Our wonderful nutritionist Rebecca was asked a question about Dairy Intolerance and UHT milk.

"I'm hoping you can help me with a few questions regarding dairy intolerance in a 13 month old who I am trying to wean!

Just to give you some background, my little girl first showed signs of a dairy intolerance around 9 months when I gave her some cottage cheese. She got a few itchy spots around her chest - these disappeared in around an hour. I took her to the doctor who advised us that dairy intolerance is relatively common in children and many grow out of it (I think he said by the time they're 2).

Baby has been breastfed since birth, and my plan was to wean her straight to cows milk at around 1 year old. We started putting cows milk on her porridge just after she turned 1 and again she got a few spots, this time around her mouth. We persisted with little bits of cows milk on her breakfast and the spots gradually seemed to get less. We also found that she could eat yoghurt with no problems at all, and could tolerate a little cheese (occasional spots only). When things seemed to be going well at breakfast time I tried giving her a midday feed of cows milk instead of breast milk (mixed in some yoghurt as she didn't really fancy the cows milk). The first day she didn't drink much but also had no reaction. The second day she drank more and a big blister came up on her lip! This disappeared in around and hour and didn't really bother her except that it stuck out a bit so she kept licking her lip! I got worried after the blister so stopped cows milk.

We have been using UHT goat's milk for the past month or so and she seems to tolerate this well. However I found a pack of Healtheries powdered goats milk in the supermarket last week and decided to try as it sounded purer (no stabilisers) and i thought it might taste better than the UHT stuff. I think it does taste better, but this morning baby had it on her porridge and got one spot!!

Currently she's breast fed first thing in the morning. Eats porridge with fruit, museli and goats milk for breakfast, has sandwiches or toast for lunch usually with avocado or honey on them, plus some banana and a pottle of yoghurt (My First Yoghurt brand). For dinner she normally gets veges with meat, egg or fish, followed by a cup of UHT goat's milk made into a smoothie with banana (trying to get her used to the goats milk). She drinks water happily and has fruit or cracker snacks between meals.

My first question would be - is it ok to use UHT milk for a toddler. Does it maintain it's nutritional properties through the heating process?

I'm also wondering if the heating process is breaking down the proteins in some way that means she tolerates it better and if so, perhaps I could use UHT cows milk?

I'm keen to use cow or goat's milk rather than rice or oat etc as I've heard they don't have the same protein content, but would like to hear your opinion on what might work best!! Sorry for the very long message, and thank you in advance for your advice."

Rebecca took a deep breath and replied, "I have spent quite some time researching whether it is advisable to feed your baby UHT milk and I haven't been able to provide you with a definitive answer unfortunately. However I can tell you that nutritionally, UHT is slightly inferior to standard cows milk as some of the vitamins and minerals are destroyed in the heat processing. Any form of heat treatment is known to denature proteins and although this makes the product easier to digest it does mean the protein quality isn't as high. For short periods, such as on holiday when you can't guarantee fresh milk supply, UHT is fine but I wouldn't suggest you continue it long term.  

Have you considered offering your daughter soy milk? Although there is an association with cows milk allergies and soy milk allergies your daughter may be fortunate that she can indeed tolerate soy milk. If this is the case it will open up many more options as soy milk, yoghurt and cheese are now readily available. You are correct in that rice and oat milk have lesser protein contents than cow and soy milk. Next time you're at the doctors I would suggest you ask them their thoughts on milk alternatives for your daughter.

 Apologies for not being able to fully answer your question and just remember that although cows milk allergy is the most common food allergy in infants and toddlers, the majority do outgrow these allergies so fingers crossed your daughter falls into this category."