Nutrition beyond 12 months: supporting toddlers with cow’s milk allergy

Nutrition beyond 12 months: supporting toddlers with cow’s milk allergy

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From 12 months of age, nutrition remains a key consideration for toddlers with cow’s milk allergy. It’s important to ensure that growing toddlers continue to receive the energy, protein, calcium and other nutrients needed to support their growth and development.

Ashleigh Mitchel, Paediatric Dietitian, has 15 years’ experience, is a published author and a mum of two. We brought her in to help parents and families build confidence with her calm, practical guidance, that makes cow’s milk allergy feel less frightening and more manageable.

According to Ashleigh, “it’s important to consider nutrition in the context of the child’s entire diet, rather than focusing solely on the foods that need to be removed.”

“When we remove a food group, we need to think about how we’re replacing the nutrition it would have provided.”

Focus on what you need to add, not just what needs to come out

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When a toddler has cow’s milk allergy, it’s easy to focus on the foods that need to be avoided. But beyond 12 months of age, the bigger nutritional question becomes: what needs to be added back to the diet to replace the nutrients dairy would have provided.

Cow’s milk and dairy products can make an important contribution to a toddler’s intake of calcium, protein, energy and fat. When dairy is removed, it is important to ensure these nutrients are replaced through other foods and appropriate milk alternatives.¹

Not all dairy-free alternatives provide adequate nutrition. While products may look similar on the supermarket shelf, their nutritional profiles can vary considerably. Some may be fortified with calcium but contain very little protein, some are NOT fortified with calcium, and others are much lower in energy and fat than cow’s milk. Choosing a dairy-free alternative is about more than finding a product that is free from cow’s milk; it’s about finding one that makes a meaningful nutritional contribution to your toddler’s diet.

When comparing milk alternatives, consider:

• Calcium
• Protein
• Energy
• Healthy fats
• Added vitamins and minerals.

For this reason, breast milk, specialised formula and calcium-fortified milk alternatives can all have an important role in helping toddlers meet their nutritional requirements while maintaining a balanced and varied diet.

Building a balanced diet

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Beyond choosing an appropriate milk alternative, it is important to consider your child’s overall diet. While calcium is often the first nutrient parents think about when dairy is removed, it is only one piece of the nutritional puzzle.

Ashleigh explains that it’s about looking at the whole diet and ensuring nutrients are replaced from a variety of sources.

“We’re wanting to make sure, obviously, that calcium has been replaced. But we also use energy from other sources, for example with fats. So, we might use avocados and oils, as well as making sure they’re getting protein from other food groups.”

For toddlers and older children, aim to offer a variety of foods from each of the core food groups across the day:

• Protein-rich foods including meat, chicken, fish, eggs, legumes, tofu and nut or seed butters (when age appropriate)
• Energy-rich foods such as avocado, olive oil, nut and seed butters, tahini and other healthy fats
• Calcium-containing foods and fortified products
• Fruit, vegetables, grains and family meals adapted to your child’s allergy needs

The goal is not simply to replace dairy with a dairy-free alternative, but to create a varied and balanced diet that provides the energy, protein, calcium and other nutrients a toddler needs beyond 12 months of age.

If your child has a dairy allergy or any other food allergy, consult your healthcare professional before making dietary changes or introducing new foods.

Calcium: one of the key nutrients to replace

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Calcium plays an important role in supporting bone and teeth development in toddlers.² Dairy products are a key source of calcium, but there are other ways to meet a toddler’s needs, including:¹

• Calcium enriched alternative milks
• Specialised formula for toddlers
• Calcium-fortified yoghurt alternatives
• Almonds or tofu
• Fish such as sardines or salmon
• Leafy green vegetables and broccoli.

While some plant foods naturally contain calcium, they are often consumed in amounts too small to provide the same calcium contribution required to support toddlers’ calcium intake.

Choosing an adequate milk alternative

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Not all milk alternatives provide the same nutritional value as cow’s milk.

Supermarket rice, almond, oat and other nut-based drinks are often lower in protein, fat and energy than cow’s milk. While they may be suitable for some children, they should not automatically be considered nutritionally equivalent.

When comparing milk alternatives, look beyond the front of the pack and review the nutrition information panel. Consider:

• Calcium content
• Protein content
• Energy content
• Fat content
• Added vitamins and minerals

It’s important to ensure your toddler is getting enough calcium. If you’re unsure, a healthcare professional can provide guidance based on your child’s individual needs.

Breast milk, specialised formula and fortified milk alternatives

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After 12 months, there are several ways toddlers may continue to meet their nutritional requirements. These may include:

• Continued breastfeeding
• A specialised formula recommended by a healthcare professional
• A nutritionally appropriate calcium-fortified milk alternative

For some children, particularly those with multiple food allergies, poor dietary variety or higher nutritional needs, a specialised formula may continue to play an important role beyond infancy.

The decision to move away from breast milk or specialised formula should be based on nutritional adequacy and individual needs, rather than age alone. It is recommended to speak with your doctor or paediatric dietitian to ensure your toddler’s overall diet is meeting their nutritional requirements and that the most appropriate milk alternative is selected beyond 12 months of age.

Healthy eating can still feel normal

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Cow’s milk allergy may change some of the foods your family buys, but it does not have to make every meal feel different.

Start with familiar family dishes and make simple swaps. Cook one dairy-free pasta sauce for everyone. Use olive oil in mashed vegetables. Keep safe snacks within easy reach. Let your child see you enjoying the same foods they are eating.

Most importantly, remember that you are not expected to work it all out alone. With guidance from your child’s doctor, specialist and/or paediatric dietitian, you can create a diet that is safe, nutritionally complete and genuinely enjoyable, without fear becoming the main ingredient at the table.

“It’s never going to be easy,” Ashleigh acknowledges. But with the right information and support, families can gradually feel more confident about feeding their child and meeting their nutritional needs.

The right support can make a world of difference. Kiindred’s Parenting with Confidence series brought to you by Novalac Allergy Toddler brings you calm, credible education that meets you as a parent in the messy middle of uncertainty, without making you feel even more so. The campaign is built around real parent questions, expert guidance and emotional reassurance for families navigating cow’s milk allergy. For more, see HERE.

This article is for general information only and is not a substitute for personalised medical advice. If you’re worried about your child’s symptoms, feeding, growth or nutrition, speak with your GP, paediatrician, allergist or paediatric dietitian.

References

1. National Health and Medical Research Council. Australian Dietary Guidelines. Canberra: NHMRC; 2013.
2. NHMRC. Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes. Calcium, 2006.

Novalac Allergy Toddler is a Food for Special Medical Purposes. Use under medical supervision. AU-IMF-09-26-00006.