Introduction
Your child has been diagnosed or is suspected to have a cow’s milk, egg, wheat and soya intolerance or allergy. This information sheet is intended as a guide to identifying suitable foods for this diet.
Although there are obvious sources of milk, soya, egg and wheat, derivatives of milk, soya, egg and wheat are also found in many manufactured foods.
Pre-packed foods for sale within the UK containing milk, soya, egg and wheat must have these allergens highlighted in the ingredients list. This may be in bold, underlined, or in italics. As of October 2021, Natasha’s Law was implemented in the UK. This means that foods made and packaged on site (such as in a café or bakery – called pre-packed foods for direct sale) must also have a full ingredients list on the food with the allergens highlighted in the same way as for pre-packed manufactured foods.
There must also be a list of product ingredients available for all foods that may not be labelled as they are sold loose such as those sold in a delicatessen or bakery. This may be written down or explained to you verbally.
Labels that say ‘may contain...’ are increasingly being used, but are not covered by labelling laws. They are used to indicate that the food is produced in the same area as foods containing allergens, and there may be a risk of cross contamination. This should be following a strict risk assessment.
Avoid any foods with the following ingredients:
Milk
- Cow’s milk/ evaporated milk/ condensed milk
- Non-fat milk solids/ milk sugar solids/ milk powder/ milk solids
- Casein/ caseinates/ milk protein
- Whey/ whey syrup sweetener
- Lactose
- Butter/ margarine
- Cream, cheese and yoghurt
- Flavourings that contain milk
Soy and soy derivatives
- Soya milk, soya yoghurts and desserts
- Hydrolysed vegetable protein
- Soya lecithin E322
- Soya protein products; for example, miso, tofu, edamame, tamari, nimame, natto, okara, soja, tempeh
- Soy sauce, Worcestershire sauce, oyster sauce, teriyaki sauce, vegetable broth, vegetable starch
Please note: A product labelled ‘free from soya or soya derivatives’ may contain soya oil and/or soya shortening. Soya oil, as used in manufactured products, is refined and contains no protein; it is considered soya free. Cold pressed soya oil, available from health food shops, may contain soya protein and should be avoided.
Egg
- Egg/ fresh eggs (including all birds' eggs)
- Egg protein (albumin, ovalbumin, globulin, ovoglobulin, livetin, ovomucin, vitellin, ovovitellin)
- Dried egg
- Egg albumin
- Egg lecithin E322
- Egg yolk
- Egg white
- Frozen egg
- Pasteurised egg
Wheat
- Breadcrumbs or batter
- Hydrolysed wheat protein
- Wheat bran
- Wheat flour
- Wheat germ
- Wheat germ oil
- Wheat gluten
- Wheat starch (please note that many gluten-free products still contain gluten-free wheat starch and are therefore not wheat-free)
- Raising agents (unless specified as being made from another cereal (for example corn)
| Suitable foods | Foods to check | Unsuitable foods | |
|---|---|---|---|
| Other milks |
Suitable foods
Many non-dairy alternative milks should not be given as your child’s main drink until they are two years old. There are some that are more appropriate to use as a main drink from 1 year with dietetic advice. They can all be used in cooking from six months. Choose calcium enriched types. + Coconut milk eg Koko dairy free, Coconut dream + calcium, supermarket own brand. Check ingredients as some brands contain soya + Pea milk drink (Mighty M.lk, Wunda, Qwrkee) + Hazelnut milk eg Alpro chilled hazelnut milk + Almond milk eg Alpro almond, Almond dream, Almond breeze + Rice milk for children over 4½ years eg Rice Dream or Provamel rice drink |
Foods to check
Oat milk and oat cream – most brands do not use wheat as an ingredient. Please check the label for cross-contamination if your wheat allergy is severe. Some brands of coconut milk contain soya beans or soya protein. |
