Children allergic to cows' milk should not be given soy, sheep or goat alternatives, new guidelines warn.
Published in the Archives of Disease in Childhood the new guidelines recommend that only extensively hydrolysed and amino-acid based formulas should be used for children with cows' milk allergies (CMAs).
Drawn up by the allergy experts Act Against Allergy, the guidelines offer clear recommendations on how to diagnose and manage CMA for breastfed and formula-fed children.
Soy should be avoided due to the risk of secondary intolerance, which can present itself in up to 60% of infants, say the guidelines.
Alternative mammalian milks such as sheep, horse, goat and buffalo present an even higher risk of cross reactivity.
Milk substitutes based on grains such as rice, oats, peas or almonds should also be avoided in infants and young children due to their poor nutritional value.
Chair of the Act Against Allergy taskforce Yvan Vandenplas said: "Our recommendations will assist in establishing CMA diagnosis and level of severity, offering clear guidance on the recommended management at each stage, whilst debunking some of the misconceptions over the value of soy and other alternative milk sources in CMA."