While soy milk has traditionally been the most commonly used cow's milk alternative, there are many options available. Use of tree nut milk, including almond and cashew milks, have become increasingly popular. Rice and oat milk, as well as hemp milk, are also possible alternatives

1. Milk Alternatives for Cow’s Milk
Protein Allergy (CMPA)
Prof. Louay Labban

2. Breast feeding is the best

3. Why we use cow’s milk in children feeding?

6. Prevalence
• In infants 0.5- 4.9 % 1st year
• In Syria ?

12. Characteristics of Milk Alternative
• Free of allergens
• Availability
• Cost
• Nutritive value
• Palatability
• Processing
• Ease of supplementation
• Shelf-life

13. Common milk alternatives for CMPA
• Hypoallergenic formulas (Commercially
manufactured)
• < 1 year old

14. > 1 year old
• Animal based
• Plant based

15. Hypoallergenic formulas
• From birth to two years Extensively hydrolyzed
formulas
• These formulas contain proteins that have
been broken down into smaller segments so
they are less likely to cause an allergic
reaction. Examples include:

16. Extensively Hydrolyzed Formulas
• Extensively hydrolyzed formulas break casein
into pieces.
• About 90% of babies with cow’s milk allergy
will tolerate these formulas.
• Enfamil® Nutramigen®, Pregestimil®, Similac®
Alimentum® or Similac® Expert Care®

17. • Some of these may contain prebiotics that
promote the growth of good bacteria in the
gut and lactose, which improves the taste.

18. Amino Acid-Based (elemental)
Formulas
• Recommended when an extensively
hydrolyzed formula has either not been
tolerated
• Offer complete nutrition for infants, toddlers
and older children who need additional
nutrition support.
• They are tolerated by most children because
do not contain any whole proteins.
• Neocate®, EleCare®, PurAmino™, Alfamino™

19. Partially Hydrolyzed Formulas
• Whey, casein are broken into smaller pieces.
These formulas are NOT used for infants
allergic to cow’s milk.
• (e.g., Enfamil NeuroPro™ Gentlease®,
Gerber® Good Start® Gentle or Similac® Pro-
Total Comfort™)

20. Animal source of milk alternatives
• Sheep’s milk
• Goat’s milk
• Buffaloes' milk
• Camel’s milk
• Donkey’s milk??????????????

22. Plant sources of milk alternatives
• Soymilk
• Coconut milk
• Cashew milk
• Rice milk
• Chickpea milk
• Oats milk

26. Protein sources for supplementation
• Pea Protein
• Hemp Protein
• Pumpkin Seed Protein
• Brown Rice Protein
• Lentils Protein
• Soy Protein
• Sunflower Seed Protein
• Sacha Inchi Protein ‫فول‬
(
‫فستق‬
)
‫األنكا‬
• Chia Protein

27. Sacha Inchi

28. A2 Milk
• A2 milk contains only A2 beta-casein.
• Studies suggest that A1 beta-casein may be
harmful and that A2 beta-casein is a safer
choice.
• A2 Milk are not genetically modified.
• A simple DNA test is performed on calves
using a hair follicle then separated from the
rest of the herd

29. • A2 milk is produced by the A2 Milk Company
and contains no A1 beta-casein.

30. https://www.dellchildrens.net/wp-
content/uploads/sites/60/2016/08/Pediatric-
Milk-Substitute-Recommendations.pdf