Unsuitable foods
All cow's, soya, goat’s and sheep’s milk. Fresh, dried, condensed, evaporated, and skimmed cow’s milk. Coffee whiteners, such as Coffee Mate, Coffee Compliment. Single and double creams including those made from vegetable fat, eg Elmlea |
| Cheese | Suitable foods Coconut-based cheese eg Koko, Violife, Vitalite, Applewood, and supermarket own brand | Foods to check | Unsuitable foods Cheese and cheese spreads containing cow’s milk, sheep’s milk, goat’s milk and any other mammalian milk |
| Fats/ oils |
Suitable foods
Dairy and soya-free margarines eg Pure or Vitalite Lard, suet, dripping, vegetable oils |
Foods to check
Olive oil spreads Hydrogenated vegetable oils may contain milk or soya – please check ingredients |
Unsuitable foods Butter, margarine and spreads containing milk. Soya margarines such as Tomor, Vitaquell, Vitasieg, Granose. |
| Yoghurt and desserts |
Suitable foods
Nut based yoghurt eg Petit Filous Dairy Free, Nush Dairy-free and soya-free ice cream for example The Coconut Collaborative, Booja Booja, Freaks of Nature Jelly made up with a suitable milk/ water Tapioca made with a suitable milk |
Foods to check
Oat yoghurt, oat custard, oat cream, oat crème fraiche Most oat brands do not use wheat as an ingredient, however oats may be cross contaminated with wheat. Gluten free oats are suitable. Please check the label for cross-contamination if your wheat allergy is severe. |
Unsuitable foods
Yogurt, fromage frais, crème fraiche, dairy or soya ice cream, milk chocolate desserts. Dairy desserts eg custard, mousse, instant whips, trifle, Angel Delight, rice pudding Soya yoghurt and milk desserts Egg custard Semolina |
| Breakfast cereals | Suitable foods Cereals based on rice, corn or buckwheat Gluten free porridge oats |
Foods to check
Porridge oats Cereals containing barley malt extract Muesli |
Unsuitable foods Cereals containing wheat (eg Weetabix, Shredded Wheat, malted wheats) |
| Other cereals | Suitable foods Rice, ground rice, tapioca, sago, buckwheat, millet, quinoa | Foods to check Barley and rye – check with your dietitian if you can include these | Unsuitable foods |
| Flours | Suitable foods Rice, corn, potato, sago, buckwheat, millet, arrowroot | Foods to check | Unsuitable foods Wheat, soya, semolina, bulgar wheat, durum wheat, couscous, spelt |
| Alternative pastas | Suitable foods Rice, corn or buckwheat pastas (not containing egg) | Foods to check Rice noodles | Unsuitable foods All wheat containing pasta eg spaghetti, macaroni, noodles |
| Alternative breads and crackers |
Suitable foods
Rice cakes, corn cakes Any other cow’s milk, soya, egg and wheat free breads and crackers, eg BFree range |
Foods to check Ryvita, rye bread, oatcakes |
Unsuitable foods
All wheat-based breads and crackers All wheat-free bread and crackers containing cow’s milk, soya and/or egg |
| Meat, fish, chicken and alternatives |
Suitable foods
Most varieties of freshly prepared and cooked meat, fish, chicken and alternatives without milk, soya, wheat or egg products Tinned and dried pulses, for example, red kidney beans, chickpeas, peas, and other beans |
Foods to check
All pre-packaged/processed ham, sausages, burgers, meats and chicken Quorn products (many contain egg, wheat or milk) |
Unsuitable foods
Fish, chicken or meat in batter or breadcrumbs Pasties, sausage rolls Soya mince Textured vegetable protein |
| Eggs |
Suitable foods
Egg replacers may be used for cooking and baking Homemade egg replacer eg equal parts chickpea flour and water |
Foods to check | Unsuitable foods All forms of eggs |
| Vegetables and potatoes | Suitable foods All fresh, frozen or tinned without butter or flour coating |
Foods to check
Instant potato, waffles, potato shapes, potato crisps Potato salad, vegetable salad, coleslaw Oven chips Baked beans |
Unsuitable foods
Vegetables pre-packed in butter, or milk/cheese based sauces |
