Coconut cream is also surprisingly easy to locate; you’ll find it in the Asian foods section of most grocery stores under the guise of canned coconut milk. Coconut cream is simply the rich part of full-fat coconut milk. As the coconut milk rests, the cream rises to the top to form a very thick layer that can be scooped out like soft ice cream.

In fact, the sign of a good canned coconut milk is one that separates into a watery base with up to three-quarters of a cup of “stand a fork in it” cream on top. In warmer months, chill the coconut milk in the refrigerator for a few hours to assist in the separation.

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.

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