lots of vitamin D. With the right modifications to her diet, your daughter will receive all the nutrients she needs

Non-dairy foods for an 18-month-old

Rich in Calcium
• Broccoli
• Bok choy
• Tahini
• White beans
• Calcium-fortified orange juice

Rich in Vitamin D
• Egg yolks
• Fish
• Liver
• Fortified margarines
• Soy beverages

See question and answer on substituting eggs.

Alisa Bar-Dayan, RD, is the Marketing Dietitian at the Specialty Food Shop in Toronto’s Hospital for Sick Children, www.specialtyfoodshop.com. First published in Allergic Living magazine, Winter 2008. To order that issue or to subscribe, click here.

© Copyright AGW Publishing Inc.

A Eggs perform different functions in various types of food, so choosing one egg substitute over another really depends on what you’re making.

In cakes, eggs act as a leavening agent and make them fluffy and light. In cookies and muffin recipes, eggs add moisture and hold ingredients together. The type of egg substitute you use may change the taste of your recipe.

For baked goods such as muffins, pancakes and pumpkin or banana bread, try a small ripe mashed banana or one-quarter cup of applesauce; both will add a nice fruit-flavoured sweetness. One-quarter cup of canned pumpkin, squash or pureed prunes can also work, but the flavour may come through, and they’ll make the finished product slightly denser than the recipe intended. None of these replacements help your baking to rise, so be sure the recipe calls for some baking powder or baking soda.

You can also buy a vegan replacement powder from your local health or specialty food store. Look for brands such as Kingsmill, Bob’s Red Mill, Orgran and Ener-G. Most are flavourless and can be used in baked goods as well as casseroles and loafs. Many contain a combination of ingredients such as guar gum, potato starch, cornstarch, baking powder and tapioca flour. Be careful as some egg replacers use egg whites as one of the ingredients.

Homemade egg substitutes are usually cheaper than store-bought, but require a bit more preparation. Remember that egg substitutes usually contain fewer calories and cholesterol than eggs, so they may be a good alternative even for those who don’t have an egg allergy.

Homemade Egg Substitutes
Following are a few basic homemade egg substitutes. Each would be the equivalent of one egg in a recipe. Try the flour-based ones in your cake recipes; the tofu blend would be nice in a casserole:

• 2 tbsp chickpea or soy flour + 2 tbsp water
• 1 tbsp arrowroot flour + 1 tbsp soy flour + 2 tbsp water
• 1⁄4 cup tofu blended with liquid portion of the recipe
• 1 tbsp soy milk powder + 1 tbsp cornstarch + 2 tbsp water
• 1⁄4 tsp xanthan gum + 2 tsp potato starch + 1/2 tsp oil
• 2 tbsp flour + 1⁄2 tbsp shortening + 1⁄2 tsp baking powder + 2 tsp water

You’ll have to experiment to figure out which substitute is best for your recipes. Have a little fun: use tofu in traditional egg dishes such as quiche and egg salad (you can replace regular mayonnaise with soy mayonnaise). If you’re feeling adventurous, scramble some tofu for breakfast or add to a pita for lunch. Add a small amount of mustard or turmeric to scrambled tofu and you’ll have yellow-coloured “eggs”.

See question and answer on substituting milk for toddlers.

Alisa Bar-Dayan is the Marketing Dietitian at the Specialty Food Shop in Toronto’s Hospital for Sick Children. Visit www.specialtyfoodshop.com. Specialty Food Shop dietitians can be reached toll-free at 1-800-737-7976 or e-mail sfs@sickkids.ca.

First published in Allergic Living magazine.
To order a single issue or to subscribe, click here.
See previous issues here.

© Copyright AGW Publishing Inc.