| Fruit | Suitable foods Fresh, frozen, dried, tinned in juice or syrup, fruit in jelly, fruit juices | Foods to check |
Unsuitable foods
Fruit tarts or flans Fruit yoghurt |
| Snacks |
Suitable foods
Plain and salted popcorn, olives, corn snacks, rice cakes Dried fruit and dried fruit snacks |
Foods to check
Crisps, including potato/ corn snacks Hummus Guacamole |
Unsuitable foods Twiglets, cheese straws, toffee popcorn, puffed wheat, prawn crackers and corn snacks containing milk, cheese, egg |
| Preserves and confectionery |
Suitable foods
Sugar, glucose, jam, honey, syrup treacle, marmalade Some brands of plain chocolate (eg Plamil, Organica, Nomo) Boiled sweets, lollies, pastilles, gums, jelly sweets, peppermints |
Foods to check
Other plain/ dark chocolate Marshmallows ‘Free from’ chocolate |
Unsuitable foods
Lemon curd Toffee, fudge, caramels, butterscotch Milk and white chocolate ‘Milk-free’ chocolate made with soya |
| Beverages |
Suitable foods
Tea, coffee Crusha syrup Plain cocoa powder Squashes, fizzy drinks, fresh fruit juices |
Foods to check Nesquik powder |
Unsuitable foods
Malted drinks such as Horlicks, Ovaltine, Milo, Options, Drinking chocolate, milkshakes, yoghurt drinks, soya milks Marmite Vegemite Bovril |
| Soups, sauces and gravies | Suitable foods Homemade using milk, soya, wheat and egg-free ingredients |
Foods to check
All packaged soups, sauces, stock (cubes and fresh) and gravy Egg-free mayonnaise and salad cream |
Unsuitable foods
Mayonnaise Pesto Cream sauces Most standard gravy granules eg Bisto, supermarket own Most standard stock cubes eg Knorr, Oxo |
| Miscellaneous | Suitable foods Salt, pepper, herbs, spices, vinegar, mustard powder, bicarbonate of soda, cream of tartar, baking powder, yeast, colourings, essences, gelatine, and monosodium glutamate |
Foods to check
Tablets containing lactose filler Low calorie sweeteners Monosodium glutamate with lactose filler, (bought as a powder for Chinese cooking) |
Unsuitable foods |
Please note: All branded products are cow’s milk, soya, wheat and egg free at the time of printing but are subject to change without notification. Always check the ingredients. Detailed information on manufactured products can be obtained from the customer services department of most supermarkets.
Milk substitutes
Infants and children under two years of age should be given a suitable cow’s milk- / soya- free formula to ensure adequate supplies of vitamins and calcium. Your dietitian will advise you as to the most suitable formula for your child.
In instances where a specialist formula is not indicated, or where a child is more than two years of age, other milk substitutes can be used, such as almond milk, soya milk and oat milk. Rice milk is a suitable substitute for children over the age of 4½ years. It is recommended that you choose one which is calcium and vitamin enriched.
Calcium/ vitamin supplementation
If a calcium and/or vitamin supplement is required your dietitian will advise you on an appropriate product and dose for your child.
Egg replacers
Egg replacers have little nutritional value, but they can be useful in cooking for making cakes and such. They can generally be obtained from health food stores, large supermarkets or from the manufacturer. Some homemade ideas for egg replacers are mashed banana, chickpea water (or chickpea flour mixed with water in equal quantities) or grated fruit such as apple or pear.
Orgran: No Egg (200g); 1 pack = 66 eggs
Holland and Barrett: Vegan Egg Replacer (200g)
Free and Easy: Free From Egg replacer 135g; 1 pack = 45 eggs
Oggs: Oggs Egg Alternative Aquafaba (200ml); 1 pack = 4 eggs
Tesco: Tesco Egg alternative (135g); 1 pack = 22 eggs
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Smoking is not allowed anywhere on the hospital campus. For advice and support in quitting, contact your GP or the free NHS stop smoking helpline on 0800 169 0 169.
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